Endocrinology Flashcards
Common Causes of hyperprolactinemia
1) Prolactinoma
2) Hypothyroid
3) Meds: Reglan, TCA
Treatment of hyperprolactinemia ______, _______
Bromocriptine
Cabergoline (dopamine –|Prolactin)
Most common cause of hyper-cortisol
Cushing syndrome (Pitutiary Adenoma), very rarely adrenal mass
______ characterized by pronounced jaw enlargement, sweating. Diagnosed with _____
Acromegaly, IGF-1 levels
Tx: surgical resection, octreotide, cabergoline, pegvisomant (GH antagonist)
Anosmia with hypogonadism______
Kallman syndrome, hypothalmic dysfunction
____ is an IL-5 inhibitor used for asthma, in which there is history of eosiniphilia/atopy
mepolizumab, omalizumab (IgE binder)
treatment of ABPA____ and ______
oral steroids, itraconazole
How to distinguish COPD vs Asthma on PFT
DLCO increase in asthma, DLCO decreased in COPD
backbone of asthma therapy _____, vs backbone of COPD____
steroids, muscarinic/b agonist (ipatropium)
causes of bronchiectasis _____, ______
ABPA, Cystic Fibrosis, ILD
Medications that may cause ILD _____, ____, ____
Amiodarone, nitrofurantoin, bacterim
hyperuricemia is a common side effect of ______ TB therapy
pyrazinamide
optic neuritis is a common side effect of ______ TB therapy
Ethambutol
______ is a common side effect of isoniazid
peripheral neuropathy
minimum duration of active TB therapy _____ months
6 months (isoniazid, Rifampin)
Indication for Adjuvant chemo in breast cancer post resection____, ______
Lymph node involvement
Lesion>1cm
Tamoxifen is a ______, therefore antagonizes estrogen receptor in breast, but is an agonist in the uterus/ovary
SERM
_____ is a common side effect of Herceptin
Cardiotoxicity
When to do prophylactic mastectomy for 1st degree BRCA mutation relatives for breast cancer____ age
40
Colon Cancer Screening Rules
1) Normal _____, q10years for colonoscopy
2) Genetic Syndrome: Peutz-Jeger, FAP, Gardner, Juvenile Polyposis ______
3) First degree family history _____
45+
12+
25+
Low Dose CT Screen Rules
Age 55+ , ____ pack-years low dose CT annually , within ____ years of quitting
30 pack-years
15 years
When to do excisions lung biopsy for lesion greater than ______
1cm
_____ diabetes drug may increase risk of heart failure
-glitazones
A good add-on hypoglycemic after metformin_____
Sitagliptin (DPP4)
______ help in weight loss, in contrast ____ causes weight gain
Exatenide/Liraglutide ; sulfonyureal
LDL goal for either CAD/Diabetes <100, if both aggressive LDL goal
70
ACE causes efferent ____
Dilation, reduction of intraglomerular hypertension
Pituitary adenomas can produced TSH (T/F)
True
Thyroid storm management _______
Steroids, Iodine pulse,propranolol, PTU
When is surgery indicated for hyperparathyroidism_____
Symptomatic disease (Calcium>12.4, renal insufficiency, osteoporosis, Age<50)
Hyperaparathyroidism is associated with _______
Men 1
Treatment if pitutiary lesion cannot be removed from Cushing ______
Somatostatin analogue (pasireotide), mifepristone
Ideal steroid for addisons crisis______
Hydrocort (mineralo, glucocorticoid activity)
First step in diagnosis of Addisons_____. This is followed by CT imaging
Cosyntropin stimulation (ACTH analogue)
Conns syndrome is also known as ______. Can be diagnosed with lab markers
Renin______
Salt Loading resulting in ____ aldosterone
Hyperaldosteronism
For pheochromocytoma, best initial test_____ most accurate ____. This is associated with ____ genetic condition
urine/plasma metanephrine
MIBG scan, CT/MRI
Men 2
______ version of CAH causes both HTN and hirsuitism. ______ version causes only HTN
HTN itself is caused by _____, which acts as a mineralocorticoid
11 hydroxylase, 17 hydroxylase
11 deoxycortisone
____, ____, ____ are famous for causing high prolactin
____ endocrin condition leads to high prolactin state
Tx _____ or _____
TCA, -phenazines, Reglan (metoclopramide)
Hypothyroidism (TRH –|Prolactin)
Cabergoline/Bromocriptine (Dopamine –| Prolactin), cabergoline is better
_____ characterized by head enlargment, jaw enlargement, excess sweating. Best initial test_____
Tx: ____, cabergoline, pegvisomant
Acromegaly , IGF-1 ; GH is short acting, may try a glucose suppression test
Octreotide (somatostatin suppresses GH)
pegvisomant is a ____ inhibitor, used to treat _____
growth hormone, acromegaly
_____ results in a female looking male without scrotum, penis or prostate
Androgen insensitivity
_____ results female without internal anatomy (cervix, ovaries, fallopian tubes); sort of blank phenotype
Mullerian agenesis
PCOS results in increased _____, metabolic syndrome
DHEA (weak androgen: amenorrhea, acne), spironolactone can be used as an anti-androgen (famous side effect: gynecomastia)
A hypogonad, tall male is a clue to _______. Resulting in ___ FSH/LH
XXY (Klinefelter), High ; the testicles do not respond to LH/FSH so no testosterone produced
_____ is a tertiary level hypogonadism, low everything resulting in hypogonadism, famously associated with anosmia
Kallman Syndrome (ciliary cells did not migrate to the hypothalmus, low GNRH
ACE inhibitors ______ efferent arterioles, to reduce glomerular pressure
Decrease
Diabetes ruins negative charge on the slits/podocytes, resulting in worsened nephropathy
Graves caused by aberrant Trab antibody that is like a decoy TSH, radio-iodine scan shows ____ uptake
increased, gland is working because it is being artificially stimulated
____ graves treatment is safe during pregnancy
PTU (Inhibits thyroid peroxidase); organification of T4/T3
Mechanism of exophthalmos in graves
mucopolysaccharide depositions, B stimulation of CN3 to raise the levator muscle
Difference between subacute and silent thyroiditis ________
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
Most common type of thyroid cancer_____
Papillary thyroid cancer
When is sestamibi scan done for hyperparathyroid, the most common cause of hypercalcemia
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)
____ electrolyte is co-regulated with calcium, so low amounts can cause hypocalcemia
magnesium
Other causes: PPI, fat malabsorption (Chronic pancreatitis)
For ectopic, adrenal source of cushing, ACTH is ______
Low
Medical treatment agent for cushing, mifepristone works by _____
cortisol receptor antagonist
Test for Addisons_____
Cosyntropin (ACTH) stim test
Conns syndrome characterized by ___ renin ___ aldosterone
Low, high ; may be characterized by polyuria given DI from hypokalemia
Androgen insensitive patients do not have ______
penis, scrotum, prostate
Klinfelter has ___ FSH/LH
High, testicles don’t respond to FSH/LH, no testosterone produced
