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Misc Boards Review > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Myxedema Coma
Symptoms?
Medications that can cause?
Tx?

A
  • Low body temp, swelling, confusion, difficulty breathing
  • Lithium, Amiodarone
  • IV T4
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2
Q

Synthroid major side effects? Caution in who?

A
  • Cardiac
  • Elderly and those with heart disease (need 12.5 starting dose)
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3
Q

When to recheck thyroid levels with Synthroid?

A
  • Every 4-8 weeks until therapeutic then q6-12 months
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4
Q

Synthroid not well absorbed if taken with what?
LT risks of what?

A
  • Biotin (vitamin B7)
  • Osteoporosis
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5
Q

Medication for normal TSH/T4 but a low T3?

A
  • Triostat
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6
Q

Causes of Hyperthyroidism?

A
  • Grave’s, excess iodine, thyroiditis
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7
Q

Treatment of hyperthyroidism? 1st? 2nd? 3rd?

A
  • 1st line: Radioactive iodine
  • 2nd: Thyroidectomy
  • 3rd: Tapazole or PTU (remissions and relapses)
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8
Q

PTU needs what labs? How often to take? SE? Pregnancy?

A
  • CBC
  • TID
  • Agranulocytosis -> decreased WBC
  • Need to take during first trimester 0-13wk
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9
Q

Subclinical hypothyroidism tx

A
  • Monitor every 6 months
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10
Q

Hyperparathyroid labs vs. Hypoparathyroid

A
  • HyPER: HIGH calcium, LOW phos
  • HyPO: LOW calcium, high phosphorus
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11
Q

High calcium concern for what?

A
  • Malignancy
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12
Q

Hypoparathyroidism treatment

A
  • Calcium and vitamin D so the body can absorb the calcium
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13
Q

Somogyi Effect
What is it?
Tx? (3)

A
  • Dip in the middle of the night (3am) with rebound rise
  • Tx: Cutting back night time insulin, have night time snack, avoid exercise before bed
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13
Q

Dawn Phenomenon- what is it? Typical cause?

A
  • Glucose steadily increases all night
  • Cause: Increased hormones (GH/cortisol/epi)
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14
Q

When to start DM screening in healthy adults? When to Repeat?

How often to check A1C in controlled DM?

A
  • Healthy: Age 45 and repeat every 3 years
  • every 6 months
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15
Q

Name the Med endings: SGLT2, Sulfonyurea, TZD, GLP1, DPP4

A
  • SGLT2- Flozin
  • Tide- GLP1
  • Zone - TZD
  • Gliptan – DPP4
  • Ide - Sulfonyurea
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16
Q

What meds need stopped if starting insulin d/t risk of hypoglycemia?

A
  • Sulfonylureas and TZD’s
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17
Q

Side Effects Sulfonylureas? Don’t give to who?

A
  • Hypoglycemia and weight gain
  • Bad for older adults d/t risk of falls
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18
Q

What DM meds are contraindicated in symptomatic HF d/t fluid retention and edema?

A
  • TZDs
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19
Q

What DM meds are contraindicated in liver failure?

A
  • TZDs
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20
Q

What A1C to start dual therapy and insulin?

A
  • A1C > 9
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21
Q

How does metformin work? (2)

A
  • Decrease glucose production in the liver (hepatic gluconeogenesis)
  • Decreases glucose uptake in the intestines
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22
Q

Positive DM screening tests for DM (A1C, FBG, OGTT, RPG)

A
  • A1C>6.5
  • Fasting blood glucose > 125
  • 2hr OGTT > 200
  • RPG>200 with symptoms
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23
Q

Avoid metformin for which 2 groups? Check what before starting?

A
  • Alcoholics
  • Liver failure
  • Renal function
24
How do SGLT2 Inhibitors work?
- Pee out all the glucose
25
What do TZDs do? Contraindicated in who?
- Lower insulin resistance - Heart & liver failure
26
How do DPP4s work? Affect weight? Avoid with?
- Increase insulin production, decrease glucagon secretion - weight neutral or loss - hx pancreatitis
27
Alpha glucoside – Meds? How to take? What if hypoglycemic?
- Miglitol, acarbose - Take with first bite of food - Need glucose tabs if low
28
How do GLP1s work? Avoid with who? (2)
- Delay gastric emptying - Avoid with pancreatitis and thyroid CA
28
Yearly screening for DM?
- Microalbumin urine – check for nephropathy
29
Do DM patients need daily aspirin?
- Yes if they are at increased risk of heart disease
30
What is happening in Addison’s disease? Risk factor?
- Not enough cortisol - Chronic steroid use
31
Symptoms of Addison’s? Labs we see?
- Low BP, weight, temp, hair, mood, energy, amenorrhea, low BS - Labs: Everything low except K (hyper P for double D)
32
How to administer steroids in Addison’s? When to take even more?
- Majority in the morning and smaller dose at bedtime (mimic normal body) - When stressed or sick
33
Symptoms of Cushings? Labs we see?
- Big, round, hairy, big red face, big infections, broken bones, moon face - Everything is HIGH except for potassium
34
How is SLE diagnosed?
- 4/11 criteria: malar rash, discoid rash, photosensitivity, oral/nasal ulcers, non-erosive arthritis, cardiopulmonary complaints, renal complains, neurological/renal/immune/hematologic concerns, +ANA
35
SLE Symptoms
- Fatigue and joint pain that comes and goes, fever, brain fog
36
Complication of SLE? Look out for what? Routine what?
- Lupus nephritis – antibodies kill the kidneys - Look out for glomerulonephritis and proteinuria - Routine UA
37
Onset time: Rapid Short/Regular NPH Long
- Rapid: 15min - Short/Regular: 30min-1hr - NPH: 1-2hr - Long: 2 hr
38
Peak Time: Rapid Short NPH Long
- Rapid: 1hr - Short/Regular: 2-4hr - NPH: 6-12 - Long: none
39
Duration Time: Rapid Short/Regular NPH Long
- Rapid: 2-4hr - Short: 6-8hr - NPH: 24hr - Long: 24hr
40
Sjogren’s closely related to what condition?
SLE
41
SLE most common in who? Which populations?
- Women of childbearing age 15-45 - High risk in Black, Asian, Latina
42
Do we diagnose lupus?
- No refer to rheumatology
43
Cheapest insulin? Oral?
- NPH - metformin
44
What does ACTH test for?
- Adrenal insufficiency with Addison’s Disease
45
Cushing’s Diagnostic tests
- Dexamethasone suppression test - Serum plasma cortisol level - 24hr urinary free cortisol
46
Lab to check before stating statin?
LFTs
47
What are the 5 criteria for metabolic syndrome?
- Waist >35in women and >40in men - Fasting glucose >100 - Trig > 150 - HDL <40 men, <50 women - BP >130/85
48
What to do for insulin dependent patient with BS spikes between meals?
- Add mealtime novolog
49
What do we base long acting insulin dosing on?
- The patient’s morning fasting glucose levels
50
Avoid what heart medication long term in thyroid disease?
Amiodarone
51
Synthroid increases risk for what?
- Osteoporosis
52
Untreated Addisonian crisis can lead to what? Keep what with them?
- Severe hypotension and organ failure - IM steroids
53
Symptoms of hyperparathyroidism
Decreased appetite, N/V/C Muscle weakness, bone pain Fatigue
54
Most common cause of Cushing’s?
- Pituitary tumor
55
Complications of radioactive iodine?
- Bone marrow suppression, infertility, swollen salivary glands
56
How do sulfonyureas work?
Stimulate pancreas to make more insulin

Misc Boards Review (19 decks)

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