Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

English 2 > Endocrinology > Flashcards

Endocrinology Flashcards

You may prefer our related Brainscape-certified flashcards:
Proverbs and Idioms flashcards
1
Q

Diabetes mellitus type 1 (PE)

A

Autoimmune pancr beta-cell destruction; insulin def
Polyuria, polydipsia, polyphagia, rapid weight loss
Nonobese child; young adult
Ass w/ HLA-DR3 and -DR4

At onset: anti-islet cell Ab, anti-GAD Ab, anti-insulin Ab, anti-Zn transporter Ab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diabetes mellitus type 1 (dg, ttt)

A

Dg: at least 1 of 3:

  • Random glu ≥200 w/ symptoms
  • Fasting(>8h) glu ≥126 then 2h-post glu toler test ≥200
  • HbA1c >6.5%

ttt: ins injec to get preprand glu 80-130 and postprand glu <180; test HbA1c /3months (goal <7%; child <7.5%)
Ins pump for continuous short-act ins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Diabetes mellitus type 2 (PE)

A

Insulin resistance in periph tissues w/ insuff ins secretion
Polyuria, polydipsia, polyphagia, blurred vision, fatigue
Insidious onset; usually already w/ complic

Older adults w/ abdo obesity
Strong genet predispo
RF: obesity, rapid weight gain, fam Hx, sedentary, ↑age, metabolic sd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Diabetes mellitus type 2 (dg)

A

Dg: at least 1 of 3:

  • Random glu ≥200 w/ symptoms
  • Fasting(>8h) glu ≥126 then 2h-post glu toler test ≥200
  • HbA1c >6.5%

Negative anti-islet cell Ab, anti-GAD Ab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Diabetes mellitus type 2 (screening, ttt)

A

Screening: all ptts w/ RF (HTN/ob/fam Hx/racial-ethn minorities); if no RF, HbA1c for all 45yo, if <5.7% repeat/3y; if fasting glu >100+<126 or impaired toler, fqt retest

ttt: goal HbA1c <7% (aver glu 154)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Health maintenant in DM2

A

DM = highest R for CVds
All DM ptts given statin if >40yo + ≥1 other CV RF
BP control <140/80; ACEIs/ARBs #1

Annual PE screen CVds (BP/lipid), nephropa (microalb), retinop (eye exam), neurop (foot care)
Pneumonia vaccine to all DM >19yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Acute complication of DM1

A

DKA
Precip by stress (inf/MI/trauma/alcoh); ins noncompliance
Abdo pain/N/V/Kussmaul resp/mental stat ch/fruity breath
Glu>250; metab acid (bicar<18); ↑ketones (urine+serum); ↑anion gap; Nl serum osm
ttt: fluid, K+, contin ins, P, ttt cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Acute complication of DM2

A

Nonketotic hyperosmolar hyperglycemia (HHS)
Precip by stress (inf/MI/trauma/alcoh); ins noncompliance; bad diet
Dehydration/mental stat ch
Glu>600; No acid (bic>18); No ketones; Nl anion gap; Serum osm >320
ttt: aggres fluids, e- repl, insulin, ttt cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Chronic complications of DM (retinopathy, nephropathy, macrovascular)

A

Retinopathy (nonprolif/prolif): when DM ≥3-5y; prevent w/ gly+BP control, eye exam, laser photocoag for retinal neovasc

Nephropathy: glomer hyperfiltr then microalb; when DM >10y; prevent w/ ACEIs/ARBs, BP+gly control

Macrovasc complic: CV, cerebroV, PVD
CV complic #1 death in DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Chronic complications of DM (neuropathy)

A

Neuropathy: periph N; symm sensorimotor; burn/pain/trauma/inf/ulcers; foot care + analgesics
GI: gastroparesis; ttt metoclopramide
GU: neurogenic bladder, overflow incont, erect dysf
CV: orthostatic hypoTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Metabolic syndrome (PE, ttt)

A

MS = Insulin resistance sd = sd X
Ass w/ ↑R of CAD and CV mortality
Abdo obesity; high BP; impaired gly contr; dyslip

ttt: intensive weight loss; aggres chol manag; BP contr
Metformin + lifestyle modi ↓ DM onset in this sd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Metabolic syndrome (dg)

A

≥3 of 5 criteria:

  • waist ≥102cm men/ ≥88cm women
  • Tg ≥150
  • HDL <40 men; <50 women
  • BP ≥ 130/85 or requirement for anti-HTN
  • Fasting glu ≥100
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Thyroid function tests (TFTs)

A
  • TSH: #1 for screening (unless Hx of brain injury, then free T4 also)
  • Radioactive iodine uptake+scan: level+distrib of I uptake
  • Total T4: Not for screening; 99% of circ T4 bound to TBG (total T4 dep on level of TBG)
  • Free T4: preferred screening test

