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USMLE Step 3 > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Common Causes of hyperprolactinemia

A

1) Prolactinoma
2) Hypothyroid
3) Meds: Reglan, TCA

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2
Q

Treatment of hyperprolactinemia ______, _______

A

Bromocriptine

Cabergoline (dopamine –|Prolactin)

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3
Q

Most common cause of hyper-cortisol

A

Cushing syndrome (Pitutiary Adenoma), very rarely adrenal mass

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4
Q

______ characterized by pronounced jaw enlargement, sweating. Diagnosed with _____

A

Acromegaly, IGF-1 levels

Tx: surgical resection, octreotide, cabergoline, pegvisomant (GH antagonist)

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5
Q

Anosmia with hypogonadism______

A

Kallman syndrome, hypothalmic dysfunction

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6
Q

____ is an IL-5 inhibitor used for asthma, in which there is history of eosiniphilia/atopy

A

mepolizumab, omalizumab (IgE binder)

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7
Q

treatment of ABPA____ and ______

A

oral steroids, itraconazole

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8
Q

How to distinguish COPD vs Asthma on PFT

A

DLCO increase in asthma, DLCO decreased in COPD

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9
Q

backbone of asthma therapy _____, vs backbone of COPD____

A

steroids, muscarinic/b agonist (ipatropium)

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10
Q

causes of bronchiectasis _____, ______

A

ABPA, Cystic Fibrosis, ILD

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11
Q

Medications that may cause ILD _____, ____, ____

A

Amiodarone, nitrofurantoin, bacterim

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12
Q

hyperuricemia is a common side effect of ______ TB therapy

A

pyrazinamide

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13
Q

optic neuritis is a common side effect of ______ TB therapy

A

Ethambutol

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14
Q

______ is a common side effect of isoniazid

A

peripheral neuropathy

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15
Q

minimum duration of active TB therapy _____ months

A

6 months (isoniazid, Rifampin)

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16
Q

Indication for Adjuvant chemo in breast cancer post resection____, ______

A

Lymph node involvement

Lesion>1cm

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17
Q

Tamoxifen is a ______, therefore antagonizes estrogen receptor in breast, but is an agonist in the uterus/ovary

A

SERM

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18
Q

_____ is a common side effect of Herceptin

A

Cardiotoxicity

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19
Q

When to do prophylactic mastectomy for 1st degree BRCA mutation relatives for breast cancer____ age

A

40

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20
Q

Colon Cancer Screening Rules

1) Normal _____, q10years for colonoscopy
2) Genetic Syndrome: Peutz-Jeger, FAP, Gardner, Juvenile Polyposis ______
3) First degree family history _____

A

45+

12+

25+

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21
Q

Low Dose CT Screen Rules

Age 55+ , ____ pack-years low dose CT annually , within ____ years of quitting

A

30 pack-years

15 years

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22
Q

When to do excisions lung biopsy for lesion greater than ______

A

1cm

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23
Q

_____ diabetes drug may increase risk of heart failure

A

-glitazones

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24
Q

A good add-on hypoglycemic after metformin_____

A

Sitagliptin (DPP4)

25
Q

______ help in weight loss, in contrast ____ causes weight gain

A

Exatenide/Liraglutide ; sulfonyureal

26
Q

LDL goal for either CAD/Diabetes <100, if both aggressive LDL goal

A

70

27
Q

ACE causes efferent ____

A

Dilation, reduction of intraglomerular hypertension

28
Q

Pituitary adenomas can produced TSH (T/F)

A

True

29
Q

Thyroid storm management _______

A

Steroids, Iodine pulse,propranolol, PTU

30
Q

When is surgery indicated for hyperparathyroidism_____

A

Symptomatic disease (Calcium>12.4, renal insufficiency, osteoporosis, Age<50)

31
Q

Hyperaparathyroidism is associated with _______

A

Men 1

32
Q

Treatment if pitutiary lesion cannot be removed from Cushing ______

A

Somatostatin analogue (pasireotide), mifepristone

33
Q

Ideal steroid for addisons crisis______

A

Hydrocort (mineralo, glucocorticoid activity)

34
Q

First step in diagnosis of Addisons_____. This is followed by CT imaging

A

Cosyntropin stimulation (ACTH analogue)

