Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Medicine > Endocrine Disorders > Flashcards

Endocrine Disorders Flashcards

1
Q

A 35 year-old female presents with irregular periods, weight gain, and hair loss. Labs most consistent with these findings might include a ______ (high/low) TSH and a ______ (high/low) free T4.

A

High, low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The most common form of hypothyroidism is called ______.

A

Hashimoto’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the etiology of Hashimoto’s?

A

Autoimmune

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A patient with a history of Graves Disease presents with an agitated delirium, atrial fibrillation at a rate of 130, and an elevated BNP (indicative of congestive heart failure). What condition do you suspect?

A

Thyroid storm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What class of medication might you administer to a patient with thyroid storm to counteract the symptoms of sympathetic stimulation (tachycardia, eg).

A

Beta-blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A 70 year-old female presents with a high-normal TSH of 8 and a normal T4. She is asymptomatic. The most prudent course of treatment is:

A. Levothyroxine
B. Tri-iodothyronine
C. Radioactive Iodine Ablation
D. Observation without immediate treatment

A

D. Observation without immediate treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A patient presents with tachycardia, increased appetite with weight loss, heat intolerance, and anxiety. What disorder do you suspect?

A

Hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

In hyperthyroidism, ______ levels are elevated, while ______ levels are decreased.

A

T4, TSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

You are examining a patient with a history of Graves Disease. You observe a lumpy hardening of the skin on the lower leg and top of the foot. What is the most likely diagnosis?

A

Infiltrative dermopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

You are treating a patient for hyperthyroidism that is poorly managed with medications. While discussing the possibility of radioactive iodine ablation, you explain to the patient that she has high likelihood of developing which disorder after the procedure?

A

Hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

True or false: The vast majority of hypothyroid patients are symptomatic and require aggressive therapy.

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

True or false: Excess body fat results from but does not contribute to insulin insensitivity.

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A patient with no prior medical history presents for an annual physical. His BMI is 31 (42” waist), fasting glucose is 102, and BP is 136/90. Assuming that these values are repeatable, what is the most likely diagnosis?

A

Metabolic Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

A non-obese 11 year-old patient presents with a 1-week history of weight loss, polyuria, polydipsia, and fatigue. You order labs, expecting serum glucose to be ______ (high/low).

A

High

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A non-obese 11 year-old patient presents with a 1-week history of weight loss, polyuria, polydipsia, and fatigue. The non-fasting serum glucose is 298. What is the most likely diagnosis?

A

Type I DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A non-obese 11 year-old patient presents with a 1-week history of weight loss, polyuria, polydipsia, and fatigue. The non-fasting serum glucose is 298. Name two additional lab values you might evaluate to assess for significant potential complications.

A

Serum potassium, urine ketones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

You are treating a patient in the ICU for DKA. The patient’s EKG shows flat t-waves. What common complication of DKA is the culprit, and what is your most urgent concern for this patient?

A

Hypokalemia, arrythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

True or false: A white male patient with central obesity, hypertension (141/92), and an HDL of 39 must also have impaired fasting glucose in order to warrant a metabolic syndrome diagnosis.

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In ______ (type I/type II) DM, there is an absolute (or near absolute) absence of insulin production by the pancreas.

A

type I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

While examining a patient, you note a dark, velvety discoloration to the skin on the back of the neck. You document the presence of ______, and suspect that the patient has a severe degree of what feature of metabolic syndrome?

A

acanthosis nigricans, insulin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

The most profound clinical improvements in patients with metabolic syndrome result from decreasing which of the following:

A. body weight
B. blood pressure
C. fasting glucose
D. triglycerides

A

A. body weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

A patient presents with abdominal pain, nausea and vomiting. Respirations are deep and rapid. Lab work shows an anion gap of 22 and a glucose of 405. What is the most likely diagnosis?

A

Diabetic Ketoacidosis

23
Q

A patient presents with abdominal pain, nausea and vomiting. Respirations are deep and rapid. Lab work shows an anion gap of 22 and a glucose of 405. You suspect that the patient has a history of ______ (type I/type II) DM.

A

Type I

24
Q

A patient with a history of type 2 DM presents with confusion, agitation, tremor, tachycardia, and diaphoresis. Which lab value would be of greatest benefit in treating this patient, and do you expect the value to be low, high, or normal?

A

glucose, low

25
Q

You are rounding on an inpatient floor when you find an insulin-dependent diabetic patient unresponsive. Finger-stick glucose is 28. Which dose of oral glucose would you administer?

A

None: unresponsive patients don’t get PO meds

26
Q

You have diagnosed a patient with type II DM and started treatment. As a part of follow-up, you plan to assess A1C every _____ ______, targeting a value less than ______.

A

three months, 7%

27
Q

A 28 year-old female who is 5 months postpartum presents with a painless goiter. TSH is normal, T4 is mildly elevated, and TPO antibodies are present. What is the most likely diagnosis?

A

Postpartum thyroiditis

28
Q

A 28 year-old female who is 5 months postpartum presents with a painless goiter. TSH is normal, T4 is mildly elevated, and TPO antibodies are present. In which phase of disease has the patient presented?

