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Physician Assistant Exam > Endocrinology > Flashcards

Endocrinology Flashcards

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2
Q

What two hormones are produced in the posterior pituitary?

A

Oxytocin and antidiuretic hormone (ADH, vasopressin)

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3
Q

What role does c-peptide play in the diagnosis of diabetes?

A

It is a marker of insulin production. Elevated C-peptide points to DM 2. Decreased c-peptide points towards DM 1

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4
Q

How do fibrates work to affect the lipid profile?

A

They inhibit synthesis of VLDL and elevate lipoprotein lipase

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5
Q

How do statins work to affect the lipid profile?

A

They slow the rate limiting step of cholesterol synthesis

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6
Q

How does nicotinic acid work to affect the lipid profile?

A

It inhibits secretion of VLDL

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7
Q

What heparin complication is relevant to endocrinology?

A

Adrenal infarct leading to a cushing’s syndrome

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8
Q

During pregnancy which is the prefered treatment of hyperthyroidism PTU or methimazole?

A

PTU

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9
Q

Propranolol belongs to what class of medication?

A

Beta blockers

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10
Q

Is metformin indicated or contraindicated in renal failure?

A

Contraindicated

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11
Q

List the 5 Insulines in order of peak efficacy?

A

Lispro 1-2 hrs, Regular 2-4 hrs, NPH 5-7 hrs, Lente 4-8 hrs, UltraLente 8-14 hrs

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12
Q

What medication class does metformin (glucophage) fall into?

A

Biguanide

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13
Q

Does niacin increase or decrease HDL?

A

Increase

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14
Q

What life threatening side effect do statins have?

A

Rhabdomyolysis

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15
Q

Which lipid medication may cause flushing?

A

Niacin

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16
Q

What class of medications is the first line for lowering LDL?

A

Statins

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17
Q

What are the 5 criteria for Metabolic syndrome?

A

HDL 135/85, Triglycerides >150, Fasting glucose > 100, Waist > 40 inches in men > 35 inches in women

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18
Q

What is included in Whipple’s triad of hypoglycemia?

A

History of previous hypoglycemia, serum glucose of < 40, immediate recovery upon administration of glucose

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19
Q

How often should a diabetic’s HgbA1C be checked and what should it be?

A

Every three months (remember the life a RBC is 90-120 days) and it should be below 6.5%

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20
Q

Typically what is the first medication started in type 2 DM?

A

Metformin

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21
Q

What is the suffix associated with sulfonylureas?

A

ide, glipizide, Tolbutamide,Tolazamide

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22
Q

What class of medications does pioglitazone (Actos) fall into?

A

Thiazolidinediones also known as glitazones

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23
Q

How do glitazones work?

A

They improve insulin sensitivity

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24
Q

How do sulfonylureas medications work?

A

They stimulate the production of insulin

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25
Q

How does metformin work?

A

Decreases the hepatic glucose production and increases peripheral glucose uptake

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26
As it relates to diabetics, what is the dawn phenomenon?
Reduced insulin response between 5 and 8 am
27
What specific breathing pattern is associated with diabetic ketoacidosis?
Kussmaul respirations
28
Fruity breath should make you think of what diagnosis?
Diabetic Ketoacidosis
29
Patient presents with erectile dysfunction and complains of some numbness in his feet. On second thought he has noticed significant polyuria and polydipsia. What diagnosis should you be thinking of?
Diabetic neuropathy
30
Stocking glove should make you think of what diagnosis?
Diabetic neuropathy and B12 deficiency neuropathy
31
List four diagnostic criteria for diabetes?
Random glucose > 200, fasting plasma > 126, two hour postprandial glucose > 200, HgA1c > 6.5%
32
HLA-DR gene is a marker for what endocrine disorder?
DM type 1
33
What is the most common cause of DM type 1?
Autoimmune destruction of the islet cells in the pancreas
34
What percentage of diabetes in the US is type 2?
80-90%
35
What is the first first line medical treatment for pheochromocytoma?
Beta blockers
36
What is the test to begin with if you suspect pheochromocytoma?
24 hour urine for catecholamines
37
What is the treatment for Addison's disease?
Hydrocortisone or prednisone
38
Will ACTH be elevated or decreased in Addison's disease?
Elevated if the problem is at the adrenal glands
39
Hyperpigmentation of the skin along creases should make you think of what diagnosis ?
Addison's disease
40
Cortical adrenal insufficiency is also known as what disease?
Addison's disease
41
List two ectopic tumors that may produce ACTH and give a patient Cushing's syndrome?
Small cell lung cancer, pancreatic islet cells, thymomas
42
Name two tests you might use to rule out Cushing's syndrome.
24 hour free cortisol urine test and dexamethasone suppression test
43
List 4 physical exam findings for Cushing's syndrome.
Moon face, buffalo hump, purple strai, central obesity, supraclavicular fat pads, easy bruising
44
Is Cushing's syndrome an elevated or decreased ACTH?
Elevated
45
Moans, groans, stones and bones describe symptoms of what endocrine problem?
Hyperparathyroid
46
What is the most common cause of hyperparathyroidism?
Single parathyroid adenoma in 80% of cases.
47
What is Trousseau's sign?
Inflate BP cuff and hold for 3 minutes. Patient with low Ca will get carpel tunnel symptoms.
48
What is Chvostek's sign?
Tap on facial nerve and get a twich with low Ca
49
What is the most common cause of hypoparathyroid?
Post thyroidectomy with the complication of parathyroidectomy
50
What is the main function of parathyroid hormone?
Increase serum Ca
51
What is the treatment for myxedema?
Levothyroxine and slow warming
52
Positive antithyroid peroxidase and antithyroglobulin antibodies should make you think of what diagnosis ?
Hashimoto's
53
What medication might you use prior to thyroidectomy in a patient with hyperthyroidism?
Methimazole or propylthiouracil (PTU)
54
In a patient with hyperthyroidism will TSH most likely be elevated or decreased?
Decreased
55
Which thyroid cancer is the most aggressive?
Anaplastic
56
Name the four thyroid cancers.
Papillary, Follicular, Medullary, Anaplastic
57
What is the least aggressive thyroid cancer?
Papillary
58
What is the most common thyroid cancer?
Papillary makes up about 80% of thyroid cancers
59
How does levothyroxine work?
It helps convert T4 to T3
60
What is Hashimoto's disease?
An autoimmune cause of hypothyroid
61
What is the first line medical treatment for a patient who presents with palpitations and nervousness secondary to hyperthyroidism?
Beta Blockers
62
What is Graves' disease?
The most common cause of hyperthyroidism. It is an autoimmune disease.
63
A 35 year old female presents with heat intolerance, weight loss and palpitations. What diagnosis should you be thinking of?
Hyperthyroidism
64
Pretibial myxedema should make you think of what diagnosis?
Graves' disease
65
Exophthalmos should make you think of what diagnosis?
Hyperthyroidism
66
What is the best imaging for a thyroid nodule?
Ultrasound
67
How much more potent is T3 than T4?
3-4x
68
Diabetes insipidus is caused by a deficiency of which hormone?
Vasopressin
69
Large doughy hands should make you think of what diagnosis?
Gigantism
70
What is the most common pituitary adenoma?
Prolactinoma
71
What is Sheehan's syndrome?
Ischemia of the pituitary due to volume depletion during or after childbirth
72
What is the most common cause of hypopituitarism?
Tumor

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