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0. PANCE Review > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

What two hormones are secreted by the posterior pituitary?

A
  • Oxytocin

- Antidiuretic hormone (ADH, vasopressin)

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2
Q

What is Sheehan’s syndrome?

A

Ischemia of the pituitary due to volume depletion during or after childbirth.

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3
Q

How do glitazones work?

A

They improve insulin sensitivity.

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4
Q

What is the most common pituitary adenoma?

A

Prolactinoma

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5
Q

Large doughy hands should make you think of what diagnosis?

A

Gigantism

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6
Q

Diabetes insipidus is caused by a deficiency of which hormone?

A

Vasopressin

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7
Q

How much more potent is T3 than T4?

A

3-4x

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8
Q

What is the first line medical treatment for a pheochromocytoma?

A
  • Alpha blocker.

You should never use a pure beta blocker.

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9
Q

What is the best imaging for a thyroid nodule?

A

Ultrasound

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10
Q

A patient presents with erectile dysfunction and complains of some numbness in his feet. On second thought he has noticed significant polyuria and polydipsia. What diagnosis should you be thinking of?

A

Diabetic neuropathy

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11
Q

Pretibial myxedema should make you think of what diagnosis?

A

Graves’ disease

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12
Q

A 35 year old female presents with heat intolerance, weight loss and palpitations. What is the most likely diagnosis?

A

Hyperthyroidism

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13
Q

What is the first line medical treatment for a patient who presents with palpitations and nervousness secondary to hyperthyroidism?

A

Beta Blockers

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14
Q

What is Hashimoto’s disease?

A

An autoimmune cause of hypothyroid

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15
Q

How does levothyroxine work?

A

It is a synthetic T4

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16
Q

What is the most common thyroid cancer?

A
  • Papillary

Makes up about 80% of thyroid cancers.

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17
Q

In a patient with hyperthyroidism will TSH most likely be elevated or decreased?

A

Decreased

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18
Q

How do fibrates work to affect the lipid profile?

A

They inhibit synthesis of VLDL and elevate lipoprotein lipase.

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19
Q

What medication might you use prior to thyroidectomy in a patient with hyperthyroidism?

A

Methimazole or propylthiouracil (PTU)

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20
Q

What is included in Whipple’s triad of hypoglycemia?

A
  • Hx of previous hypoglycemia,
  • Serum glucose of <40,
  • Immediate recovery upon administration of glucose
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21
Q

Positive antithyroid peroxidase and antithyroglobulin antibodies should make you think of what diagnosis?

A

Hashimoto’s

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22
Q

What is the treatment for myxedema?

A

Levothyroxine and slow warming

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23
Q

What is the most common cause of hypoparathyroid?

A

Post thyroidectomy with the complication of parathyroidectomy.

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24
Q

What is Chvostek’s sign?

A

Tap on facial nerve and get a twitch with low Ca.

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25
Q

Cortical adrenal insufficiency is also known as what disease?

A

Addison’s Disease

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26
Q

What is Trousseau’s sign?

A

Inflate BP cuff and hold for 3 minutes. Patient with low Ca will get carpel tunnel symptoms.

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27
Q

What is the most common cause of hyperparathyroidism?

A

Single parathyroid adenoma in 80% of cases.

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28
Q

In Cushing’s disease is ACTH elevated or decreased?

A

Elevated

29
Q

What is Graves’ disease?

A
  • The most common cause of hyperthyroidism.

- It is an autoimmune disease.

30
Q

What specific breathing pattern is associated with diabetic ketoacidosis?

A

Kussmaul respirations

31
Q

What is the least aggressive thyroid cancer?

A

Papillary

32
Q

Name two tests you might use to rule out Cushing’s syndrome.

A
  • 24 hour free cortisol urine test &

- Dexamethasone suppression test

33
Q

List two ectopic tumors that may produce ACTH and give a patient Cushing’s syndrome?

A
  • Small cell lung cancer,
  • Pancreatic islet cells,
  • Thymomas
34
Q

What is the treatment for Addison’s disease?

A

Hydrocortisone or prednisone

35
Q

What is the test to begin with if you suspect a pheochromocytoma?

A

24 hour urine for catecholamines

36
Q

Exophthalmos should make you think of what diagnosis?

