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PANCE Subjects 2 > Endocrine- DM, Lipids, Thyroid, Adrenal, Pituitary > Flashcards

Endocrine- DM, Lipids, Thyroid, Adrenal, Pituitary Flashcards

1
Q

What DM meds have hypoglycemia risk?

A

Sulfonylureas- Glyburide, Glipizide, Tolbutamide
Meglitinide Analogs- Repaglinide (Prandin)

~Acarbose (Precose) if used in combination

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2
Q

What DM meds are also good for weight loss

A

Incretins
GLP-1 Receptor Agonist- Victoza, Byetta
DPP-IV Inhibitors- Sitagliptan (Januvia), Saxagliptan(Onglyza)

SGLT2 Inhib- Invokana

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3
Q

What DM meds stimulate insulin secretion?

A

Sulfonylureas- Glyburide, Glipizide, Tolbutamide
Meglitinide Analgos- Repaglinide (Prandin)
D-phenylalanine Deriv- Nateglinide (Starlix)
?DPP-IV- Januvia, Onglyza

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4
Q

What DM med decrease renal reabsorption of glucose?

A

SGLT 2 Inhibitors- Invokana

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5
Q

Newly diagnosed DMII, initial therapy

A

lifestyle changes
Metformin 500mg BID
HTN management, lipids if indicated

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6
Q

DM patient who is going to have imaging for renal stones

A

Should D/C metformin prior to any contrast procedures

risk of lactic acidosis

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7
Q

Normal A1C

A

6.0= 125 average bs

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8
Q

Every 1% A1C rises is ~ equal to what blood sugar increase

A

30

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9
Q

What comes first, targeting blood sugar or targeting lipids?

A

Target sugars first

then lipids

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10
Q

What DMII med is preferred in renal disease or elderly?

A

Metiglinide

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11
Q

What DMII med should not be used in heart failure patients?

A

Thiazolid- Pioglitazone

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12
Q

In diabetes Insipidus the serum osmolarity is_____ and the urine osmolarity is _______

A

serum high

urine low

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13
Q

With a vasopressin challenge test _____ causes of diabetes insipidus will respond, but _____ causes will not

A

Central responds

nephrogenic will not

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14
Q

Patho of diabetes insipidus

A

failure of central of peripheral ADH
hyperkalemia results
will have excessive intake of fluids (polydipsia)
so free body water increase and plasma osmolarity decreases
will have compensatory increase in urinary free water excretion (polyuria)
serum osm now high compared to urine osm

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15
Q

TOC nephrogenic diabetes insipidus

A

indomethacin

+/- HCTZ, desmopressin, amiloride

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16
Q

TOC diabetes Insipidus associated with pregnancy

A

desmopressin and good hydration

17
Q

TOC central diabetes insipidus

A

desmopressin, hydration

look for neoplasms

18
Q

Treatment of thyroid storm

A

Methimazole

19
Q

Lyte abnormalities seen in Addison’s Disease

A

Na- low
K- high
Glucose- ~low
Calcium- ~high

20
Q

MCC Addison’s Disease

A

autoimmune destruction of adrenals

21
Q

Addison’s disease is from deficiency in _______

A

cortisol

22
Q

20 y/o M presents c/o 1 week of fatigue and 2 days of HA, n/v, and weight loss. Is craving chips and french fries. On exam he is hypotensive and you notice darker pigmentation on his arms and face.
Work up

A

plasma cortisol

23
Q

TOC for Addisons

A

hydrocortisone PO BID

24
Q

Cushings “disease” is

A

d/t ACTH hypersecretion by pituitary adenoma

25
Q

Initial work up for cushing syndrome

A

dexamethasone suppression test

26
Q

Hypoparathyroid causes______ calcemia

A

hypocalcemia

27
Q

MCC hypothyroidism

A

Hashimotos

28
Q

MCC hyperthyroidism

A

Graves disease

29
Q

Severe life threatening hypothyroidism with lyte abnl and CNS manifestations is called

A

Myxedema Crisis/thyroid storm?

30
Q

what radiographs are taken to determine bone age in pt with short statue?

A

L wrist and hand

31
Q

what hormones are produced in the posterior pituitary?

A

oxytocin

vasopressin (ADH)

32
Q

mcc of hyperparathyroidism

A

parathyroid adenoma

33
Q

kidney stones, depression, constipation, and bone pain

A

hyperparathyroidism

34
Q

chvostek sign

A

facial muscle contraction on tapping facial nerve in front of ear
sign of low calcium
hypoparathyroid

35
Q

tx for hypoparathyroidism

A

calcium and vitD replacement

PANCE Subjects 2 (14 decks)

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