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Step 2 Study > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Panhypopituitarism

A

Compression or damage of the pituitary gland.

Caused by tumors, cancers, adenomas, cysts, meningiomas, craniopharyngionas, or lymphoma

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2
Q

Panhypopituitarism causes

A 
hemochromatosis
sarcoidosis
histiocytosis X
infection with fungi, TB, parasites
Autoimmune and lymphocytic  infiltration damages gland
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3
Q

Prolactin def presentation

A

male: no symptoms
female: patient cannot lactate normally after childbirth

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4
Q

LH and FSH deficiency presentation

A

decreased libido, decreased axillary, pubic, body hair

men: no testosterone or sperm & erectile dysfunction
women: unable to ovulate or menstruate normally and become amenorrheric

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5
Q

GH deficiency presentation

A

children: dwarfism

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6
Q

Kallman syndrome

A

decreased FSH, LH, GnRH

and anosmia

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7
Q

Diabetes Insipidus

A

decreased in the amount of ADH from pituitary (central DI) or its effect on kidney (nephrogenic DI)

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8
Q

Central Diabetes Insipidus

A

Damage to the brain

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9
Q

Nephrogenic Diabetes Insipidus

A 
Chronic pyelonephritis
Amyloidosis
Myeloma
Sickle cell disease
Lithium
Hypercalcemia or hypokalemia inhibits ADH effects
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10
Q

Central DI Tx

A

Vasopressin

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11
Q

Nephrogenic DI Tx

A

Correct the cause (hypokalemia or hypercalcemia)

HCTZ, NSAIDs, amiloride

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12
Q

Acromegaly

A

soft tissue overgrowth throughout the body

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13
Q 
increased hat, ring, and shoe size
carpal tunnel
body odor
deep voice
colonic polyps
arthralgias
hypertension
Cardiomegaly, CHF,  erectile dysfunction
A

Acromegaly
pts are hyperglycemic, glucose intolerant, hyperlipidemia

Best initial test: IGF
Most accurate test: glucose suppression test
MIR: after lab values

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14
Q

Acromegaly treatment

A

transphenoidal resection of pituitary
Meds:
cabergoline (dopamine agonists inhibit GH release)
octreotide or lanreotide (somatostatins inhibit GH)
Pevisomant

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15
Q

Hyperprolactinemia

A

pregnancy, chest wall stimulation, cutting pituitary stalk, antipsych, TCA, SSRI, methyldopa, metoclopromide, opioids,
Cosecretion with GH, hypothyroidism with pathologically high TRH levels

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16
Q

Hyperpolactinemia tests

A

Thyroid function tests
Pregnancy tests
BUN/creatinine
Liver function tests

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17
Q

Hyperprolactinemia treatment

A

Dopamine agonists

cabergoline is better than bromocriptine

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18
Q

Hypothyroidism

A

Bradycardia, constipation, weight gain, fatigue lethargy, coma, decreased reflexes, cold intolerance, hypothermia (hair loss, edema)

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19
Q

Hyperthyroidism

A

Tachycardia, palpitations, arrhythmia, diarrhea, weight loss, anxiety, nervousness, restlessness, hyperreflexia, heat intolerance, fever

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20
Q

Hypothyroid tests

treatment?

A

T4 and TSH

synthroid

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21
Q

Hyperthyroidism all have

A

elevated T4 levels

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22
Q

TSH level in hyperthyroidism is

A

elevated in pituitary adenoma

inhibited in other forms

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23
Q

Graves Ophthalmopathy

A

Tx: with steroids

decompressive surgery

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24
Q

Subacture thyroiditis tx

A

painful nodular

treat with aspirin

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25
Q

Pitutary adenoma

tx

A

surgery

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26
Q

Thyroid storm

A 
Propanolol
Thiourea drugs
Iodinated contrast material
Steroids
Radioactive iodine
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27
Q

Normal TSH/T4 levels but thyroid nodule is present

A

FNA

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28
Q

Hypercalcemia causes

A 
Vitamin D intox
Sarcoidosis and other granulmatous disease
thiazide diuretics
hyperthyroidism
metastases to bone and multiple myeloma
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29
Q

Hypercalcemia most common cause

A

Primary Hyperparathyroidism

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30
Q

confusion, stupor, lethargy, SHORT QT

constipation

A

Hypercalcemia

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31
Q

Hypercalcemia Treatment

A
  • saline hydration at high volume
  • bisphosponates: pamidronate, zoledronic acid
  • calcitonin
32
Q

Primary hyperparathyroidism

A

solitary adenoma most common
hyperplasia of all 4 glands
parathyroid malignancy

33
Q

Low phosphate
short QT on EKG
elevated BUN and creatinine
Alk phos elevated from effect of PTH on bone

A

Hyperparathyroidism

high calcium and high PTH

34
Q

Hypocalcemia presentation

A

twitchy, hyperexcitable

35
Q

Hypercalcemia presentation

A

lethargic, slow

36
Q

Neural hyper excitability is found in

A 
hypocalcemia
chvostek sign
carpopedal spasm
perioral numbness
mental irritability
seizures
trousseau sign
37
Q

Hypocalcemia EKG

A

prolonged QT

may cause ventricular tachycardia

38
Q

Cushing disease

A

pituitary overproduction of ACTH

39
Q

Cushing syndrome

A

ectopic production of ACTH

40
Q

Moon face, truncal obesity, buffalo hump, thin extremities, increased abdominal fat, striae, easy bruising, decreased wound dealing, increased sodium reabsorption in kidney

A

Hypercortisolism

41
Q

Before you get a CT in hypercortisol you need to

A

establish where the source is

42
Q

Cortisol is an anti-insulin stress hormone which means you will find what on lab?