35
Q

Conns syndrome is also known as ______. Can be diagnosed with lab markers

Renin______
Salt Loading resulting in ____ aldosterone

A

Hyperaldosteronism

36
Q

For pheochromocytoma, best initial test_____ most accurate ____. This is associated with ____ genetic condition

A

urine/plasma metanephrine
MIBG scan, CT/MRI

Men 2

37
Q

______ version of CAH causes both HTN and hirsuitism. ______ version causes only HTN

HTN itself is caused by _____, which acts as a mineralocorticoid

A

11 hydroxylase, 17 hydroxylase

11 deoxycortisone

38
Q

____, ____, ____ are famous for causing high prolactin

____ endocrin condition leads to high prolactin state

Tx _____ or _____

A

TCA, -phenazines, Reglan (metoclopramide)

Hypothyroidism (TRH –|Prolactin)

Cabergoline/Bromocriptine (Dopamine –| Prolactin), cabergoline is better

39
Q

_____ characterized by head enlargment, jaw enlargement, excess sweating. Best initial test_____

Tx: ____, cabergoline, pegvisomant

A

Acromegaly , IGF-1 ; GH is short acting, may try a glucose suppression test

Octreotide (somatostatin suppresses GH)

40
Q

pegvisomant is a ____ inhibitor, used to treat _____

A

growth hormone, acromegaly

41
Q

_____ results in a female looking male without scrotum, penis or prostate

A

Androgen insensitivity

42
Q

_____ results female without internal anatomy (cervix, ovaries, fallopian tubes); sort of blank phenotype

A

Mullerian agenesis

43
Q

PCOS results in increased _____, metabolic syndrome

A

DHEA (weak androgen: amenorrhea, acne), spironolactone can be used as an anti-androgen (famous side effect: gynecomastia)

44
Q

A hypogonad, tall male is a clue to _______. Resulting in ___ FSH/LH

A

XXY (Klinefelter), High ; the testicles do not respond to LH/FSH so no testosterone produced

45
Q

_____ is a tertiary level hypogonadism, low everything resulting in hypogonadism, famously associated with anosmia

A

Kallman Syndrome (ciliary cells did not migrate to the hypothalmus, low GNRH

46
Q

ACE inhibitors ______ efferent arterioles, to reduce glomerular pressure

A

Decrease

Diabetes ruins negative charge on the slits/podocytes, resulting in worsened nephropathy

47
Q

Graves caused by aberrant Trab antibody that is like a decoy TSH, radio-iodine scan shows ____ uptake

A

increased, gland is working because it is being artificially stimulated

48
Q

____ graves treatment is safe during pregnancy

A

PTU (Inhibits thyroid peroxidase); organification of T4/T3

49
Q

Mechanism of exophthalmos in graves

A

mucopolysaccharide depositions, B stimulation of CN3 to raise the levator muscle

50
Q

Difference between subacute and silent thyroiditis ________

A

both conditions of high T4, no painful gland for silent, subacute treated with aspirin

Tertiary hyperthyroid from TSH from hyperpitutiary

Exogenous thyroid hormone use will atrophy the thyroid gland

51
Q

Most common type of thyroid cancer_____

A

Papillary thyroid cancer

52
Q

When is sestamibi scan done for hyperparathyroid, the most common cause of hypercalcemia

A

To localize which gland/adenoma, only 20% cases are 4 gland hyperplasia, associated with MEN1

If lasix, hydration, calcitonin does not reduce calcium —> steroids (for granulomatous disease etiology)

53
Q

____ electrolyte is co-regulated with calcium, so low amounts can cause hypocalcemia

A

magnesium

Other causes: PPI, fat malabsorption (Chronic pancreatitis)

54
Q

For ectopic, adrenal source of cushing, ACTH is ______

A

Low

55
Q

Medical treatment agent for cushing, mifepristone works by _____

A

cortisol receptor antagonist

56
Q

Test for Addisons_____

A

Cosyntropin (ACTH) stim test

57
Q

Conns syndrome characterized by ___ renin ___ aldosterone

A

Low, high ; may be characterized by polyuria given DI from hypokalemia

58
Q

Androgen insensitive patients do not have ______

A

penis, scrotum, prostate

59
Q

Klinfelter has ___ FSH/LH

A

High, testicles don’t respond to FSH/LH, no testosterone produced

USMLE Step 3 (19 decks)

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