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Clinical: Emergency Medicine > Endocrinology > Flashcards

Endocrinology Flashcards

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1
Q

what is addisons disease

A

autoimmune or infectious disease of the adrenal gland - decrease in cortisol secretion

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2
Q

what is secondary adrenal insuffiency

A

pituitary adenoma or discontinuation of steroid - pituitary failure

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3
Q

what is the treatment of addisons

A

cortisol replacement therapy + androgen replacement

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4
Q

a 34-year-old female complaining of irritability and nervousness, heat intolerance with increased sweating, and weight loss despite an increase in appetite.
Whats her diagnosis

A

hyperthyroidism

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5
Q

what is graves disease

A

hyperthryoidism
diffuse goiter with a bruit, exopthalmos, pretibial myxedema

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6
Q

what is the presentation of thyroid storm

A

fever, tachycardia and delirium

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7
Q

how is hyperthryoidism diagnosed

A

Decreased TSH
Elevated T4
RAIU studys shows increased uptake in graves and toxic multinodular goiter

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8
Q

what antibody is present with graves

A

anti-thyrotropin antibodies

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9
Q

what antithyroid drug is prefered during pregnancy

A

PTU

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10
Q

a 32-year-old woman comes to the clinic because of new skin markings on her abdomen. Physical exam shows a round face, large purple striae over the abdomen, and several ecchymoses over her trunk, arms, and legs. She describes easy bruising, as well as a significant weakness when she tries to stand up from sitting on the ground. Her 24-hour urine free cortisol is 3 x the upper limit, her late-night serum cortisol is elevated and her plasma ACTH level is < 5 pg/mL.
what is her diagnosis

A

cushings disease

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11
Q

how is cushings diagnosed

A

24hr urine free cortisol
late-night serum cortisol
and/or
low-dose dexamethasone suppression test

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12
Q

what is the treatment of cushings disease

A

transphenoidal selective resection of pituitary tumor

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13
Q

a 28-year-old woman with increased fatigue and a 10-lb weight gain over the last 2 months. She states that she “feels cold” all the time, has decreased energy, and is experiencing worsening constipation. Patient has a tender thyroid, increased TSH, elevated antimicrosomal antibodies, and increased antithyroglobulin antibodies.
What is the patients diagnosis

A

hypothyroidism

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14
Q

what is hashimotos

A

hypothyroidism

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15
Q

what is the lab presentation of hypothyroidism

A

Low T4 and elevated TSH

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16
Q

what is diabetes insipidus

A

caused by a deficiency of or resistance to vasopressin (ADH), which decreases the kidneys’ ability to reabsorb water, resulting in massive polyuria

17
Q

what is central diabetes insipidus

A

Deficiency of ADH from posterior pituitary/hypothalamus
* No ADH production. The most common type is idiopathic, autoimmune destruction of the posterior pituitary from head trauma, brain tumor, infection, or sarcoidosis

18
Q

what is nephrogenic diabetes insipitud

A

Lack of reaction to ADH
* Partial or complete insensitivity to ADH: caused by drugs (Lithium, Amphoterrible), hypercalcemia, and hypokalemia affect the kidney’s ability to concentrate urine, acute tubular necrosis

19
Q

how is diabetes insipidus diagnosed

A

Serum osmolality is high and urine osmolality is low
- water deprivation test
- desmopressin stimulation test

20
Q

what is the treatment of central diabetes insipidus

A

Desmopressin/DDVAP

21
Q

what is the treatment of nephrogenic diabetes insipidus

A

sodium and protein restriction
HCTZ
indomethacin

22
Q

how is T1DM diagnosed

A

random plasma glucose >200 with classic symptoms, or fasting >126 or > on more than one occasion

23
Q

what are side effects of metformin

A

lactic acidosis
GI side effects

24
Q

what are sulfonylurea medications

A

glyburide (diabeta)
glipizide (glucotrol)
glimepiride (amaryl)

25
Q

what are thiazolidinedione medications

A

pioglitazone (actos)
rosiglitazone (avandia)

26
Q

what are DDP-4 inhibitors

A

sitaglipitin (januvia)
saxaglipitin (onglyza)

27
Q

what are SGLT2 Inhibitors

A

canagliflozin

28
Q

what is the MOA of SGLT2 inhibitors

A

lowers renal glucose threshold which results in increased urinary glucose excretion

29
Q

what are side effects of SGLT2 inhibitors

A

vulvovaginal candidiasis
UTI
bone fractures
lower limb amputations
AKI
DKA

30
Q

what is the treament of DKA

A

IV fluids = critical first step
regular insulin
potassium
bicarab in severe acidosis

31
Q

a 37-year-old female with a 2-week history of a painful mass in her neck after having a sore throat and fever for 3 days. The patient reports the mass has slowly been enlarging over that time span and has become more painful to the touch. She also reports feeling hot, even when her coworkers feel cold, and reports loose stools over the past week. The patient’s vital signs are T 98.6F, BP 140/90, Pulse 110 bpm, and SpO2 100%. On exam, you note a diffusely enlarged thyroid that is painful to the touch. Thyroid-stimulating hormone (TSH) is decreased, T4/T3 is elevated, and radioactive iodine uptake and scan at 24 hours reveals an uptake of 3% (normal 8-25%).
What is her diagnosis

A

thyroididits

32
Q

what medications can cause thyroiditis

A

antithryoid medicatons
lithium
amiodarone

33
Q

what is a essential tremor

A

usually presents with a postural tremor of the hands or head that is often worsened by psychic stress; can occur at any age

34
Q

what is the treatment of essentail tremor

A

BB (propranolol)

35
Q

a 33-year-old woman presents to the emergency department due to diffuse pain and fatigue. The woman states that she feels like her bones and muscles diffusely hurt. She also has experienced some abdominal pain as well and states that she has trouble focusing.
what is her diagnosis

A

hyperparathyroidism

36
Q

what is the presentation of hyperparathyroidism

A

Stones, bones, abdominal groans, psych moans, and fatigue overtones

37
Q

what is the treatment of hyperparathyroidism

A

primary - surgical correction
secondary - replace cause

Clinical: Emergency Medicine (13 decks)

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