A

Hyperthyroid phase

29
Q

After diagnosing a patient with thyroid cancer, you refer him to hospice with a very poor prognosis. Which type of cancer was the most likely cause?

A

Anaplastic

30
Q

You are examining a patient with exophthalmus, proptosis, and excessive tearing. You expect TSH to be ______ (high/low) and T4 to be ______ (high/low).

A

low, high

31
Q

You are treating a hypothyroid patient and order thyroid function labs. The TSH is low-normal and the T4 is low. This patient’s hypothyroidism is ______ (primary/secondary).

A

Secondary

32
Q

What is the most common cause of thyrotoxicosis?

A

Graves Disease

33
Q

You are examining a patient and find a thyroid nodule. The TSH is low, so you order a radioiodine uptake and thyroid scan, which show a hyperfunctioning nodule. Should you biopsy the nodule? Why or why not?

A

No, because the vast majority of hyperfunctioning nodules are benign

34
Q

A patient with a history of osteoporosis and chronic kidney stones presents with abdominal pain and vomiting, confusion, and anxiety. On exam, you notice that tapping the facial nerve causes a twitching around the patient’s lips. You order a CMP, expecting to find that the calcium is ______ (high, low, normal).

A

High

35
Q

A patient with a history of osteoporosis and chronic kidney stones presents with abdominal pain and vomiting, confusion, and anxiety. On exam, you notice that tapping the facial nerve causes a twitching around the patient’s lips. The calcium level is high at 13. PTH is also elevated. What is the most likely diagnosis?

A

Primary hyperparathyroidism

36
Q

A patient with a history of osteoporosis and chronic kidney stones presents with abdominal pain and vomiting, confusion, and anxiety. On exam, you notice that tapping the facial nerve causes a twitching around the patient’s lips. The calcium level is high at 13. PTH is also elevated. What is the most appropriate initial treatment for this patient?

A

IV fluids

37
Q

A patient with a history of chronic kidney disease presents with an osteoporosis-related fracture of the distal radius. You find that the serum calcium level is normal and the PTH is dramatically elevated. What is the most likely diagnosis?

A

Secondary hyperparathyroidism

38
Q

You order an MRI on a patient, and a pituitary macroadenoma is discovered incidentally. All hormone levels are normal. Which specialist referral would be most helpful in guiding your treatment of this condition?

A

Ophthalmology

39
Q

An adult patient presents with growth of the hands and feet, frontal bossing, and macroglossia. What is the most appropriate initial lab test, and for which disorder are you screening?

A

IGF-1, acromegaly

40
Q

An adult patient presents with growth of the hands and feet, frontal bossing, and macroglossia. The IGF-1 level is high. Which test should you order to confirm your diagnosis of acromegaly?

A

GH suppression test

41
Q

An adult patient presents with growth of the hands and feet, frontal bossing, and macroglossia. The IGF-1 level is high and glucose load failed to suppress GH levels. What is the most appropriate initial treatment of the patient’s condition?

A

Surgical removal of the GH secreting tumor

42
Q

A patient with acromegaly dies from complications directly related to his disease. A failure of which body system is most likely to blame?

A

Cardiovascular

43
Q

A 50 year-old female presents with weight gain, weakness, headache, backache, and mood swings. On exam, you note central obesity, moon facies, dorsocervical fat pads, and purple striae. What test would be your first step in working this patient up?

A

24-hour urine free cortisol level

44
Q

A 50 year-old female presents with weight gain, weakness, headache, backache, and mood swings. On exam, you note central obesity, moon facies, dorsocervical fat pads, and purple striae. 24-hour urine free cortisol was high on two consecutive tests. What test should you order next?

A

ACTH level

45
Q

A 50 year-old female presents with weight gain, weakness, headache, backache, and mood swings. On exam, you note central obesity, moon facies, dorsocervical fat pads, and purple striae. 24-hour urine free cortisol was high on two consecutive tests, as was the ACTH. What is the most likely diagnosis, and what test do you order next?

A

ACTH-dependent Cushing’s Disease, pituitary MRI

46
Q

Which radiologic study is most useful in treating ACTH-independent Cushing’s Syndrome?

A

Adrenal CT

47
Q

You are treating a patient in the hospital and find that the sodium level is low. What is the most likely culprit?

A

SIADH

48
Q

A mother with a history of poorly controlled gestational diabetes gives birth. The infant is most likely ______ (small/large) for gestational age, and should be monitored carefully for ______ (hypoglycemia/hyperglycemia) in the first few days of life.

A

large, hypoglycemia

49
Q

What test is used to screen for gestational diabetes at 24-28 weeks gestation?

A

Oral glucose tolerance test

50
Q

You are treating an obese patient for hyperlipidemia and hypertension. Which other lab value would you closely monitor?

A

Glucose

51
Q

True or false: Lifestyle modifications (diet/exercise) are unlikely to benefit patients with metabolic syndrome unless they result in reducing BMI to less than 30.

A

False

52
Q

True or false: hyperlipidemia is usually caused by either inherited traits or environmental influences, but not both.

A

False

53
Q

A patient presents with episodic palpitations, sweating, and headache that are associated with hypertension. You order a 24-hour urine level of catecholamines and metanephrines, suspecting what disorder?

A

Pheochromocytoma

Clinical Medicine (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions