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Medicine > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Symptoms of severe Hyponatremia

A

(<120 mole/L)

  • Seizures
  • Altered consciousness
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2
Q

Abnormal labs in SIADH

A
  • decreased Serum Osmolality
  • decreased Serum Sodium
  • INCREASED Urine Osmolality >100mOsm
  • usually decreased Uric acid
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3
Q

Treatment of Symptomatic SIADH

A

Hypertonic saline with ICU monitoring

to prevent osmotic demyelination syndrome

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4
Q

Clinical features in Graves’ disease

A

• Pretibial Myxedema

• Opthalmopathy
exophthalmos, lid retraction, diplopia

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5
Q

Antibodies found in Graves

A
  • Thyroid receptor Abs!!
  • Antithyroid peroxidase Abs
  • Thyroglobulin antibodies
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6
Q

Description Toxic Multimodal Goitre

A

Multinodular

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7
Q

Painful goitre seen in..

A

De Quverian thyroiditis
(Subacute granulomatous thyroiditis)

—> anti TPO Abs

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8
Q

Goitre following flulike illness

A

De Quverian thyroiditis

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9
Q

TFT’s in Overt hyperthyroidism

A
  • LOW TSH
  • high Free T4 (90% of cases)
  • high Free T3

-(Graves, TMG, Toxic adenoma)

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10
Q

TFT’s in Subclinical hyperthyroidism

A
  • LOW TSH
  • normal Free T4
  • normal Free T3
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11
Q

TFT’s in Thyrotropic adenoma

A
  • Normal Or HIGH TSH
  • high Free T4
  • high Free T3
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12
Q

Pathophys and TFT’s in Toxic adenoma

A

Overproduction of hormones by single thyroid nodule

  • High T3 (peripheral conversion?)
  • Low TSH (pituitary suppression in rest of gland that is not the Toxic Nodule)
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13
Q

Primary hypothyroidism causes

A

(Thyroid gland disorder)

  • Hashimoto’s
  • De Quevain
  • Postpartum thyroiditis
  • Raidioiodine therapy
  • Drugs (amiadorome, methimazole, PTU)
  • Iodine deficiency
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14
Q

Secondary hypothyroidism caused by

Tertiary hypothyroidism causes by

A
  1. Pituitary disorder (ex. Pituitary adenoma)

2. Hypothalamic disorder

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15
Q

TFT’s in Overt hypothyroidism

A

(1ry, 2ndry, 3ry)

LOW Free T4 and T3

In 1ry: compensatory increase in TSH -HIGH

In 2ndry & 3ry: LOW TSH

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16
Q

Pathophys of Euthyroid sick syndrome

A

Abnormal TFT’s in pt. with severe nonthyroidal illness. (Cytokines mediited)

Most common: low Free T3 with normal T4 & TSH

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17
Q

Etiology of Acromegaly

A

• Pituitary Adenoma (95%)

• Neuroendocrine tumor
(ex. Small cell lung ca., Pancreatic islet cell tumor, Pheochromocytoma)

• Paraneoplastic syndrome

18
Q

Next step if IGF-1 is…

..Notmal
..Elevated?

A

Normal: Acromegaly ruled out

Elevated: OGTT

19
Q

GH not suppressed 2hrs after OGTT.

Interpretation and Next step?

A
  • Acromegaly conformed

* Pituitary MRI to determine source

20
Q

Confirmatory tests for Acromegaly:

  • Best single test?
  • Most specific test?
A
  • IGF-1 concentration

* OGTT

21
Q

Imagining modality for Acromegaly
&
Next step if normal

A

• Pituitary MRI

• Extrapituitary screen:
CT Chest, Abdomen and measure GHRH

22
Q

5 Paroxysmal P’s of Pheochromocytoma

A
  • Pressure
  • Pain (headache)
  • Palpitations
  • Perspiration
  • Pallor
23
Q

Best initial test in Pheochromocytoma

A

Metabephrines

24
Q

Confirmatory rest in Pheochromocytoma

A

Metanephrines + Catcholamines in 24 hr urine

25
Q

Medical tx in Pheochromocytoma

A

Non selective irreversible alpha blocker

• Phenoxybenzamine

26
Q

Type of adrenal insufficiency that pigments the skin

A

Primary Adrenal Insufficiency

27
Q

Type of adrenal insufficiency caused by cortisol tx __

A

Tertiary Adrenal Insufficiency

28
Q

Gold standard imaging for pituitary adenoma

A

MRI sella with IV contrast

29
Q

Surgery is 1st line 3 types of pituitary adenomas situations

A
  • Secretory pituitary adenoma
  • symptomatic Non secretory adenomas
  • Apoplexy with visual Sx
30
Q

1st line Tx in Prolactonoma

A

Dopamine agonist: Cabergoline

31
Q

Procedure done in pituitary adenoma surgery

A

Transsphenoidal Hypophysectomy

32
Q

Anti SSA/ Ro seen in__

A

• Sjogren Syndrome

33
Q

With a normal of (275 - 299mOsm/kg)

Plasma Osmolality =

A

2 x (serum Na) + (serum glucose)/18 + (serum urea) /2.8

34
Q

pH in moderate DKA is __ to __

A

7.0 - 7.24

35
Q

Normal saline & short acting (regular) insulin is __ __ in DKA

A

Initial tx

36
Q

ESR is ___ in postpartum thyroiditis with ___ iodine uptake

A
  • normal

* decreased

37
Q

In contrast to Subacute granulomatous…

• Goitre is___ in Subacute lymphocytic thyroiditis

A

• PainLESS

38
Q

8am serum cortisol > 50 nmol/L

..on low dose Dexamethasone suppression …

A

• Hypercortisolism

39
Q

24 hr urine cortisol > 3x normal

(> 300ug)…

A

• Hypercortisolism

40
Q

High Dose decamethasome suppresses ACTH, thus..

cortisol to __ baseline

A

• < 50%

Medicine (15 decks)

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