A

hyperglycemia

hyperlipidemia

43
Q

Adrenal incidentaloma found now what?

A

metanephrines of blood/urine to exclude pheo
renin and aldosterone levels to exclude hyperaldosteronism
1 mg overnight dexamethasone suppression test

44
Q

Addison’s disease

A 
chronic hypoadrenalism
Autoimmune destruction
infection
Adrenoleukodystrophy
metastatic cancer to adrenal gland
45
Q

Adrenal crisis

A

acute adrenal insufficiency

46
Q

weakness, fatigue, altered mental status, nausea, vomiting, anorexia, hypotension, hyperpigmentation from chronic adrenal insufficiency

A

Hypoadrenalism presentation

acute hypoadrenalism also shows hypotension, fever, confusion, and coma

47
Q

hypoadrenalism

labs

A

hypoglycemia, hyperkalemia, metabolic acidosis, hyponatremia, high BUN
eosinophilia is common in hypoadrenalism

48
Q

Hypoadrenalism Treatment

A

replace Steroids with hydrocortisone

fludrocortisone (high in aldosterone like effect)

49
Q

Primary hyperaldosteronism

presentation/labs/cause

A

High BP and low K

usually caused by solitary adenoma

50
Q

primary hyperaldosterone treatment

A

laproscopic if unilateral

eplerenone or spironolactone if bilateral

51
Q

Pheochromocytoma definition

A

Autonomous overproduction of catecholamines despite high BP

52
Q

Pheochromocytoma presentation

A

episodic HTN
headache
sweating
palpitations and tremors

53
Q

Pheochromocytoma best test?

A

Plasma catecholamines

confirm with 24 hr urine metanephrines and catecholamines (more accurate than VMA level)

54
Q

Pheochromocytoma Tx?

A

phenoxybenzamine
propranolol
Calcium channel blocker
laproscopic removal

55
Q

Diabetes mellitus

A

persistently increased fasting blood glucose levels> 125 on at least 2 separate occasions

56
Q

Type 1 DM

What the bananas is this?

A

the pancreas is broken return to sender. momma gave you a terrible pancreas NO INSULIN FOR YOU!

57
Q

Type 2 DM

What the bananas is this?

A

your tissues have issues and don’t wanna take the insulin.

58
Q

Polyuria, polyphagia, polydipsia

A

DM
Type 1 is thin people
Type 2 is obese individuals

59
Q

Diagnostic test for DM

NAME THEM

A

2 FBG >125 mg/dL
one reading of >200 mg/dL
abnormal oral glucose tolerance testing
hemoglobin A1C >6.5%

60
Q

Name your diabetes drugs

A 
metformin, sulfonylureas
DPPI
Glitazones
Nateglinide and repaglinide
Incretins
61
Q

Metformin

A

blocks gluconeogenesis

62
Q

Sulfonylureas

A

increase insulin release from pancrease and causes weight gain

63
Q

Dipeptidyl peptidase inhibitors

sitagliptin, saxagliptin, linagliptin

A

increase insulin

decrease glucagon

64
Q

Thiazoladinediones

Rosiglitazone, pioglitazone

A

increase fluid overload

65
Q

Nateglinide and repaglinide

A

stimulates insulin release

similar to sulfonylreas

66
Q

Incretins

Exenatide liraglutide

A

raise insulin
decrease glucagon levels
decreased gatric motility

67
Q

Alpha glucosidase inhibitors

acarbose, miglitol

A

block glucose absorption in bowel

cause flatus, diarrhea, and abdominal pain

68
Q

Pramlitide

A

decreases gastric emptying
decreases glucagon levels
decreases appetitie

69
Q

Diabetic Ketoacidosis occurs more frequently in who?

A

type 1 diabetics

70
Q 
Hyperventilation
altered mental status
metabolic acidosis with increased anion gap
hyperkalemia in blood
increased anion gap on blood testing
serum positive for ketones
A

DKA
see a high glucose level too!

when bicarb corrects they can leave the ICU

71
Q

Treatment of DKA

A

Saline and insulin
replace potassium
correct the underlying issue: noncompliance with medications, infection, any serious illness

72
Q

All diabetics should?

A

feet check
proteins in urine (+) give ARB/ACEi
BP

73
Q

Gastroparesis Tx:

A

metoclopramide or erythromycin

74
Q

Non-proliferative retinopathy treatment

A

tighter control of glucose

75
Q

Proliferative retinopathy treatment

A

treat with photocoagulation

76
Q

Neuropathy treatment

A

gabapentin
pregabalin
TCA

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