Endocrinology Flashcards
what is addisons disease
autoimmune or infectious disease of the adrenal gland - decrease in cortisol secretion
what is secondary adrenal insuffiency
pituitary adenoma or discontinuation of steroid - pituitary failure
what is the treatment of addisons
cortisol replacement therapy + androgen replacement
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
hyperthyroidism
what is graves disease
hyperthryoidism
diffuse goiter with a bruit, exopthalmos, pretibial myxedema
what is the presentation of thyroid storm
fever, tachycardia and delirium
how is hyperthryoidism diagnosed
Decreased TSH
Elevated T4
RAIU studys shows increased uptake in graves and toxic multinodular goiter
what antibody is present with graves
anti-thyrotropin antibodies
what antithyroid drug is prefered during pregnancy
PTU
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
cushings disease
how is cushings diagnosed
24hr urine free cortisol
late-night serum cortisol
and/or
low-dose dexamethasone suppression test
what is the treatment of cushings disease
transphenoidal selective resection of pituitary tumor
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
hypothyroidism
what is hashimotos
hypothyroidism
what is the lab presentation of hypothyroidism
Low T4 and elevated TSH
what is diabetes insipidus
caused by a deficiency of or resistance to vasopressin (ADH), which decreases the kidneys’ ability to reabsorb water, resulting in massive polyuria
what is central diabetes insipidus
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
what is nephrogenic diabetes insipitud
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
how is diabetes insipidus diagnosed
Serum osmolality is high and urine osmolality is low
- water deprivation test
- desmopressin stimulation test
what is the treatment of central diabetes insipidus
Desmopressin/DDVAP
what is the treatment of nephrogenic diabetes insipidus
sodium and protein restriction
HCTZ
indomethacin
how is T1DM diagnosed
random plasma glucose >200 with classic symptoms, or fasting >126 or > on more than one occasion
what are side effects of metformin
lactic acidosis
GI side effects
what are sulfonylurea medications
glyburide (diabeta)
glipizide (glucotrol)
glimepiride (amaryl)
what are thiazolidinedione medications
pioglitazone (actos)
rosiglitazone (avandia)
what are DDP-4 inhibitors
sitaglipitin (januvia)
saxaglipitin (onglyza)
what are SGLT2 Inhibitors
canagliflozin
what is the MOA of SGLT2 inhibitors
lowers renal glucose threshold which results in increased urinary glucose excretion
what are side effects of SGLT2 inhibitors
vulvovaginal candidiasis
UTI
bone fractures
lower limb amputations
AKI
DKA
what is the treament of DKA
IV fluids = critical first step
regular insulin
potassium
bicarab in severe acidosis
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
thyroididits
what medications can cause thyroiditis
antithryoid medicatons
lithium
amiodarone
what is a essential tremor
usually presents with a postural tremor of the hands or head that is often worsened by psychic stress; can occur at any age
what is the treatment of essentail tremor
BB (propranolol)
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
hyperparathyroidism
what is the presentation of hyperparathyroidism
Stones, bones, abdominal groans, psych moans, and fatigue overtones
what is the treatment of hyperparathyroidism
primary - surgical correction
secondary - replace cause
