Endocrinology

Question 1

Metformin. Mechanism?

Answer 1

Eykur insúlínnæmi perifert
Minnkar gluconeogenesu í lifur
Má ekki gefa nýrnabiluðum og eldri en 80 ára

Question 2

Sulfonylurea. Mechanism? (glipizide, glimepiride)

Answer 2

Eykur endogen insúlínframleiðslu

Question 3

Thiazolidinediones. Mechanism? (pioglitazone)

Answer 3

Eykur insúlínnæmi

Má ekki gefa í heart failure

Question 4

DPP-4 inhibitors. Mechanism? (-liptin lyf)

Answer 4

Hindra niðurbrot GLP-1

Question 5

Incretins. Mechansim? (-tides lyf)

Answer 5

GLP-1 agónisti
Hægir á food absorption
Eykur insúlín og minnkar glucagon

Question 6

Einkenni DKA?

Answer 6

Abdominal pain
Nausea
Vomiting
Kussmaul respiration
Mental status change
Fruity acetone brath odor

Question 7

Einkenni HHS (hyperosmolar, hyperglycemic state)

Answer 7

Profound dehydration

Mental status change (meiri en í DKA)

Question 8

Blóðsykur í DKA vs. HHS?

Answer 8

DKA >250 mg /dL

HHS >600mg /dL

Question 9

Metabolic syndrome criteria?

Answer 9

WEIGHHT
Waist Expanded
Impaired Glucose
Hypertension
HDL lækkað
Triglycerides hækkað

Question 10

Graves disease. Specific signs?

Answer 10

Exopthalmus
Pretibial myxedema
Thyroid bruits

Question 11

Mismunandi casts í urinalysis og hvað orsakar?

Answer 11

Muddy brown casts - acute tubular necrosis
RBC casts - glomerulonephritis
WBC casts - interstitial nephritis og pyelonephritis
Fatty casts - nephrotic sx
Broad and waxy casts - chronic renal failure

Question 12

Thyroid storm presentation?

Answer 12

A. fib
Fever
Delirium

Question 13

Thyroid storm meðferð?

Answer 13

antithyroid drugs
iodine
esmolol
steroids
ICU meðferð

Question 14

Hvenær á að meðhöndla subclinical hypothyroidism?

Answer 14

Ef TSH > 10mU/L

Question 15

bone pain + hearing loss. Hvað?

Answer 15

Paget’s

Question 16

Hypercalcemia einkenni?

Answer 16

Stones
Bones
Moans
Groans
Psychiatric overtones

Question 17

Hypercalcemia. Meðferð?

Answer 17

IV fluids
Loop diuretics
Bisphosphonates ef malignancy

Question 18

Orsakir hypoparathyrodism?

Answer 18

Iatrogenic
Autoimmune
Congenital (DiGeorge)
Infiltrative (hemochromatosis, Wilsons)

Question 19

Familial hypocalciuric hypercalcemia er hvað?

Answer 19

Fólk er með hækkað Ca en allt annað eðlilegt
Engin meðferð og án einkenna.
ATH: lágt Ca í þvagi því stökkbreytingar i calcium receptors

Question 20

Hvað er sheehan sx?

Answer 20

pituitary infarction

oft tengt postpartum hemorrhage

Question 21

Hver er munurinn á cushing syndrome og disease?

Answer 21

Syndrome = of mikið cortisol
Disease = of mikið cortisol vegna ACTH seytandi pituitary adenoma

Question 22

Hvað gerist ef hyponatremia er leiðrétt of hratt?

Answer 22

Central pontine myelinolysis

Question 23

Meðferð við SIADH?

Answer 23

Fluid restriction er cornerstone!

Question 24

Hvar er DHEAS framleitt?

Answer 24

BARA í adrenal gland

Question 25

Einkenni primer adrenal insufficiency?

Answer 25

Aukin skin pigmentation
Minni glucocorticoids
Minni mineralocorticoids

Ef sekúnder þá er bara lækkaðir glucocorticoids en ekki skin og ekki hyperkalemia

Question 26

Adrenal crisis management?

Answer 26

4S's
Salt
Steroids: IV hydrocortisone 100mg á 8 tíma fresti
Support
Search for underlying illness

Question 27

Hvað er waterhouse-friedrichsen syndrome?

Answer 27

adrenal hemorrhage vegna N. meningitidis

Question 28

Pheochromocytoma regla?

Answer 28

Rule of 10's
10% extra-adrenal
10% bilateral
10% malignant
10% in children
10% familial

Question 29

Pheochromocytoma einkenni?

Answer 29

5P's
Pressure (BP)
Pain (headache)
Perspiration
Palpitations
Pallor

Question 30

Pheochromocytoma meðferð?

Answer 30

Aðgerð til að fjarlægja en fyrst:
alfa-blokkar og beta-blokkar
gefa alfa fyrst því bara beta eitt og sér getur valdið severe hypertension

Question 31

Hvað er Conn sx?

Answer 31

Hyperaldosteronism vegna unilateral adrenal adenoma

Question 32

MEN 1 líffæri?

Answer 32

3P’s
Pancreas
Pituitary
Parathyroid

Question 33

MEN 2A líffæri?

Answer 33

2P’s
Parathyroids
Pheochromocytoma

Question 34

MEN 2B líffæri?

Answer 34

1P’s

Pheochromocytoma