Endocrine Flashcards
triad of insulinomas?
3 lab values?
test to confirm diagnosis?
symptoms of hypoglycemia, measured hypoglycemia, symptoms relived by giving glucose
hypoglycemia, elevated insulin and c peptide
insulin still elevated after 72 hour fast
3 classic lab values associated with hypoparathyroidism?
low calcium, high phosphate and low pth
two step process to diagnose thyroid nodules?
US THEN radio uptake
TSH stimulates TSH and what other hormone?
prolactin
If GISTs are c kit mutation what is the chemo drug of choice and why?
imatinib because it is a tyrosine kinase muation
If I see a patient with chronic kidney disease and a case with a fracture what I am thinking?
because of the kidney disease, high PTH goes and breaks up the bone.
What med to use to treat graves in pregnancy?
PTU
big differentiator between hypothyroidism and depression?
depression you tend to lose weight and hypo you gain
what is the 3 step process in the diagnosis of primary hyper aldosterone?
first measure the plasma aldosterone to plasma renin activity, if it is greater than 20 do a sodium loading test. if the sodium does not lower the aldosterone to lower than 10, they have primary and do a CT to see if it is adenoma or hyperplasia.
how do we manage lobular carcinoma of the breast?
excisional biopsy to rule out DCIS
10% rule for pheo?
10% recur, familial, bilateral, extra adrenal, malignant, and in children
most common thyroid cancer and what will be in the vinette?
papillary
radiation exposure
before surgical resetion of parathyroid adenoma, what do we use to localize it?
sestambi scan
How to treat primary adrenal insufficiency?
secondary and tertiary?
gluco and fludro or hydro
just gluco
3 symptoms of high calcium crisis to remember?
how to treat?
NV, fatigue and confusion
saline to flush it out, loops, maybe calcitonin after
which htn drug is good for older pts with osteoporosis and why?
thiazides because they hold on to calcium
diagnostic choice for gastric cancer?
two countries to always remember about gastric cancer?
endoscopy
japan and korea
mom presents for 6 week post partum appointment and has all signs of hyperthyroidism? how do we go about managing it and why is it happening?
postpartum thyroiditis. It is a spontaneous autoimmune disease. beta blockers
If I have a patient where I am suspecting thyroid cancer and the calcitonin is elevated, what type of cancer am I thinking and why?
medullary thyroid cancer because this type of cancer originates from the parafollicular cells which produce calcitonin
what is the initial and confirming test for acromegaly?
first check Insulin like growth factor level
if that is up, confirm with GH suppression test
first line treatment for acromegaly?
When to use ocreatide
transphenoidal resection
not good surgery candidates or have symptoms after resection
which thyroiditis usually comes on after a viral or flu like illness?
what will iodine uptake show and why?
how to treat?
de quervain thyroiditis
decreased uptake because the excess hormone released is just stored hormone
NSAIDS
besides SCC of lung causing PTRP hormone what other cancer does this?
breast
What is the phenomenon in the morning causing hyperglycemia and why?
dawn phenom because early morning growth hormone secretion anti insulin
