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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
Cortical adrenal insufficiency is also known as what disease?
Addison's Disease
26
What is Trousseau's sign?
Inflate BP cuff and hold for 3 minutes. Patient with low Ca will get carpel tunnel symptoms.
27
What is the most common cause of hyperparathyroidism?
Single parathyroid adenoma in 80% of cases.
28
In Cushing’s disease is ACTH elevated or decreased?
Elevated
29
What is Graves' disease?
- The most common cause of hyperthyroidism. | - It is an autoimmune disease.
30
What specific breathing pattern is associated with diabetic ketoacidosis?
Kussmaul respirations
31
What is the least aggressive thyroid cancer?
Papillary
32
Name two tests you might use to rule out Cushing's syndrome.
- 24 hour free cortisol urine test & | - Dexamethasone suppression test
33
List two ectopic tumors that may produce ACTH and give a patient Cushing's syndrome?
- Small cell lung cancer, - Pancreatic islet cells, - Thymomas
34
What is the treatment for Addison's disease?
Hydrocortisone or prednisone
35
What is the test to begin with if you suspect a pheochromocytoma?
24 hour urine for catecholamines
36
Exophthalmos should make you think of what diagnosis?
Hyperthyroidism
37
What percentage of diabetes in the US is type 2?
80-90%
38
HLA-DR gene is a marker for what endocrine disorder?
DM type 1
39
What is the main function of parathyroid hormone?
Increase serum Ca
40
List four diagnostic criteria for diabetes?
- Random glucose >200, - Fasting glucose >126, - Two hour postprandial glucose >200, - HgA1c >6.5%
41
Moans, Groans, Stones, Bones Describe symptoms of what endocrine problem?
Hyperparathyroid
42
Stocking glove anesthesia should make you think of what diagnosis?
- Diabetic neuropathy & | - B12 deficiency neuropathy
43
Fruity breath should make you think of what diagnosis?
Diabetic ketoacidosis
44
As it relates to diabetics, what is the dawn phenomenon?
Reduced insulin response between 5 and 8 am
45
What is the most common cause of hypopituitarism?
Tumor
46
How does metformin work?
Decreases the hepatic glucose production and increases peripheral glucose uptake
47
How do sulfonylureas work?
They stimulate the production of insulin.
48
What class of medications does pioglitazone (Actos) fall into?
Thiazolidinediones also known as glitazones
49
What is the suffix associated with sulfonylureas?
Ide is the suffix. Examples: - Glipizide, - Tolbutamide, - Tolazamide.
50
Typically what is the first medication started in type 2 DM?
Metformin
51
How often should a diabetic's HgbA1c be checked and what should it be?
Every three months (remember the life of an RBC is 90-120 days) and it should be below 6.5%
52
Which lipid medication may cause flushing?
Niacin
53
What life threatening side effect do statins have?
Rhabdomyolysis
54
Does niacin increase or decrease HDL?
Increase
55
What medication class does metformin (Glucophage) fall into?
Biguanide
56
List insulins meds?
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
Is metformin indicated or contraindicated in renal failure?
Contraindicated
58
What is the most common cause of DM type 1?
Autoimmune destruction of the islet cells in the pancreas
59
List 4 physical exam findings for Cushing's syndrome.
- Moon face, - Buffalo hump, - Purple striae, - Central obesity, - Supraclavicular fat pads, - Easy bruising
60
Propranolol belongs to what class of medication?
Beta blockers
61
During pregnancy which is the prefered treatment of hyperthyroidism PTU or methimazole?
PTU
62
Name the four thyroid cancers.
- Papillary, - Follicular, - Medullary, - Anaplastic
63
What heparin complication is relevant to endocrinology?
Adrenal infarct leading to a Cushing's syndrome
64
How does nicotinic acid work to affect the lipid profile?
It inhibits secretion of VLDL.
65
Hyperpigmentation of the skin along creases shoul | make you think of what diagnosis ?
Addison's disease
66
Which thyroid cancer is the most aggressive?
Anaplastic
67
How do statins work to affect the lipid profile?
They slow the rate limiting step of cholesterol synthesis.
68
Will ACTH be elevated or decreased in Addison's disease?
Elevated if the problem is at the adrenal glands.
69
What role does C-peptide play in the diagnosis of diabetes?
It is a marker of insulin production. Elevated C-peptide points to DM 2. Decreased C-peptide points towards DM 1.

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