Endocrine Disorders Flashcards
treatment for hypotensive patients with diabetes insipidus
normal saline
treatment for normotensive patients with diabetes insipidus
hypotonic saline (.45% saline or D5%)
17 alpha-hydroxylase deficiency
hypertension, hypokalemia, decreased sex hormones
XY: externally female, no internal structures
XX: externally female, normal internal structures, lacks secondary sex characteristics
21-hydroxylase deficiency
most common form
hypotension, hyperkalemia, increased renin
elevated 17-hydroxyprogesterone
masculinization, female pseudohermaphroditism
11 beta-hydroxylase deficiency
hypertension and masculinization
partial 21-hydroxylase deficiency
present in early adulthood with hyperandrogenism, not usually accompanied by salt wasting
increased levels of 17-hydroxyprogesterone, confirm with ACTH stimulation test
hypokalemia, alkalosis, normotensive blood pressure
urine chloride concentration is high
bartter syndrome
gitelman syndrome
diuretic abuse
most reliable indicator of metabolic recovery in patients with DKA
serum anion gap or arterial pH
acid/base status in primary hyperaldosteronism
metabolic acidosis
hypokalemia causes potassium to move out of cells into extracellular space, hydrogen ions then move into cells to maintain electrical neutrality
defective mineralization of bone
osteomalacia: vitamin D deficiency in adults
defective mineralization of bone and cartilage
rickets: vitamin D deficiency in children
disordered skeletal remodeling
paget’s disease
defective formation of collagen
osteogenesis imperfecta
low bone mass with normal mineralization
osteoporosis: low bone mass but bone is normally mineralized per unit volume
most common cause of death in patients with acromegaly
congestive heart failure
MEN2a syndrome
medullary thyroid cancer
pheochromocytoma
parathyroid adenoma
ret gene
MEN2b syndrome
medullary thyroid cancer
pheochromocytoma
mucosal neuroma
marfinoid habitus
ret gene
MEN1 syndrome
pituitary adenoma
parathyroid adenoma
pancreatic islet cell tumor
menin tumor suppressor gene
treatment of pituitary adenoma
< 10 mm = microadenoma, treat with bromocriptine or cabergoline
surgery reserved for patients who do not respond to medication
radiation reserve for patients refractory still, as it has a slower response rate
cause of hypertension in thyrotoxicosis
systolic hypertension caused by hyperdynamic circulation
cause of hypertension in hypothyroidism
diastolic hypertension caused by increased systemic vascular resistance
causes of thyrotoxicosis with low radioactive iodine uptake
subacute painless thyroiditis subacute granulomatous thyroiditis iodine-induced thyroid toxicosis levothyroxine overdose struma ovarii
myxedema madness
paranoia and hallucinations in hypothyroidism
carpal tunnel syndrome with amyloid fibril deposition
amyloidosis secondary to end-stage renal disease or chronic hemodialysis
carpal tunnel syndrome with tenosynovial inflammation
rheumatoid arthritis
carpal tunnel syndrome with accumulation of matrix substances
hypothyroidism
carpal tunnel syndrome with accumulation of fluid in the carpal tunnel
pregnancy related volume overload
carpal tunnel syndrome with synovial tendon hyperplasia
acromegaly
where DHEA is produced
ovaries and adrenals
where DHEAS is produced
adrenals
hypothyroid symptoms with elevated T3, T4, and normal TSH
generalized resistance to thyroid hormone
hashimoto’s thyroiditis can lead to this type of malignancy
thyroid lymphoma
treatment for diabetic neuropathy
amitriptylline
second line: TCAs may worsen urinary symptoms and orthostatic hypotension, so use gabapentin in these patients
diagnostic test for acromegaly
measuring growth hormone following an oral glucose load
