Endocrine Flashcards
what are some signs of hypercortisolism?
- purple striae
- fatigue
- easy bruising
- proximal muscle weakness
- central obesity
- hyperglycemia
- hypokalemia
- hypertension
which lung CA produces ectopic ACTH (peptide hormone)?
small cell; look for person with cushings and mediastinal mass
what lab values would you expect to see in someone with secondary hyperparathyroidism (CKD)?
increased phosphate, increased PTH, decreased calcium, decreased calcitriol/1,25 dihydroxy vitamin D
what is a physical sx of secondary hyperparathyroidism in the setting of CKD?
bone pain associated with renal osteodystrophy
what are the lab values associated with primary hyperparathyroidism (parathyroid adenoma mc)?
hypercalcemia, hypophosphatemia
what are the signs and sx of primary hyperaldosteronism?
- increased. aldosterone leads to:
- hypertension
- hypokalemic alkalosis
- muscle weakness and parasthesias
*may be worse after initiation of diuretics
what are the lab values associated with primary hyperaldosterinism?
- elevated aldosterone
- low plasma renin activity
treatment for primary hyperaldosteronism due to bilateral adrenal hyperplasia
spioronolactone (aldosterone antagonist)
kwhat is important to rule out when someone presents with dementia symptoms?
hypothyropidism
treatment for primary adrenal insufficiency
glucocorticoids (hydrocortisone, prednisone) and mineralocorticoids (fludrocortisone)
what is the cause of exercise-associated hyponatremia?
- excessive hypotonic fluid intake and nonosmotically mediated release of inappropriately high levels of ADH
what are the sequelae of exercise-associated hyponatremia?
seizures, comfusion, even death
order of tests for workup of a thyroid nodule
- serum TSH
- if normal or high, do ultrasound
- nodule>1cm= FNA
pt with cardiovascular disease and type 2 DM is on metformin and needs a second DM medication. what are best for CV disease?
glucago-like peptide agonists or sodium glucose cotransporter 2 inhibitors
chronic pancreatitis or pancreatic resection can cause loss of insulin producing beta cells leading to pancreatogenic diabetes; exogenous insulin is required. Why are these patients at risk for severe hypoglycemia?
they also lose glycagon secreting alpha cells and cannot secrete glucago to counteract the exogenous insulin given
how does hypothyroidism cause lactation?
hypothyroidism leads to increased scretion of TRH from hypothalamus which stimulates both TSH and prolactin from the pituitary
how long should you wait to check TSH levels after starting medication for hypothyroidism?
check TSH in 6 weeks
pt presents with chronic fatigue, weightloss/thin body habitus, loss of sexual hair growth, secondary hypothyroidism, amenorrhea, and inability to lactate who presents in adrenal crisis after physiologic stress should make you think of _____
Sheehan syndrome (aka postpartum hypopituitarism)
the anterior pituitary is vulnerable to infarction with postpartum hemorrhage
