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Casey: Panre > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

What two hormones are secreted by the posterior pituitary?

A

Oxytocin and antidiuretic hormone (ADH:vasopressin)

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2
Q

What is Sheehan’s syndrome?

A

Ischemia of the pituitary due to volume depletion

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3
Q

how do glitazones work?

A

They improve insulin sensitivity.

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4
Q

Large doughy hands make you think of what dx?

A

Gigantism

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5
Q

Diabetes insipidus is caused by deficiency of what hormone?

A

Vasopressin

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6
Q

How much more potent is T3 than T4?

A

3-4x

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7
Q

What is the first line medical tx for a pheochromocytoma?

A

Alpha blocker.

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8
Q

What is the best imaging for a thyroid nodule?

A

Ultrasound

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9
Q

A patient presents with ED and c/o of some numbness in his feet. On second thought, he has noticed significant polyuria and polydipsia. What dx should you be thinking of?

A

Diabetic neuropathy

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10
Q

Pretibial myxedema should make you think of what dx?

A

Graves’ disease

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11
Q

A 35 yo female presents c heat intolerance, wt loss and palpitations. What is the most likely dx?

A

Hyperthyroidism

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12
Q

what is the first line medical tx for a pt who presents with palpitations and nervousness secondary to hyperthyroidism?

A

Beta blockers

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13
Q

What is Hashimoto’s disease?

A

An autoimmune cause of hypothyroidism

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14
Q

How does levothyroxine work?

A

It is a synthetic T4

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15
Q

What is the most common thyroid cancer?

A

Papillary: it makes up about 80% of thyroid CA

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16
Q

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

A

Decreased

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17
Q

How do fibrates work to affect the lipid profile?

A

They inhibit synthesis of VLDL and elevate lipoprotein lipase

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18
Q

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

A

Methimazole or propylthiouracil (PTU)

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19
Q

What is included in Whipple’s triad of hypoglycemia?

A

hx of previous hypoglycemia
serum glucose of <40
immediate recovery upon admin of glucose

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20
Q

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

A

Hashimoto’s

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21
Q

What is the tx for myxedema?

A

Levothyroxine and slow warming

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22
Q

What is the most common cause of hypoparathyroid?

A

post thyroidectomy with the complication of parathyroidectomy

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23
Q

What is Chvostek’s sign?

A

Tap on facial nerve and get a twitch with low Ca

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24
Q

cortical adrenal insufficiency is also known as what dz?

A

Addison’s disease

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25
Q

What is Trousseau’s sign?

A

Inflate BP cuff and hold for 3 minutes. Pt c low Ca will get carpal tunnel syndrome.

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26
Q

What is the most common cause of hyperparathyroidism?

A

Single parathyroid adenoma in 80% of cases.

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27
Q

In cushing’s disease, is ACTH elevated or decreased?

A

Elevated

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28
Q

What is Graves’ disease?

A

The most common cause of hyperthyroidism. It is an autoimmune disease.

29
Q

What specific breathing pattern is associated with diabetic ketoacidosis?

A

Kussmaul respirations

30
Q

What is the least aggressive thyroid CA?

A

Papillary

31
Q

Name 2 tests you might use to r/o cushion’s syndrome.

A

24 hr free cortisol urine test

dexamethasone suppression test

32
Q

List 2 ectopic tumors that may produce ACTH and give a pt cushion’s syndrome.

A

Small cell lung cancer
pancreatic islet cells
thymomas

33
Q

Exophthalmos should make you think of what dx?

A

Hyperthyroidism

34
Q

What percentage of diabetes in the US is type 2?

A

80-90%

35
Q

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

A

DM type 1

36
Q

What is the main function of parathyroid hormone?

A

Increases serum Ca

37
Q

List 4 diagnostic criteria for diabetes.

A

Random glucose >200
FBG >126
2h post prandial glucose >200
HgA1c> 6.5%

38
Q

Moans, groans, stone and bones describe symptoms of what endocrine problem?

A

Hyperparathyroid

39
Q

Stocking glove anesthesia should make you think of what dx?

A

Diabetic neuropathy and B12 deficiency neuropathy

40
Q

Fruity breath should make you think of what dx?

A

Diabetic ketoacidosis

41
Q

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

A

Reduced insulin response between 5 & 8 am

42
Q

What is the most common cause of hypopituitarism?

A

Tumor

43
Q

How does metformin work?

A

Decreases the hepatic glucose production

increases peripheral glucose uptake

44
Q

How does sulfonylureas work?

A

They stimulate production of insulin

45
Q

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

A

Thiazolidinediones aka glitazones

46
Q

What is the suffix associated with sulfonylureas?

A

Ide is the suffix
Glipizide
Tobutamide
Tolazamide

47
Q

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

A

Metformin

48
Q

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

A

every 3 months (Life of an RBC is 90-120 days) and it should be below 6.5%

49
Q

What are the five criteria for metabolic syndrome?

A 
HDL<40 men, <50 for women
BP>135/85
Tri >150
FBG>100
Waist >40" men, >35" women
50
Q

What class of medication if the first line for lowering LDL?

A

Statins

51
Q

Which lipid medication may cause flushing?

A

Niacin

52
Q

What life threatening SE do statins have?

A

Rhabdomyolysis

53
Q

Does niacin increase or decrease HDL?

A

Increase

54
Q

What medication class does metformin (Glucophage) fall into?

A

Biguanide

55
Q

List the 5 insulins in order of peak efficiency.

A 
Lispro 1-2h
Regular 2-4h
NPH 5-7h
Lente 4-8 hr
Ultralente 8-14h
56
Q

Is metformin indicated or contraindicated in renal failure?

A

contraindicated

57
Q

What is the most common cause of DM type 1?

A

Autoimmune destruction of the islet cells in the pancreas

58
Q

List 4 physical exam findings for Cushing’s syndrome.

A 
Moon facies
buffalo hump
purple striae
central obesity
supraclavicular fat pads
easy bruising
59
Q

Propranolol belongs to what class of meds?

A

Beta blockers

60
Q

During pregnancy, which is the preferred tx of hyperthyroidism PTU or methimazole?

A

PTU

61
Q

Name the four thyroid CA

A

Papillary
Follicular
Medullary
Anaplastic

62
Q

What heparin complication is relevant to endocrinology?

A

Adrenal infarct leading to a Cushing’s syndrome

63
Q

How does nicotinic acid work to affect the lipid profile?

A

It inhibits secretion of VLDL.

64
Q

Hyper pigmentation of the skin along creases should make you think of what dx?

A

Addison’s disease

65
Q

Which thyroid cancer is the most aggressive?

A

anaplastic

66
Q

How do statins work to affect the lipid profile?

A

They slow the rate limiting step of cholesterol synthesis.

67
Q

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

A

Elevated if the problem is at the adrenal glands.

68
Q

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

A

It is a marker of insulin production. Elevated C peptide points to DM2. Decreased C-peptide points toward DM 1.

Casey: Panre (12 decks)

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