Brainscape's Knowledge GenomeTM

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


See full index

Rosh Review > Endocrine/Metabolic Disorders > Flashcards

Endocrine/Metabolic Disorders Flashcards

1
Q

Pathophysiology of alcoholic keto acidosis

A

*add pic from Q4 Exam 1

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

4 H’s of Scurvy

A

Hemorrhage - perifollicular hemorrhages, petechiae, bleeding gums
Hyperkeratosis - rough skin, loose teeth, poor wound healing, “corkscrew” appearance of hairs
Hypochondriasis - irritability, emotional changes
Hematologic abnormalities - easy bruising, hemolytic anemia

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

T/F: Vitamin C deficiency is often associated with iron deficiency

A

True

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

Symptoms of pituitary tumor

A
  • Bitemporal hemianopsia, nonspecific headache, diplopia, ptosis, Horner’s syndrome, CSF rhinorrhea
  • Prolactinoma: amenorrhea, impotence, infertility
  • Growth hormone: gigantism (children), acromegaly (adults)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

True or false: postpartum thyroiditis can occur after miscarriage

A

True

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

What is pituitary apoplexy?

A

Sudden hemorrhage into pituitary gland, often from pituitary tumors
Initial sx related to increased pressure in and around pituitary gland (sudden onset excruciating headache, diplopia, hypopituitarism

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

Tx for pituitary apoplexy

A
  • Surgical decompression
  • Corticosteroids (pt likely with adrenal insufficiency with hypotension, fatigue, abd pain, hyponatremia, hyperkalemia, hypoglycemia) -> hydrocortisone
  • Dopamine agonist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Recognizing pheochromocytoma (sx and dx)

A
  • Severe and intense headaches that abruptly resolve
  • Diaphoresis, palpitations and tachycardia, HTN
  • Urinary and plasma fractionated metanephrines and catecholamines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Tx pheochromocytoma

A 
Surgical resection (phenoxybenzamine preop)
- In acute hypertensive crisis - Phentolamine (first line) otherwise sodium nitroprusside or nicardipine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T/F: patients with COPD are often hyperchloremic

A

False; often hypochloremic

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

T2DM medications that have risk of causing hypoglycemia

A
  • Sulfonylureas (glyburide, glipizide)
  • Meglitinides (-glinide)
  • Insulin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which oral hypoglycemic agents are associated with euglycemic DKA?

A

Sodium-glucose cotransporter-2 inhibitors (canagliflozin, dapagliflozin, empagliflozin)

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

Symptoms of pellagra

A

Niacin (Vitamin B3) Deficiency

  • Dermatitis (photosensitive, pigmented, scaling rash commonly around neck and referred to as “Casal’s necklace”)
  • Diarrhea
  • Dementia
  • Bright red glossitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Patients at risk for niacin deficiency

A
  • Alcoholics
  • Corn-based diets
  • Pts taking isoniazid
  • Congenital defects of intestinal or renal absorption of amino acid tryptophan
  • Carcinoid syndrome where tryptophan converted to serotonin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hyponatremia causes based on volume status, serum osm, urine Na

A

Q#386235

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

Symptoms of hypercalcemia

A
  • Altered mental status
  • Abdominal pain, n/v
  • Weakness/lethargy
  • Muscle aches
  • Depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Most common cause of hypercalcemia

A

Primary hyperparathyroidism

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

Tx for hypercalcemia

A
  • IVF
  • furosemide
  • bisphosphonates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Chvostek sign

A

Twitching of ipsilateral facial muscles with tapping of facial nerve -> hypocalcemia

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

CRAB acronym of multiple myeloma

A

Calcium (high)
Renal insufficiency
Anemia
Bone lesions (lytic)

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

Labs for multiple myeloma

A
  • Monoclonal antibody spike
  • Peripheral blood smear with Rouleaux formations
  • Serum protein electrophoresis: M spike
  • Protein electrophoresis UA: Bence-Jones proteins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Pathophysiology of Diabetes Insipidus

A

Deficiency of ADH and inability to concentrate urine

Central DI: due to a decrease in release of ADH

Nephrogenic DI: due to a resistance to ADH at level of kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Differences between central and nephrogenic DI (causes, findings, water deprivation test, treatment)

A

Central:

  • causes: neurosurgery, trauma, tumors, ischemia, infiltrative diseases, idiopathic
  • findings: decreased ADH, serum osm >290 mOsm/kg, hyperosmotic volume contraction
  • water deprivation test: >50% increase in urine osmolality only after administration of ADH analog (DDAVP)
  • Tx: intranasal desmopressin acetate, hydration

