Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Rotation 1: Pediatrics > Endocrinology (3%) > Flashcards

Endocrinology (3%) Flashcards

1
Q

What is the development of DM during pregnancy called?

A

Gestational DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some examples of Alpha Glucosidase Inhibitors?

A

Acarbose, Miglitol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What will be seen on ECG of a pt with hypercalcemia?

A

Shortened QT interval, prolonged PR interval, QRS widening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hyperglycemia is observed in both DKA and HHS with sx such as….

With sx of ______ seen in pts with DKA and ______ in pts with HHS

A

thirst, polyuria, polydipsia, nocturia, weakness, fatigue, confusion, nausea, vomiting, CP

abd pain: DKA

mental status changes: HHS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the tx goals for DKA?

HHS?

A

Closing of the anion gap in DKA

Normal mental status in HHS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

_____ and _____ are results of INSULIN DEFICIENCY and counterregulatory hormonal excess in diabetics as a direct response to stressful triggers (most commonly ______)

A

DKA and HHS

infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Lab values that indicate DKA?

HHS?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the HPT (hypothalamus, pituitary, thyroid) axis

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What medications can cause hypothyroidism?

A

Amiodarone (contains iodine)

Lithium

Alpha interferon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the dawn phenomenon?

Management?

A

Normal glucose until rise in serum glucose levels between 2am - 8 am

Results from decreased insulin sensitivity and nightly surge of counter regulatory hormones (during nighttime fasting)

Management: bedtime injxn of NPH, avoiding carb heacy snacks before bed, insulin pump use early in the AM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is HHS?

How is it different from DKA?

A

Hyperosmolar hyperglycemic state (HHS) is a complication of DM in which high blood sugar results in high osmolarity w/o significant ketoacidosis

Sx include signs of dehydration, weakness, legs cramps, trouble seeing, and an altered level of consciousness

Differences: see picture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some examples of Thiazolidinediones?

A

Pioglitazone, Rosiglitazone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some examples of SGLT-2 Inhibitors?

A

Canagliflozin, Dapagliflozin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Cretinism?

What would a pt with this condition present with?

How to tx?

A

Congenital hypothyroidism due to maternal hypothyroidism or infant hypopituitarism

Macroglossia, hoarse cry, coarse facial features, umbilical hernia, weight gain

Mental development abnormalities may all develop if not corrected

Thyroid hormone replacement: Levothyroxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

_______ is the most common cause of end stage renal dz

A

DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tx for mild hypercalcemia?

Tx for severe/sx hypercalcemia?

A

No tx for mild

Sx: IV saline, Furosemide 1st line, avoid HCTZ (causes increased calcium), Calcitonin, bisphophonates for severe cases, steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are possible causes of hypercalcemia that are not related to the parathyroid gland?

A

Malignancy (secretes PTH-related protein), decreased amounts of intact PTH

Vit D excess (granulomatous dz, vit intoxication)

Vit A excess, milk alkali syndrome

Thiazides

Lithium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Will Free T3 and Free T4 be elevated or low in hyperthyroidism?

Hypothyroidism?

A

Elevated in Hyperthyroidism

Low in Hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are some examples of pre mixed insulins?

A

Humulin 7/30

Novolin 70/30

Novolog 70/30

Humulin 50/50

<em>administered 2x daily before meals</em>

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are potential risk factors for developing Type II DM?

What does CHAOS stand for?

A

H/o impaired glucose tolerance, FHx, 1° relative, Hispanic, African American, Pacific Islander, HTN, HLD, delivery of baby >9lbs

Syndrome X/insulin resistance: CHAOS –> Chronic HTN, Atherosclerosis, Obesity (central), Stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the triad of hyperparathyroidism?

A

Increased calcium

Increased intact PTH

Decreased phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why are pts with DM at an increased risk of infections?

A

D/t vascular insufficiency and immunosuppresion from hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are some examples of DPP-4 Inhibitors?

A

Sitagliptin, Linagliptin, Saxagliptin

24
Q

What are some examples of Meglitinides?

A

Repaglinide, Nateglinide

25
Q

What are classic sx of pts with Type I DM?

A

polyuria, polydipsia, polyphagia, weight loss

Diabetic ketoacidosis, HHS

26
Q

What are some examples of Biguanides?

A

Metformin

27
Q

What two findings on PE are pathognomonic for DKA?

A

KETOTIC BREATH (fruity with acetone smell) & KUSSMAUL RSESPIRATIONS (deep and labored)

28
Q

90% of cases of hypercalcemia are due to ________ or _______

A

primary hyperparathyroidism

malignancy

29
Q

What will TSH levels be in Hyperthyroidism?

Hypothyroidism?

A

Low in Hyperthyroidism

High in Hypothyroidism

30
Q

What are some examples of Sulfonylureas?

A

Glipizide, Glyburide, Glimepiride

31
Q

What is the recommended managment for and goals of DM?

A

Diet, exercise, lifestyle changes: should be tried first in Type II DM

  • ± insulin if unable to control glucose with trial of diet, exercise, lifestyle changes, meds

Insulin therapy initiated in Type I DM

Insulin preferred for glucose control in gestational DM

Glucose control: Hgb A1c <7.0%

Lipid control: LDL<100; HDL 40; TG<150

Neuropathy: Gabapentin, ±TCAs, Foot care (wide, loose-fitting shoes, nail trimming, podiatrist monitoring at least yearly)

Retinopathy: DM control, laser photocoagulation tx, Bevacizumab (proliferative), Vitrectomy, Yearly eye screening by an ophthalmologist

Nephropathy: DM control, ACE Inhibitors if microalbuminuria, Low sodium diet, yearly screening for microalbuminemia, yearly checks of BUN & creatinine

32
Q

What are some examples of GLP-1 Agonists?