! ↑TBG in pgncy/estrog admin/inf: No ttt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hyperthyroidism / Thyrotoxicosis (dg)

A

HyperTh: ↑ synthesis T3/T4
Thyrotox: ↑ levels T3/T4

Dg: TSH then T4, rarely T3
+/- RAI scan; thyroglobulin

Thyroid storm: acute life-threat thyrotox: AF/fever/delirium; ttt: urgent antithyr then iod/IV esmolol/CS and ICU adm; high-dose potassiun iodide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hyperthyroidism / Thyrotoxicosis (etiologies)

A
  • Graves ds: autoimm; TSH recept-stimulating Ab ↑ synthesis T3/T4; exopht/preteb myxedema/thyroid bruits
  • Toxic adenoma/toxic multinodular goiter: hyperT by autonom hyperactive nodules
  • Thyroiditis: transient infl of Th; release of previous Hes; tempor ↑T3/T4; hypoTh may follow hyperT
  • Fetal thyrotoxicosis: infant to mother w/ Graves; TSH-stim Ab (IgG) cross placenta
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hyperthyroidism / Thyrotoxicosis (ttt)

A

Propranolol
Antithyroid drugs (methimazole, PTU)
Radioactive I131 ablation or total thyroidectomy (then levothyroxine)
Steroids for severe ophthalmopathy

If unttt: long-term bone loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hypothyroidism (etiologies)

A
  • Hashimoto thyroiditis: autoimm; antithyroglobulin Ab + antithyroid peroxidase Ab
  • Thyroiditis (postpartum/postviral/subacute): hypoTh then hyperTh
  • Secondary hypoTh: pituitary tumor/surgery
  • Congenital hypoTh: dysgenesis; failure to thrive, hypotonia, umbilical hernia, prolonged jaundice
  • Generalized resistance to Hes: ↑T3/T4; Nl/↑ TSH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hypothyroidism (dg, complic, ttt)

A

Dg: TSH#1 then free T4; ↑ LDL/Tg; ↑CK; hypothermia
Complic: ↑R of thyr lymphoma (in Hashimoto); myxedema coma (severe hypoTh w/ ↓ mental status, hypothermia, hypoTN, bradycardia, hypoventil; morta 30-60-%; ttt ICU and urgent IV levothyr + IV hydrocortisone)

ttt: levothyroxine: if uncomplic or in subclinical hypoTh if TSH>10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Thyroiditis

A

Infl
Subtypes: subacute granulomatous, radiation-induced, autoimmune, postpartum, drug-induced

Subacute: tender thyr, malaise, URI symptoms, painful
Other subtypes: painless
Dg: thyrotoxicosis then hypoTh; ↓ uptake RAI
ttt: B- (hyperTh) or levothyrox (hypoTh); subacute is self-limited but NSAIDs or oral CS if severe

20
Q

Thyroid neoplasms (PE)

A

Th nodules: ↑ w/ age; 95% benign
Usually asympt, incident dg
If hyperfct nod: hyperTh sympt, not malignant
Large nod near trachea/esoph: dysph, dyspn, cough

↑R of malign: Hx of neck radiation; cold nod (min uptake); female; <20 or >70yo; fam Hx; firm/fixed nod; rapidly growing + hoarsness
Check ant cervical LN

21
Q

Thyroid neoplasms (ttt)

A

Benign FNA: follow w/ PE/US to see develop of suspicious charact

Malignant FNA: surgical resec (hemi/total) #1; then adj radioiodine ablation for follicular

Intermediate FNA: watchful waiting vs hemithyroidectomy

22
Q

Types of thyroid carcinoma

A

Papillary: 75-80%; F3:M1; slow grow; lymph spread; ⊕prognosis; (orph Annie nuclei + psammoma bodies)

Follicular: 17%; hemato spread; ⊕prognosis

Medullary: 6-8%; ass w/ MEN2; calcitonin-prod C cells; prognosis related to degree of vasc invasion

Anaplastic: <2%; rapid enlarg+metast; ⊖prognosis

23
Q

Osteoporosis (RF, complication)

A

Low bone mass
Esp thin postmenop women; ↑R x2 after 65yo

After min trauma: fx of hip/verteb compress/distal radius
RF: smoking, age, excess caff/alcoh, estrog deplet, hypogonad men, unttt hyperTh, chron infl ds, CS

Complic: fx w/ 50% ↑ morta in 1y after hip fx

24
Q

Osteoporosis (dg, ttt)