Nephrogenic:

  • causes: hereditary, 2/2 hypercalcemia, lithium, demeclocycline
  • findings: normal ADH levels, serum osm > 290 mOsm/kg, hyperosmotic volume contraction
  • water deprivation test: minimal change in urine osmolality, even after administration of ADH analog
  • Tx: HCTZ, indomethacin, amiloride, hydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

SIADH vs. dehydration vs. diabetes insipidus

Serum Na, serum osm, urine osm

A

Q678786

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Clinical manifestations of hypercalcemia

A

Bones - abnormal bone remodeling and fracture risk
Stones - increased risk of kidney stones
Groans - abdominal cramping, nausea, ileus, constipation
Psychiatric overtones - lethargy, depressed mood, psychosis, cognitive dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Tx of hypercalcemia

A
  1. IV NS
  2. Bisphosphonates (inhibit calcium release from bones)
  3. Calcitonin (inhibits bone resorption and enhances renal excretion of Ca)
  4. Steroids (chronic granulomatous disease)
  5. Parathyroidectomy (for hyperparathyroidism)
  6. Dialysis (severe hypercalcemia >18 mg/dL

AVOID THIAZIDES - increase calcium resorption

27
Q

Associated side effect of bisphosphonates

A

Jaw osteonecrosis

28
Q

EKG finding of hypercalcemia

A

Shortened QT interval

29
Q

Administration of IV calcium can precipitate dysrhythmia in patients taking what medication?

A

Digitalis

30
Q

ECG changes due to hyperkalemia

A
  1. Peaked T waves
  2. Dropped p wave
  3. Widened QRS complex
  4. Sine wave
31
Q

What is the approximate duration of action of calcium on cardiac membrane stabilization?

A

30-60 minutes

32
Q

Five I’s of DKA

A 
Infection
Ischemia
Infarction
Insulin deficit
Intoxication
33
Q

Tx of pheo

A
  • Surgical resection
  • Phenoxybenzamine (preop)
  • Phentolamine (acute hypertensive crisis)
  • Sodium nitroprusside (acute hypertensive crisis)
  • Nicardipine (acute hypertensive crisis)

Alpha-blockade must precede b-blockade

34
Q

Describe Cushing syndrome

A
  • Moon face (facial plethora)
  • Resistant hypertension
  • Irregular menstrual cycles
  • Cutaneous findings (easy bruising, striae)
  • Androgen excess (hirsutism)
  • Enlarged supraclavicular fat pads
  • Proximal muscular atrophy and weakness
  • Osteoporosis
  • Cardiac hypertrophy
  • Poor wound healing
  • Obesity
  • Glucose intolerance
  • Thromboembolic events
    Q184365 with visual
35
Q

Cause of Cushing syndrome

A

Pituitary adenoma in most non-iatrogenic cases - increases amplitude and duration of ACTH secretion

36
Q

Causes of hypernatremia

A

Q165006

37
Q

What irreversible neurologic illness can be the manifestation of salt poisoning

A

Osmotic demyelination syndrome

38
Q

Signs of hypocalcemia

A
  • Chvostek sign: contraction of ipsilateral facial muscles elicited by tapping facial nerve just anterior to the ear
  • Trousseau sign: induction of carpopedal spasm characterized by adduction of thumb, flexion of MCP joints, extension of interphalangeal joints, flexion of wrist caused by inflation of BP cuff
  • Hyperreflexia
  • Prolonged QT interval
39
Q

When is Ca replaced via IV?

A

Ca = 7.5

Tetany, seizure, carpopedal spasm, prolonged QT

40
Q

Clinical presentation of Sheehan Syndrome

A
  • Inability to lactate
  • Amenorrhea or oligomenorrhea
  • Fatigue
  • Cold intolerance
  • Lethargy
  • Weight loss
  • Hypotension
41
Q

Lab results in Sheehan Syndrome

A

Consistent with adrenal insufficiency (hyponatremia) and hypogonadism

  • Growth hormone deficiency
  • Prolactin deficiency
  • TSH deficiency
  • ACTH deficiency
  • FSH and LH deficiency
42
Q

What ECG abnormality is associated with hypocalcemia?

A

Prolonged QT interval

43
Q

Labs in hypoparathyroidism

A

Low PTH
Low Calcium
High Phosphorus

44
Q

What steroid is recommended for the tx of adrenal insufficiency?

