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Family Medicine Shelf > Endocrine Disorders > Flashcards

Endocrine Disorders Flashcards

1
Q

What is the usual cause of T1DM?

A

Viral illness and immune response causing autoantibodies

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2
Q

Which cells are destroyed in T1DM?

A

Beta cells

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3
Q

What are the 3 criteria for prediabetes?

A
  1. Fasting glucose 100-125
  2. Postprandial glucose 140-199
  3. A1c: 5.7-6.4
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4
Q

T/F: does triglycerides >250 put you at increased risk for T2DM?

A

Yes

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5
Q

When should you screen for diabetes according to ADA?

A

a) Any overweight adult with 1+ risk factor
b) All adults 45+
c) Children with 2+ risk factors

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6
Q

Loss of peripheral hair can indicate what?

A

Atherosclerosis

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7
Q

What’s the ADA diabetes diagnosis criteria?

A
  1. Fasting 126+
  2. Random 200+
  3. A1C 6.5+
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8
Q

What is the ADA goal for DM control in terms of A1C?

A

7.0%

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9
Q

What’s the ADA goal for DM control in terms of BP?

A

<140/90

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10
Q

What’s the ADA goal for DM control in terms of fasting BS?

A

80-130

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11
Q

What’s the ADA goal for DM control in terms of random BS?

A

<180

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12
Q

If A1c is >7.5% to start, how many meds should you consider starting off the bat?

A

2

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13
Q

If A1c is >9.0% to start, what should you consider adding off the bat?

A

Insulin

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14
Q

What’s the most potent therapy for reversing DM?

A

Lifestyle modification

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15
Q

What class of drugs is metformin?

A

Biguanide

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16
Q

Does metformin reduce gluconeogenesis in liver?

A

Yes

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17
Q

Do not use metformin if estimated GFR < ____?

A

<30

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18
Q

What category of drug are glipizide and glyburide?

A

Sulfonylureas

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19
Q

GDM confers increased risk to which 2 things during pregnancy?

A
  1. Stillborn

2. Large baby

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20
Q

GDM confers increased risk to which 2 things during pregnancy?

A
  1. Stillborn

2. Large baby

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21
Q

What’s the T score for osteoporosis?

A

Amount of bone compared to a young adult of the same gender

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22
Q

What are the T scores for the following?:
Normal:
Osteopenia:
Osteoporosis

A

Normal: >-1
Osteopenia: -1 to -2.5
Osteoporosis: -2.5 or less

23
Q

What’s the z score for osteoporosis?

A

Amount of bone compared to same age and gender

24
Q

How is the dx of osteoporosis made?

A
  1. One or more fragility fractures

2. T score of -2.5 or less on DEXA

25
Q

When should you treat osteoporosis pharmacologically?

A

T score -2.5 to -1.0 at high risk for a fracture

26
Q

At what age should DEXA be performed?

A

65+, or less if have an increased risk

27
Q

What class of drugs are alendronate, risendronate, etc?

A

Bisphosphonates

28
Q

Normally, low Ca stimulates production of PTH, causing the following effects in:

  • renal excretion of Ca
  • renal production of vit D
  • gut absorption of Ca
A
  • Decreased renal excretion of Ca
  • Increased production of Vit D by kidney
  • Increased gut absorption of Ca
29
Q

What’s the main cause of primary hyperparathyroidism?

A

Adenoma

30
Q

Do more females or males get hyperparathyroidism?

A

Females

31
Q

About 98% of Ca is in the ________?

A

Bones

32
Q

What conditions can cause secondary hyperparathyroidism?

A

Chronic renal dz, dialysis, vit D deficiency (can be from Crohn’s or celiac)

33
Q

What type of diuretics can cause elevated Ca?

A

Thiazide

34
Q

Describe the chain of thyroid hormone production?

A

Hypothalamus: TRH released

Anterior pituitary: TSH released
-stimulates production of thyroid hormones

-Thyroid gland: mono and di to tetra-iodotyrosine to tri-iodotyrosine

35
Q

Where are T1 and T2 converted to T4?

A

Outside thyroid

36
Q

Where is T4 converted to T3?

A

Outside thyroid

37
Q

What do T3 and T4 (thyroxine) do?

A

Perform thyroid bodily functions and suppress TRH and TSH

38
Q

Is T3 or T4 more active?

A

T3

39
Q

In circulation, is T3 or T4 more prevalent?

A

T4

40
Q 
What could the following all cause:?
Low albumin
PTH resistance
Low vit D
Dietary Ca deficiency
Low Mg
Elev phosphorus
Pancreatitis
Renal failure
A

Low Ca

41
Q

T/F: the thyroid is the only place in the body that uses iodine?

A

T

42
Q

What’s a struma ovarii?

A

Teratoma that contains mostly thyroid tissue and will pick up iodine on scans

43
Q

What does an elev TSH mean?

A

Hypothyroid

44
Q

What does an elev T3/T4 mean?

A

Hyperthyroid

45
Q

Is Graves hyper or hypothyroid?

A

Hyper

46
Q

What’s the treatment of hyperthyroid?

A

PTU

47
Q

Can a goiter be euthyroid?

A

Yes

48
Q

Which is the most common (>70%) type of thyroid cancer which has low mortality but high recurrence?

A

Papillary

49
Q

Which thyroid cancer is approx 15%, usually age 40-60 years old, often has distant mets and does not pick up iodine well on scans?

A

Follicular

50
Q

Which thyroid cancer is calcitonin-secreting (C cells; parafollicular), and can be part of MEN syndrome?

A

Medullary

51
Q

Which thyroid cancer is rare, seen more in elderly males, mets to the lung quickly, and has a high death rate?

A

Anaplastic

52
Q

What are the 2 treatments for thyroid cancer?

A
  1. Surgical

2. RAI

53
Q

If a patient has high TRH, what does the type of hyperthyroidism have to be?

A

Hypothalamic tumor

Family Medicine Shelf (16 decks)

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