A

DEXA: screening all women >65yo, men >70yo + if RF
Dg: BMD <2.5 SDs than T-score
Osteopenia: BMD betw/ 1-2.5 SDs below T-score
Normal Ca/P/PTH

ttt: prevent+ttt w/ Ca + VitD supplem
Smok cess, weight-bearing exo
Bisphosphonates; antiresorptive (SERM, denosumab); anabolic (teriparatide=PTH)

25
Q

Paget disease (PE, complication)

A

↑ rate of bone turnover; mosaic lamellar bone
Ass w/ hyperparath and ↑R osteosarcoma
Esp skull, verteb, pelvis, long bones

Asympt but may have aching bone/joint, headache, bony deform, fx, nerve entrap (hear loss)
Complic: fx, high-output cardiac failure, osteosarcoma

26
Q

Paget disease (dg, ttt)

A

Dg: radiographic (lytic/sclerotic); ↑ALP but Nl GGT and Nl Ca/P

ttt: Ca + VitD supplem
Severe pain: NSAIDs, acetamino; Asympt not ttt
Fx: bisphosphonates, calcitonin slow resopt

27
Q

Hyperparathyroidism (types)

A

1* hyper: 80% from hyperfct adenoma; 15% parath hyperplasia; 5% parath carcinoma

2* hyper: ↑PTH after renal insuff (↓vitD), Ca def, vitD def

3* hyper: in dialysis w/ long-stand 2* hyperpara then hyperplasia of parath; ≥1 gld autonomous

Pseudohypoparathyroidism: PTH resist, ↑PTH but ineff; ↓Ca, ↑P; ass w/ Albright osteodystrophy

28
Q

Hyperparathyroidism (dg, ttt)

A

Most 1* asympt but may show PE hyperCa
1*: hyperCa, hypoP, hyperCaUria, ↑PTH
DEXA: may have low BMD or osteoporosis

99mTc scan + US: localize solit adenoma
Stones, bones, moans, groans, psychiatric overtones

ttt: parathyroidectomy if sympt or ↑↑Ca/↑crea/↓BMD/<50yo
Solit aden: 1 gld removed
Hyperplasia: 3.5 glds removed

29
Q

Hyperparathyroidism 1* (ttt other than surgery, complication)

A

ttt of hyperCa: IV fluids then loop diuretics
Add bisphosphonates if malignancy or acute (IV)
+/- calcitonin

If renal insuff: oral phosphate binders + ↓P in diet
Cinacalcet: lowers PTH in 2* hyperpara or if surg CI

Complic: hypercalcemia; hungry bone sd (post-surg) w/ severe/prolong hypoCa + ↑bone uptake

30
Q

Hypoparathyroidism (etiologies)

A

Iatrogenic (post-surg)
Autoimmune
Congenital (DiGeorge)
Infiltrative ds (hemochromatosis, Wilson)

31
Q

Hypopituitarism

A

By mass, surgery, radiation, Sheehan (infarction), apoplexy (hge), infiltr ds (hemochrom), inf
FSH, LH, TSH affected #1
Suddenly or gradually

Dg: 8AM cortisol, free T4, testo/estrad, IGF-1
ttt: cause

32
Q

Cushing syndrome (etiologies)

A 
#1 exog cause: prolong ttt w/ CS
#1 endog cause: Cushing ds (↑ACTH by pit adenoma)

Other: bilat adr hyperplasia/adr adenoma/adr cancer; ectop ACTH by cancer (carnicoid/medull thyr/small cell lung)

33
Q

Cushing syndrome (dg, ttt)

A

Dg: susp → overnight 1mgDXM or 24h urin free cortisol → suppr=Nl; no suppr=confirm w/ ↑urin cort → Cushing sd
ACTH+cort → ↓ACTH=adr tumor; both↑=ACTH-dep Cush
MRI pit → aden(>4-5mm)=Cush ds; No/<4mm aden then CRH-stim test + ACTH gradient (⊖ectopic/⊕Cush ds)

ttt: surgical resect of source; permanent He replac

34
Q

Acromegaly (PE, dg)

A 
#1 cause: benign pit GH-secre adenoma
↑R: carpal tun sd, obstr sleep apn, DM2, heart ds, HTN, colon K, arthritis; bitemp hemianops (by pit adenoma)

Dg: ↑IGF-1, confirm w/ oral glu suppr test (GH remains ↑); MRI. Do not measure baseline GH

35
Q

Acromegaly (ttt, complication)

A

1 cause of death: CHF (diastolic dysfct)

ttt: transsphenoidal surg resect or external beam radiation
Octreotide (somatost analogue)
Pegvisomant (GH recept antag)

36
Q

Hyperprolactinemia

A 
Etiologies: pituit adenoma (#1), pituit stalk compress, drugs (dopa antag), renal failure, cirrhosis
Inhib GnRH (↓FSH/LH): infertil/galactorrh/amenorrh; bitemp hemianops; !always r/o pgncy