A

Hydrocortisone

45
Q

Some causes of B12 deficiency

A

Veganism

Use of metformin

46
Q

Causes of hypophosphatemia

A
  • DKA
  • Malabsorption/Malnutrition
  • Alkalosis
  • Hyperparathyroidism
  • Chronic diuretic or antacid therapy
  • Sepsis
  • Chronic alcoholism
47
Q

How does DKA cause severe hypophosphatemia?

A

Metabolic acidosis
Osmotic diuresis
Mobilization of intracellular phosphate stores leading to urinary losses

48
Q

Clinical manifestations of hypophosphatemia

A
  • Myocardial Depression
  • Hypotension
  • Respiratory insufficiency
49
Q

Diagnosing Cushing Syndrome

A
  • 24-hr urinary cortisol excretion
  • Low-dose dexamethasone suppression test
  • Late-night salivary cortisol
50
Q

Which classic symptoms of Cushing syndrome are generally absent in patients with physiologic hypercortisolism (pseudo-Cushing syndrome)?

A
  • Cutaneous symptoms such as easy bruising and thinning

- Muscular involvement such as weakness and atrophy

51
Q

Initial treatment for patient with severe hyponatremia presenting with neurologic symptoms

A

3% hypertonic saline 100-150 mL over 15-20 minutes - stop infusion when sx either resolve or a target of 5 mEq/L increase in serum sodium is achieved

May repeat bolus up to a total of 3 doses or total of 450 mL

52
Q

Serum sodium level should not increase by more than what during first 24 hours?

A

8-12 mEq/L

53
Q

What is an indication fo discontinue an insulin pump in a patient with type 1 DM?

A

Ketoacidosis - assumes pump has failed (could be due to a kink, empty reservoir, disconnection, mechanical malfunction, or errors in priming the pump)

54
Q

Red flags for Thyroid Nodule

A
  • Male sex
  • Age <20 or >65 years
  • H/O head/neck irradiation
  • FHx of thyroid cancer
  • Hard, fixed nodule >4cm
  • Rapid growth of nodule
  • Sx related to local invasion (dysphagia, hoarseness)
55
Q

Most common type of radiation-related thyroid cancer

A

Papillary

56
Q

Correct order of medications in thyroid storm

A
  1. B-blocker
  2. Thionamide (propylthiouracil and methimazole)
  3. Hydrocortisone
  4. (1 hr after thionamide) iodine-containing agent (lugol solution, supersaturated KI, Iopanoic acid, Ipodate)
  5. Cholestyramine (ion-exchange resin which prevents enterohepatic recirculation of thyroid hormone and facilitates elimination from body)
57
Q

What primary acid-base disorder does acetazolamide induce?

A

Metabolic acidosis

58
Q

How should acute hypernatremia be corrected?

A

Rapidly with goal of normalizing serum sodium to 140 within 24 hours

59
Q

How does MEN type 2A present?

A
  • Medullary thyroid cancer
  • Parathyroid neoplasms
  • Pheochromocytoma
60
Q

How does MEN 2B present?

A
  • Medullary thyroid cancer
  • Mucosal neuromas
  • Pheochromocytoma
61
Q

How does MEN 1 present?

A
  • Parathyroid tumors (primary hyperthyroidism)
  • Pancreatic tumors
  • Pituitary adenoma
62
Q

Major causes of metabolic alkalosis

A

Caused by either gain of bicarb ion or loss of acid in form of hydrogen ion

GI HYDROGEN LOSS

  • vomiting/NG suction
  • congenital chloride diarrhea (cystic fibrosis)

RENAL HYDROGEN LOSS

  • Primary mineralcorticoid excess
  • Mineralcorticoid excess-like states (licorice ingestion, Liddle syndrome)
  • Loop or thiazide diuretics
  • Barter or Gitelman syndrome
  • Posthypercapnic alkalosis
  • Hypercalcemia and milk-alkali syndrome

INTRACELLULAR SHIFT OF HYDROGEN

  • Severe hypokalemia
  • Villous adenoma
  • Laxative abuse

Alkali administration with reduced renal function
Contraction alkalosis

63
Q

Pathogenesis of Refeeding Syndrome

A

Starvation -> low glucose = low insulin/high glucagon = increased gluconeogenesis -> depletion of phosphate stores -> hypophosphatemia

Refeeding -> high glucose = high insulin = increased cellular uptake of phosphate
Hypophosphatemia from starvation + phosphate demand -> severe hypophosphatemia

64
Q

What is an adverse effect of IV phosphorus therapy?

A

Hypocalcemia

Rosh Review (22 decks)

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