A

Hyperthyroidism

37
Q

What percentage of diabetes in the US is type 2?

A

80-90%

38
Q

HLA-DR gene is a marker for what endocrine disorder?

A

DM type 1

39
Q

What is the main function of parathyroid hormone?

A

Increase serum Ca

40
Q

List four diagnostic criteria for diabetes?

A
  • Random glucose >200,
  • Fasting glucose >126,
  • Two hour postprandial glucose >200,
  • HgA1c >6.5%
41
Q

Moans,
Groans,
Stones,
Bones

Describe symptoms of what endocrine problem?

A

Hyperparathyroid

42
Q

Stocking glove anesthesia should make you think of what diagnosis?

A
  • Diabetic neuropathy &

- B12 deficiency neuropathy

43
Q

Fruity breath should make you think of what diagnosis?

A

Diabetic ketoacidosis

44
Q

As it relates to diabetics, what is the dawn phenomenon?

A

Reduced insulin response between 5 and 8 am

45
Q

What is the most common cause of hypopituitarism?

A

Tumor

46
Q

How does metformin work?

A

Decreases the hepatic glucose production and increases peripheral glucose uptake

47
Q

How do sulfonylureas work?

A

They stimulate the production of insulin.

48
Q

What class of medications does pioglitazone (Actos) fall into?

A

Thiazolidinediones also known as glitazones

49
Q

What is the suffix associated with sulfonylureas?

A

Ide is the suffix.

Examples:

- Glipizide, 
- Tolbutamide, 
- Tolazamide.
50
Q

Typically what is the first medication started in type 2 DM?

A

Metformin

51
Q

How often should a diabetic’s HgbA1c be checked and what should it be?

A

Every three months (remember the life of an RBC is 90-120 days) and it should be below 6.5%

52
Q

Which lipid medication may cause flushing?

A

Niacin

53
Q

What life threatening side effect do statins have?

A

Rhabdomyolysis

54
Q

Does niacin increase or decrease HDL?

A

Increase

55
Q

What medication class does metformin (Glucophage) fall into?

A

Biguanide

56
Q

List insulins meds?

A

Drug Onset if Action Peak effect Duration

  • Lispro 5-15min 45-75min 2-4hrs,
  • Regular 30min 2hrs 5-8hrs
  • NPH 2hrs 4-12hrs 18-28hrs
  • Glargine 2hrs No peak 20->24hrs
  • Detemir 2hrs 3-9hrs 6-24hrs
  • NPL. 2hrs 6hrs 15hrs
  • Degludec 2hrs No Peak >40hrs
57
Q

Is metformin indicated or contraindicated in renal failure?

A

Contraindicated

58
Q

What is the most common cause of DM type 1?

A

Autoimmune destruction of the islet cells in the pancreas

59
Q

List 4 physical exam findings for Cushing’s syndrome.

A
  • Moon face,
  • Buffalo hump,
  • Purple striae,
  • Central obesity,
  • Supraclavicular fat pads,
  • Easy bruising
60
Q

Propranolol belongs to what class of medication?

A

Beta blockers

61
Q

During pregnancy which is the prefered treatment of hyperthyroidism PTU or methimazole?

A

PTU

62
Q

Name the four thyroid cancers.

A
  • Papillary,
  • Follicular,
  • Medullary,
  • Anaplastic
63
Q

What heparin complication is relevant to endocrinology?

A

Adrenal infarct leading to a Cushing’s syndrome

64
Q

How does nicotinic acid work to affect the lipid profile?

A

It inhibits secretion of VLDL.

65
Q

Hyperpigmentation of the skin along creases shoul

make you think of what diagnosis ?

A

Addison’s disease

66
Q

Which thyroid cancer is the most aggressive?

A

Anaplastic

67
Q

How do statins work to affect the lipid profile?

A

They slow the rate limiting step of cholesterol synthesis.

68
Q

Will ACTH be elevated or decreased in Addison’s disease?

A

Elevated if the problem is at the adrenal glands.

69
Q

What role does C-peptide play in the diagnosis of diabetes?

A

It is a marker of insulin production. Elevated C-peptide points to DM 2. Decreased C-peptide points towards DM 1.

0. PANCE Review (15 decks)

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