Endocrine

Question 1

what are some signs of hypercortisolism?

Answer 1

• purple striae
• fatigue
• easy bruising
• proximal muscle weakness
• central obesity
• hyperglycemia
• hypokalemia
• hypertension

Question 2

which lung CA produces ectopic ACTH (peptide hormone)?

Answer 2

small cell; look for person with cushings and mediastinal mass

Question 3

what lab values would you expect to see in someone with secondary hyperparathyroidism (CKD)?

Answer 3

increased phosphate, increased PTH, decreased calcium, decreased calcitriol/1,25 dihydroxy vitamin D

Question 4

what is a physical sx of secondary hyperparathyroidism in the setting of CKD?

Answer 4

bone pain associated with renal osteodystrophy

Question 5

what are the lab values associated with primary hyperparathyroidism (parathyroid adenoma mc)?

Answer 5

hypercalcemia, hypophosphatemia

Question 6

what are the signs and sx of primary hyperaldosteronism?

Answer 6

• increased. aldosterone leads to:
  
  • hypertension
  • hypokalemic alkalosis
    
    • muscle weakness and parasthesias

*may be worse after initiation of diuretics

Question 7

what are the lab values associated with primary hyperaldosterinism?

Answer 7

• elevated aldosterone
• low plasma renin activity

Question 8

treatment for primary hyperaldosteronism due to bilateral adrenal hyperplasia

Answer 8

spioronolactone (aldosterone antagonist)

Question 9

kwhat is important to rule out when someone presents with dementia symptoms?

Answer 9

hypothyropidism

Question 10

treatment for primary adrenal insufficiency

Answer 10

glucocorticoids (hydrocortisone, prednisone) and mineralocorticoids (fludrocortisone)

Question 11

what is the cause of exercise-associated hyponatremia?

Answer 11

• excessive hypotonic fluid intake and nonosmotically mediated release of inappropriately high levels of ADH

Question 12

what are the sequelae of exercise-associated hyponatremia?

Answer 12

seizures, comfusion, even death

Question 13

order of tests for workup of a thyroid nodule

Answer 13

1. serum TSH
2. if normal or high, do ultrasound
3. nodule>1cm= FNA

Question 14

pt with cardiovascular disease and type 2 DM is on metformin and needs a second DM medication. what are best for CV disease?

Answer 14

glucago-like peptide agonists or sodium glucose cotransporter 2 inhibitors

Question 15

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?

Answer 15

they also lose glycagon secreting alpha cells and cannot secrete glucago to counteract the exogenous insulin given

Question 16

how does hypothyroidism cause lactation?

Answer 16

hypothyroidism leads to increased scretion of TRH from hypothalamus which stimulates both TSH and prolactin from the pituitary

Question 17

how long should you wait to check TSH levels after starting medication for hypothyroidism?

Answer 17

check TSH in 6 weeks

Question 18

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 _____

Answer 18

Sheehan syndrome (aka postpartum hypopituitarism)

the anterior pituitary is vulnerable to infarction with postpartum hemorrhage