A

Exenatide, Liraglutide

33
Q

Most pts with hypercalcemia are asymptomatic, but if sx may present with…

A

STONES, BONES, ABD GROANS, PSYCHIC MOANS

kidney stones, polyuria, painful bones, fxs (d/t bone remodeling increase), ileus, constipation, decreased DTRs

34
Q

What is a normal fasting blood glucose level?

A

70-100 mg/dL

35
Q

______: younger pts with type I DM

______: usually older w/ T2DM (higher mortality)

A

DKA

HHS

36
Q

Dx of hypoglycemia: Random blood sugar ____-____ mg/dL

Sx occur at ____ mg/dL

Brain dysfunction begins at ____ mg/dL

A

50-60 mg/dL

60

50

37
Q

What results on each of the following tests will help make the dx of DM in a pt?

Fasting plasma glucose

2 hour glucose tolerance test

Hemoglobin A1c

Random plasma

A

Fasting plasma glucose: >/= 126

2 hour glucose tolerance test: >/= 200

Hemoglobin A1c: >/= 6.5%

Random plasma: >/= 200

38
Q

What four things are recommended for management of DKA and HHS?

A
  1. IV FLUIDS: Critical 1st step
  2. INSULIN (REGULAR)
  3. POTASSIUM: (1st verify renal output) Despite serum K levels, patient is always total body potassium deficient

<em>Correction of DKA invariably will cause hypokalemia</em>

  1. Bicarbonate: only in severe acidosis (especially since the acidosis usually resolves w/ IV fluids & insulin)

<em>Associated w/ many complications (ex. increased rate of cerebral edema)</em>

39
Q

Tx for hypothyroidism?

A

Levothyroxine

40
Q

What are some examples of hypothyroid d/o?

A

Hashimoto’s

Silent (lymphocytic) thyroiditis

Postpartum thyroiditis

deQuervain’s Thyroiditis

Medicaiton induced

Acute thyroiditis

Riedel’s thyroiditis

41
Q

What are some examples of hyperthyroid d/o?

A

Grave’s Dz

Toxic multinodular goiter

Toxic adenoma

TSH Secreting pituitary adenoma

42
Q

What is the somogyi effect?

Management?

A

Nocturnal hypoglycemia followed by rebound hyperglycemia (due to surge in growth hormone)

MANAGEMENT: prevent hypoglycemia by decreasing nighttime NPH dose or give bedtime snack

43
Q

What are potential complications of DM?

A

Neuropathy: “stocking glove”, orthostatic hypotension, CN III palsy w/ nml pupil size

Retinopathy: cotton wool spots, hard exudates, neovascularization, central vision loss

Nephropathy: microalbuminuria, kimmelstiel wilson on kidney bx (condition associated w/ long-standing DM that affects the network of tiny blood vessels in the glomerulus, which is critically necessary for the filtration of the blood –> “nodular glomerulosclerosis”)

Macrovascular: CAD

44
Q

Toxic multinodular goiter, Grave’s, toxic adenoma, or normal RAIU?

A

A. Normal

B. Grave’s

C. Toxic multinodular goiter

D. Toxic adenoma

45
Q

The MC cause of hypothyroidism in the US…

The MC cause of hypothyroidism worldwide is…

A

Hashimoto’s thyroiditis

iodine deficiency

46
Q

What are some examples of Rapid Acting Insulins?

Short Acting?

Intermediate?

Long Acting?

A

Rapid: Lispro (humalog), Aspart (Novolog)

Short: Regular (Humulin-R)

Intermediate: NPH (Humulin N, Novolin N), Lente (Humulin L, Novolin L)

Long: Detemir (Levemir), Glargine (Lantus)

47
Q

How to tell the difference between DKA and HHS?

A

DKA: Ketoacidosis

HHS: higher severity of hyperglycemia

48
Q

Describe the pathophysiology of HHS

A

Usually occurs in pts with type 2 DM w/ some illness leading to reduced fluid intake (MC infection)

dehydration, increased osmolarity, hyperglycemia

potassium deficit

absence of severe ketosis (Type II DM make enough insulin to prevent ketogenesis usually)

49
Q

______ thyroiditis = fibrous thyroid

A

Riedel’s thyroiditis

50
Q

Describe the pathophysiology of DKA

A

Insulin deficiency

hyperglycemia

dehydration

ketonemia (high anion gap metabolic acidosis)

potassium deficit

Usually occurs in Type I (may occur in some type 11).

51
Q

_______ is a complication of the management of DM

A

Hypoglycemia

usually d/t too much insulin use, too little food, or excess exercise

52
Q

What condition is described below?

Caused by pancreatic beta cell destruction (pt no longer able to produce insulin)

Most commonly presents in children/young adults (onset usually <30y)

Type 1A autoimmune beta cell destruction triggered by 1+ environmental factors

Type 1B: non-autoimmune beta cell destruction

A

Type 1 DM

53
Q

Which type of hypothyroidism occurs post-virally?

A

deQuervain’s thyroiditis

54
Q

What condition is described below?

Combo of insulin resistance and relative impairment of insulin secretion

Etiology likely due to genetic and environmental factors: especially weight gain and decreased physical activity

90% of pts are overweight

MC >40y/o

A

Type II DM

55
Q

Tx for Grave’s?

Tx for Toxic multinodular goiter?

Tx for toxic adenoma?

Tx for pituitary adenoma?

A

Grave’s: Radioactive iodine, Methimazole, Propylthiouracil, BB for sx relief

TMG and TA: Radioactive iodine, Methimazole, PTU, BB for sx

Pituitary adenoma: Transspenoidal surgery to remove

Rotation 1: Pediatrics (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions