Endocrinology Flashcards
Etiology of adrenal insufficiency
autoimmune
s/s of adrenal insufficiency
-skin hyperpigmentation
-weight loss
-fatigue
-abdominal pain
-change in body hair
-amenorrhea
Diagnosis of adrenal insufficiency
acth stimulation test
what imbalances does addison’s disease cause (-Na, -K, -glycemia)
hyponatremia
hyperkalemia
hypoglycemia
Treatment of adrenal insufficiency
hydrocortisone
What is the MC pathophysiology for Cushing’s Syndrome?
exogenous steroid or hypercortisolism from ACTH-secreting pituitary tumor
s/s of Cushing’s disease
-central obesity
-buffalo hump
-purple striae
-hirsutism
-hypertension
diagnosis of Cushing’s disease
-Dexamethasone suppression test
-24 hour free cortisol
-Serum ACTH
treatment of cushing’s disease
treat underlying condition
What is the MCC of hyperthyroidism
Grave’s disease
(autoimmune, against TSH receptors)
S/S of hyperthyroidism
-palpitations
-Heat intolerance
-increase HR
-weight loss
-exophthalmos
-goiter
Diagnosis of hyperthyroidism
Low TSH, high T3 and T4
Tx of hyperthyroidism
-methimazole
-PTU
PTU if Pregnant
MCC of hypothyroidism
Hashimoto’s thyroiditis
S/S of hypothryoidism
-fatigue
-weight gain
-cold
-hair loss
PE of Hypothyroidism
periorbital edema, dry skin, thin eyebrows
Dx of hypothryoidism
low T4, high TSH
Tx of hypothyroidism
synthroid (Levothyroixine)
Hashimoto’s is a risk factor for which lymphoma?
non-Hodgkin lymphoma
S/S of diabetes
polyuria, polydipsia, polyphagia
ADA diagnostic criteria for DM2
Symptoms plus 1 of the following:
Random plasma glucose of > 200 mg/dL
Fasting plasma glucose of >126 mg/dL on 2 separate occasions
Glycated hemoglobin (A1C) of >6.5%
Plasma glucose of >200 mg/dL two hours after a 75 g glucose load during an oral glucose tolerance test
fasting glucose levels
normal: <100
prediabetes: 100-125
diabetes: >126
A1C levels
normal: <5.6
prediabetes: 5.7-6.4
diabetes: 6.5 or higher
Which diabetic medications cause hypoglycemia?
Meglitinides (Repaglinide, Nateglinide)
Insulin (Regular, Lispro, Aspart, NPH, Glargine)
Sulfonyureas (glyburide, glipizide)
vaccines recommended for DM patients
flu
pneumonia
covid
hep b
Dawn phenomenon
nocturnal release of counter regulatory hormones increase glucose levels
somogyi effect
patient takes too much insulin before bed and becomes hypoglycemic at night and body compensates with hormones
how to tell difference between dawn phenomenon and somogyi effect
both present as hyperglycemia in the morning (fasting glucose readings)
due to body’s natural response to fasting overnight-hormones (epinephrine/cortisol) inc glucose: dawn
D/t excess amounts of exogenous inslulin with evening dose: dawn
Treatment of Dawn Phenomenon
increase evening dose of insulin
treatment of somogyi effect
decrease evening dose of insulin
MOA of metformin
inhibits hepatic gluconeogenesis
s/s of DKA
-acetone smell
-kussmaul respirations
-hypotension and tachycardia
-n/v
-abdominal pain
Tx of DKA
-fluids first
-then insulin
-check K
s/s of HHS (Hyperosmolar hyperglycemic state)
-hypotension
-tachycardia
-t2DM
-Suuuuuuuper high glucose
tx of HHS
-fluids first
-then insulin