Dg: prolact >200; MRI
ttt: #1 dopamine agon (cabergoline/bromocriptine); surgery (if refract or compression)

37
Q

Diabetes insipidus (etiologies, PE)

A

Central (ADH def): pituit tumor/ischemia/hge, brain trauma, inf, metast, autoimm
Nephrogenic (ADH resist): renal ds, drugs (lithium)

Polydipsia, polyuria, persistent thirst, dilute urine
Normonatremic; if limited water access (hosp/elderly) then hyperNa (alter ment stat/lethargy/seiz/coma)

38
Q

Diabetes insipidus (dg, ttt)

A

Dg: water deprivation test → high volume of inapprop dilute urine (No concentr)
DDAVP (ADH analog) replac test: Central (↓urin outp, ↑urin osm by 50-100%); Nephrog (No effect on both)
MRI (mass in central DI)

ttt: DDAVP (central); salt restric+water intake (nephrog) +/- thiazide

39
Q

SIADH

A

ADH releas indep of serum osm; euvolemic hypoNa
Ass w/ CNS ds, pulm ds, ectop tumor/paraneopl, drugs

Dg: Urin osm >50-100 + serum hypo-osm w/o reason for ↑ADH (CHF/cirrhosis/hypovolemia); urin Na ≥40
ttt: fluid restriction (#1); ttt cause
SLOWLY give hyperton saline if severe hypoNa or if sympt + monitor ICU to prevent central pontine myelinolysis
Demeclocyline (ADH recep antag) or Conivaptan (vasopressin recep antag): normalize natremia

40
Q

Adrenal insufficiency (etiologies)

A

1: Addison ds (autoimm cortical destruct), congen enz def, Waterhouse-Friderichsen sd (adren hge), inf, TB
2/3*: ↓ACTH prod or ↓CRH prod; cessation of long-term GC ttt (>20g for >3wks)

1: hyperpigm, ↓GC, ↓mineraloC
2: ↓GC, No hyperpigm, Nl mineraloC (MC not ACTH dep)

41
Q

Adrenal insufficiency (PE, dg)

A

Weak, fatigue, anorexia, ↓weight, hyperpigm in Addison

Dg: 8AM corti + ACTH measure; if non-dg, synthetic ACTH stimul test
Adr insuff = 8AM cort <3 w/o exog GC; failure of cort to ↑>20 after ACTH confirms dg

42
Q

Adrenal insufficiency (ttt)

A

ttt: 1* replace GC+MC; 2/3 only replace GC
Adr crisis: IV steroids (100mg/8h hydrocort), e- replac, 50% dextrose, aggr fluids (0.9% saline)
↑steroids when stress (surg/inf/trauma)

If chronic steroid ttt, taper slowly to prevent 2/3 AI

43
Q

Pheochromocytoma (etiologies, PE)

A

Tumor of chromaffin tissue; in adr medulla or extra-adr
Ass w/ MEN 2A and 2B; von-HipLin ds, neurofibromat
10%: extra-adr, bilat, malign, child, familial

Paroxysm tachycard, palpit, chest pain, diaphor, HTN, headache, tremor, anxiety

44
Q

Pheochromocytoma (dg, ttt)

A

Dg: CT, MRI; nuclear MIBG scan for extra-adr/metast
↑metaneph (free in plasma or 24-h urine)

ttt: surg resec
! pre-op: alpha-block (phenoxybenz) to contr HTN then B- to contr tachycard

45
Q

Hyperaldosteronism

A 
Adrenocort hyperpl (70%); unilat adr adenoma (=Conn sd; 30%)
HTN, headache, polyuria, muscle weakness
Dg: HypoK, metab alkal, hypoMg, hyperaldo, ↑aldo/renin ratio; CT or MRI

ttt: surgic resec if tumor (after BP + K+ correction); epleronone (aldo recep antag) if bilat hyperpl

46
Q

Congenital adrenal hyperplasia

A

Enz def → impaired cort synth
21-hydr def (95%); 11-hydr def; 17-hydr def

Dg: HypoNa, hyperK, metab acid; if severe, life-thr salt wasting; in 21-hydr def, ↑17-hydroxyprogest

ttt: immediate fluid resusc + salt replet; cortisol to ↓ACTH + androg; fludrocortisone if severe 21-hydr def
Possible surgical correction of ambig genit

47
Q

Multiple Endocrine Neoplasias

A

AD inheritance
MEN1: pancr islet cell tumors, parathy hyperplasia, pituit adenomas
MEN2A (RET mut): medull thyr carcinoma, pheo/adr hyperpl, parathy hyperplasia
MEN2B (RET mut): medull thyr carcinoma, pheo, oral/intest ganglioneuroma, marfanoid habit

English 2 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions