Endocrinology Flashcards
/What 2 hormones are secreted by the posterior pituitary
Oxytocin and antidiuretic hormone (ADH and vasopressin)
What is Sheehan’s syndrome?
Ischemia of the pituitary due to volume depletion after or during childbirth
How do glitizones work?
the improve insulin sensitivity
What it the Most common pituitary adenoma
Prolactinoma
Large doughy hands should make you think of what diagnosis?
Gigantism
Diabetes insipidius is caused by a deficiency of which hormone?
Vasopressin
How much more potent is T3 compared to T4
3-4x
What is the first line medical treatment of a pheochromocytoma?
Alpha blocker. You should never use a pure beta blocker
What is the best imaging for a thyroid nodule?
Ultrasound
A patient presents with erectile dysfunction and complains of some numbness in his feet. On a second thought he has noticed significant polyuria and polydipsia. What diagnosis should you be thinking of>
Diabetes neuorpathy
Pretibial myxedema should make you think of what diagnosis>
Graves’s disease
a 35 yo female present with heat intolerance, weight loss and palpitations. What is the most likely diagnosis>
Hyperthyroidism
What is the first line medical treatment for a patient who presents with palpitations and nervousness secondary to hyperthyroidism?
beta blockers
What is Hashimotos’ disease?
An autoimmune cause of hypothryoid
How does Levothyroxine work?
It is synthetic T4
What is the Most common thyroid cancer?
Papillary - make up about 80% of all thyroid cancers
In a patient with hyperthyroidism will TSH most likely be elevated or decreased?
decreased.
How do vibrates work to affect the lipid profile?
they inhibit synthesis of VLDL and elevate lipoprotein lipase
What medication might you used prior to thyroidectomy in a patient with hyperthyroidism?
Methimazole or Propylthiouracil (PTU)
What is included in Whipple’s triad of hypoglycemia?
History of previous hypogylcemia, serum glucose of <40, immediate recovery upon administration of glucose
Positive antithyroid peroxidase and antithyroglobulin antibodies should make you think of what diagnosis?
Hashimoto’s
What is the treatment for tibial myxedema?
Levothyroxine and slow warming
What is the most common cause of hypoparathyroid ?
Post thyroidectomy with the complication of parathyroidectomy
What is Chvostek’s sign?
tap on the facial nerve and get a twitch with low calcium
Cortical adrenal insufficiency is also know as what disease?
Addison’s disease
What is Trousseau’s sign?
Inflate a BP cuff and hold for 3 minutes. Patients with hypocalcemia will get carpal tunnel symptoms
What is the most common cause of hyperparathyroidism?
Single parathyroid adenoma in 80% of cases
On Cushing’s disease is ACTH elevated of decreased?
Elevated
What is Grave’s disease
The most common cause of hyperthyroidism. ITs an autoimmune disease
What specific breathing pattern is associated with Diabetic Ketoacidosis?
Kussmaul’s respirations
What is the least aggressive type of thyroid cancer?
Paillary
Name 2 tests you might use to rule out Cushing’s syndrome
24 hour urnine free cortisol
dexamthasone suppression test
List 2 ectopic tumors that may produce ACTH and give a patient Cushing’s syndrome
Small cell lung CA
Pancreatic islet cells
thymomas
What is the treatment of Addison’s disease?
hydrocortisone or prednisone
What is the test to begin with if you suspect a pheochromocytoma?
24 hour urine for catecholamines
Exopthalmos should make you think of what diagnosis?
hyperthyroidism
What percentage of diabetes in the US is type 2?
80-90%
HLD-DR gene is a marker for what endocrine disorder?
DM type 1
What is the function of the parathyroid hormone?
increase serum Ca
List 4 diagnostic criteria for diabetes?
Random glucose > 200
fasting glucose >126
postprandial glucose > 200
HGB a1c > 6.5
Moans, groans, stones and bones describe symptoms of what endocrine problem?
hyperparathyroid
Stocking glove anesthesia should make you think of what diagnosis?
Diabetic neuropathy and B12 defieincy
Fruity breathe should make you think of what diagnosis?
Diabetic ketoacidosis
As it related to diabetes, what is the dawn phenomenon?
reduced insulin response between 5 - 8 am
What is the most common cause of hypopituitarism?
Tumor
How does metformin work?
decreases hepatic glucose production and increases peripheral glucose uptake
How do sulfoynlureas work?
They stimulate the production of insulin
What class of medicines does pioglitazone (ACTOS) fall into?
Thiazolidinediones - also know as glitazones
What is the suffix associated with sulfonylureas?
‘-ide” is the suffix - glipizide, tolbutamide, tolazamide
Typically what is the first medication started in Type 2 DM?
metformin
How often should a diabetics HgBA1c be checked and what should it be?
q 3 months(RBC life is 90-120 days) and it should be below 6.5%
What are the 5 criteria for metabolic syndrome?
HDL<40 males/ 50females BP >135/85 Triglycerides >150 Fasting glucose > 100 Waist > 40 inches men/35 inches women
What class of medications is the first line for lowering LDL?
-statins
Which lipid medications can cause flushing?
niacin
What life threatening side effect do statins have?
Rhabdomylolsis
Does niacin increase or decrease HDL?
increases
What medication class does metformin belong?
Biguianides
List the 5 insulins in order of peak efficacy
Lispro - 1-2 hours Regular 2-4 hours NPH 507 hours Lente 4-8 hours Ultralente 8-14 hours
IS met forming indicated or contraindicated in patients with renal failure?
Contraindicated
What is the most common cause of DM type 1?
Autoimmune destruction of the islet cells in the pancreas
List 4 physics exam findings for Cushing’s syndrome
Moon face buffalo hump, purple straie central obesity supraclavicular fat pads easy bruising
Propanolol belongs to what category of medications
beta blockers
During pregnancy this is the preferred treatment of hyperthyroidism? PTU or methimazole
PTU
Name the 4 thyroid cancers
papillary,
follicular,
medullary
anapestic
What heparin complication is relevant to endocrinology?
Adrenal infarct leading to Cushing’s syndrome
How does nicotinic acid work to affect the lipid profile?
It inhibits the secretion of VLDL
Hperpigmentation of the skin along creases should make you think of what diagnosis?
Addison’s disease
Which type of thyroid cancer is most aggressive?
Anaplastic
How do statins work to affect the lipid profile
They slow the rate limiting step of cholesterol synthiesis
Will ACTH bee elevated or decreased I Addison’s disease?
Elevated if the problem is at the level of the adrenal glands
What role does C-peptide play in the diagnosis of diabetes
It is a marker of insulin production. Elevated C-peptide points to DM type 2. Decreased C-peptide points to type 1
