Endocrinology Flashcards
Diabetes diagnosis: Two fasting glucose > \_\_ One random glucose >\_\_\_ with symptoms Abnormal GTT HbA1c > 6.5%
126
200
The strongest indication for diabetes screening is
hypertension
Metformin works by
blocking gluconeogenesis
- no risk of hypoglycemia
- no weight gain
- Don’t use in renal insufficiency or with contrast
The sulfonylureas are
glyburide, glimepiride, and glipizide
- work by increasing release of insulin from the pancreas
- hypoglycemia and SIADH are risks
The dipeptidyl peptidase IV (DPP-IV) inhibitors are
sitagliptin, linagliptin, alogliptin, and saxagliptin
-block metabolism of incretins such as glucagon-like peptide
The thiazolidinediones are
rosiglitazone and pioglitazone
- increase peripheral insulin sensitivity
- DO NOT USE WITH CHF
Alpha-glucosidase inhibitors are
acarbose and miglitol
- block absorption of glucose at intestinal lining
- BAD GI symptoms
- like making a person lactose intolerant!
SGLT inhibitors such as ___ and ___ can lead to UTIs
canagliflozin and dapaglifozin
Insulin glargine is __-acting
long
-injected once a day with an extremely steady state level of insulin, used in combo with a very-short acting insulin at mealtime
Long-acting NPH insulin is administered ___ a day
twice a day
Short acting insulin includes
aspart
lispro
glulisine
-given at mealtime and lasting about 2 hours
Underproduction of insulin =
type 1 diabetes
The best initial test for DKA is
serum bicarbonate! A low bicarb implies an elevated anion gap, a marker for serious DKA
A marker of ketone production in DKA is
beta hydroxybutyrate
Very high glucose ARTIFICIALLY drops ___ levels
sodium
It is very important to supplement with ___ in DKA because a high level at first will quickly turn into a low level!
potassium
DKA will show pseudohypo-
natremia
High glucose + low bicarb = DKA; give __ and __
bolus saline and IV insulin
-add potassium when you notice the K level normalizing
Treat severe proliferative retinopathy (diabetes complication) with
VEGF inhibitors like ranibizmab or bevacizumab
If any form of protein is present in diabetics, treat with
ACE inhibitors
Never give slidenafil with
nitrates!!
The muscle that lifts the eyelid is the
levator palpebrae superioris, innervated by C3
-hyperthyroidism stimulates the beta receptors of C3
The only cause of hyperthyroidism with elevated TSH is
pituitary adenoma
Diagnose a solid thyroid nodule with
fine needle aspiration, ultrasound guided
The most common cause of hypercalcemia in outpatients is
primary hyperparathyroidism
Thiazide diuretics increase tubular reabsorption of
calcium, causing hypercalcemia
Low calcium = ___-excitable
HYPERexcitable!
When should you surgically remove the parathyroid gland? HyperPTH with:
symptoms (stones, bones, groans, moans) renal insufficiency very elevated serum calcium >12.5 Age <50 Osteoporosis
If testing for Cushing Syndrome is inconclusive on MRI/CT, the next step is
petrosal sinus sampling
Which CAH has both hypertension and virilization?
11 hydroxylase deficiency
First test to confirm Acromegaly is
insulinlike growth factor
The mechanism of diabetes and glucose intolerance in PCOS is
unknown
