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USMLE Rapid Review > Endocrinology > Flashcards

Endocrinology Flashcards

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USMLE® Step 1 flashcards
1
Q

lab findings in hashimoto’s thyroiditis

A

high TSH, low T4, and anti-TPO antibodies

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2
Q

lab findings in hashimoto’s thyroiditis

A

high TSH, low T4, and anti-TPO antibodies

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3
Q

stones, bones, groans, and psychiatric overtones

A

hypercalcemia

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4
Q

pt complains of HA, weakness, and polyuria; exam reveals HTN and tetany; labs show hypernatremia, hypokalemia, and metabolic alkalosis

A

primary hyperaldosteronism (due to conn’s syndrome or bilateral adrenal hyperplasia)

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5
Q

pt complains of tachycardia, wild swings in BP, HA, diaphoresis, AMS, and sense of panic

A

pheochromocytoma

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6
Q

first line of tx for pheo

A

a-antagonists (phentolamine or phenoxybenzamine) as b-antagonists first will cause unopposed rise in BP

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7
Q

pt w/ hx of lithium use presents w/ copious amounts of dilute urine

A

nephrogenic DI

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8
Q

tx of central DI

A

DDAVP

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9
Q

anti-diabetic agent associated w/ lactic acidosis

A

metformin

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10
Q

pt complains of weakness, N/V, weight loss, and new skin pigmentation. lab shows hyponatremia and hyperkalemia. Dx? Tx?

A

primary adrenal insufficency (Addison’s dz). tx w/ glucocorticoids, mineralocorticoids, and IVF

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11
Q

goal HA1c for pt w/ DM

A

less than 7

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12
Q

tx of DKA

A

IVF, insulin, and electrolyte repletion (ie. K)

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13
Q

why are b-blockers contraindicated in DM?

A

mask symptoms of hypoglycemia

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14
Q

stones, bones, groans, and psychiatric overtones

A

hypercalcemia

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15
Q

pt complains of HA, weakness, and polyuria; exam reveals HTN and tetany; labs show hypernatremia, hypokalemia, and metabolic alkalosis

A

primary hyperaldosteronism (due to conn’s syndrome or bilateral adrenal hyperplasia)

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16
Q

pt complains of tachycardia, wild swings in BP, HA, diaphoresis, AMS, and sense of panic

A

pheochromocytoma

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17
Q

first line of tx for pheo

A

a-antagonists (phentolamine or phenoxybenzamine) as b-antagonists first will cause unopposed rise in BP

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18
Q

pt w/ hx of lithium use presents w/ copious amounts of dilute urine

A

nephrogenic DI

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19
Q

tx of central DI

A

DDAVP

20
Q

anti-diabetic agent associated w/ lactic acidosis

A

metformin

21
Q

pt complains of weakness, N/V, weight loss, and new skin pigmentation. lab shows hyponatremia and hyperkalemia. Dx? Tx?

A

primary adrenal insufficency (Addison’s dz). tx w/ glucocorticoids, mineralocorticoids, and IVF

22
Q

goal HA1c for pt w/ DM

A

less than 7.0

23
Q

tx of DKA

A

IVF, insulin, and electrolyte repletion (ie. K)

24
Q

why are b-blockers contraindicated in DM?

A

mask symptoms of hypoglycemia

25
Q

chronic GI disease can cause vit D def due to malabsorption –> what electrolyte imbalances?

A

hypocalcemia, hypophosphatemia, and elevated PTH

26
Q

pt w/ HTN and low renin levels. dx?

A

primary hyperaldosteronism - elevated aldosterone suppresses renin secretion through feedback inhibition

27
Q

pt w/ HA, deafness, bone pain + isolated elevated AP, normal calcium, phosphorus, and other liver enzymes

A

pagets dz of the bones - characterized by increased bone remodeling (increased AP) and abnormal osteoid formation

28
Q

DKAs effects on K?

A

“paradoxical hyperK” - DKA is characterized by an osmotic diuresis that reduces total body K stores even though the serum K level may be elevated

29
Q

proximal muscle weakness can be seen w/ what hormone imbalance?

A

hyperthyroidism

30
Q

G6PD def causes hemolytic anemia due to …

A

oxidative injury to RBCs precipitated by infection or medications

31
Q

symptom mgmt in hyperthyroidism?

A

propranolol

32
Q

diabetic autonomic neuropathy can affect the GU tract causing…

A

neurogenic bladder –> overflow incontinence (dribbling, poor urinary stream, high post-void residual volume)

33
Q

pregnant women (increased estrogen) effects on TBG, thyroxine, T3, free T4, and TSH

A

increased TBG, increased thyroxine and T3, normal free T4, and normal THS

34
Q

MEN-2 genetic testing

A

RET proto-oncogene

35
Q

electrolyte abnormalities associated w/ alcoholics

A

hypoMg, which causes hypoCa (hypoMg causes decreased release of PTH and PTH resistance)

36
Q

hypoCa, hyperphosphatemia, and increased PTH indicate…

A

secondary hyperparathyroidism in chronic renal failure

37
Q

high serum osmol + low urine osmol (dilute urine)

A

DI - inability to produce concentrated urine as a result of ADH dysfunction

38
Q

labs for DI:
water depreivation test…
DDAVP…

A

water depreivation test shows no increase in urine osmol (distinguishes from primary polydipsia)
DDAVP shows central having decreased urine output and increased urine osmol vs nephrogenic no change

39
Q

low plasma osmol + high urine osmol > 100 - 150 (concentrate urine)

A

SIADH - persistent ADH release independent of serum osmol (retention of free water)

40
Q

OTC med that can cause SIADH

A

NSAIDs

41
Q

diabetic neuropathy DOC

A

TCAs; gabapentin is alternative

42
Q

tx options for diabetic gastroparesis

A

prokinetic agents such as metoclopramide, erythromycin, cisapride can sometimes help

43
Q

tx for pagets

A

bisphosphonates; calcitonin is usually reserved for pts intolerant to bisphosphonates

44
Q

differentation of follicular thryoid adenomas vs follicular thyroid cancers

A

histopath demonstration of invasion of the capsule and blood vessels = cancer

45
Q

when is FNA of the thyroid recommended?

A

pts w/ normal or high TSH, cold nodules (hot are usually benign), thyroid cancer family hx, or suspicious thyroid on US

46
Q

two important causes of hypoglycemia in non-DM pts w/ elevated insulin levels. dx? differentiate?

A

insulinoma (beta cell tumor) vs surreptitious use of insulin or sulfonylurea.
c-peptide is high in insulinoma vs low in surreptitious use of insulin

USMLE Rapid Review (16 decks)

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