Endocrinology Flashcards
A weight-neutral anti-hyperglycemic agent
DDP-4 inhibitors
Target TG levels in diabeticts:
<150 mg/dL
First defence against hypoglycemia
Decrease in insulin secretion
Second and third defence against hypoglycemia
Glucagon then Epinephrine
Cortisol and GH have no role
Predominant ketone body in ketosis
B-hydroxybutyrate
Components of the criteria for Metabolic Syndrome
Central obesity Low HDL Triglycerides Hypertension >130/85 Impaired fasting glucose
Most common pattern of thyroid hormone elevation/decrease in sick euthyroid syndrome
Decreased total and unbound T3
Normal TSH and T4
Treatment for severe Graves’ ophthalmopathy
Methylprednisolone pulse therapy
Most common cause of acute thyroiditis in children and young adults
Presence of a pyriform sinus
Treatment for subacute thyroiditis
Aspirin, NSAIDs, or glucocorticoids
Next step in diagnosis of a thyroid nodule with low TSH:
Thyroid scan
Next step in diagnosis of a thyroid nodule with hight TSH:
UTZ-guided FNAB
Most specific UTZ finding of a malignant thyroid nodule:
marked hypoechogenicity
Most sensitive UTZ finding of a malignant thyroid nodule:
Solid
Sequential loss of pituitary hormones from compression:
GH -> FSH/LH -> TSH -> ACTH
Screening tests for the following:
GH excess
Cushings syndrome
GH excess - serum IGF-1
Cushing’s syndrome - 24 hr urine cortisol
Most common paraneoplastic syndrome
Hypercalcemia
After measuring 24hr urine cortisol in Cushing syndrome, and hypercortisolism is diagnosed, what is the next step?
Measure plasma ACTH
Confirmatory test for acromegaly
75g-OGTT
Most significant clinical impact of GH excess occurs with respect to the _______ system
Cardiovascular system (cardiomyopathy, coronary heart disease, arrhythmias, LVH, etc.)
Drug is a glucocorticoid receptor antagonist that can be used to treat hyperglycemia in Cushing’s disease
Mifepristone
Drug for Cushing’s disease that inhibits cortisol synthesis at the level of 11B hydroxylation
Metyrapone
Disorder characterized by hyperpigmentation and rapid pituitary tumor enlargment due to increased ACTH
Nelson syndrome
Origin of most nonfunctioning adenomas
Gonadotrope cells
Differentiates central vs. peripheral DI
Water deprivation test
There is no convincing role of infection of autoimmune thyroiditis except in:
Congenital rubella syndrome
Most common cause of ectopic ACTH secretion
Carcinoid lung tumor
Differentiate type 1a and 1b DM
1a: Autoimmune destruction of beta cells
1b: Non-autoimmune destruction of beta cells
Major user of postprandial glucose
Muscles
Ketone body preferentially detected by nitroprusside
Acetoacetate
Features of diabetes are not evident until
70-80% of beta cells are destroyed
Leading cause of blindness between ages 20-74
DM retinopathy
Treatment of macular edema
Focal photocoagulation
Diagnosis of renal insufficiency is established by:
Cosyntropin test
HbA1c levels suggestive of IFG
5.7-6.4%
Most common presenting feature of adult hypopituitarism
Hypogonadism
Hallmarks of hyperprolactinemia in women
Amenorrhea, galactorrhea, infertility
Mainstay of therapy for micro or macroprolactinomas
Dopamine agonists (Cabergoline, Bromocriptine)
Initial treatment for most patients with GH-secreting adenomas
Surgical resection
Most common cause of cushingoid features
Iatrogenic hypercortisolism
Most common clinical features of Cushing’s (2)
Obesity + thin skin
Test suggestive of ACTH-secreting tumor rather than ectopic ACTH secretion
Cortisol reduction from high dose dexamethasone suppression test
_________ inhibits 11B hydroxylase and normalizes plasma cortisol
Metyrapone
Most common type of pituitary adenoma
Nonfunctioning pituitary adenomas
Most common causes of hypothyroidism in iodine-sufficient areas (2)
Hashimoto’s and iatrogenic (treatment of hyperthyroidism)
Most devastating complication of osteoporosis
Fracture
Most common early consequence of estrogen deficiency
Vertebral fracture
Major nonmetabolic complication of DKA treatment
Cerebral edema
Hallmark of proliferative diabetic retinopathy
Neovascularization
Most effective therapy for diabetic retinopathy
Prevention
Most common mononeuropathy in DM
Third cranial nerve palsy
Unifying hypothesis for metabolic syndrome
Insulin resistance
Most common cause of erectile dysfunction
Interruption of blood flow to and from the penis
Hormones that should be measured in erectile dysfunction: (2)
Serum testosterone
Serum prolactin
(PSA May be requested according to recommended clinics guidelines)
The ion of primary physiologic importance in pancreatic secretion:
Bicarbonate
Clinically important weight loss is defined as loss of _____ kg or >__% of body weight over 6-12 months
4.5 kg (10 pounds); >5%
Nutritional vitamin D deficiency is best assessed by serum levels of:
25 hydroxyvitamin D
Most common acid base disturbance in critically ill patients
Chronic respiratory alkalosis
Most common cause of drug induced respiratory alkalosis
Salicylates
Mainstay of pharmacologic therapy in Paget’s disease
Bisphosphonates
2 types of peakless insulin
Detemir, Glargine
The dominant sign of pheochromocytoma
Hypertension
Most sensitive biochemical testing for pheochromocytoma
Plasma metanephrines
Gold standard for diagnosis of Wilson’s disease
Liver biopsy with quantitative copper assays
Drug that acts by competitive inhibition of GH
Pegvisomant
Dominant sign in pheochromocytoma
Hypertension
Most common cause of primary adrenal insufficiency
Autoimmune adrenalitis
Diagnosis of adrenal insufficiency is established by
Cosyntropin test
2 primary bile acids
Chenodeoxycholic and cholic acid
Thyroglobulin levels are elevated in all cases of thyrotoxicosis except:
Thyrotoxicosis facticia
