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COMLEX 2 > Endocrinology/Rheumatology > Flashcards

Endocrinology/Rheumatology Flashcards

1
Q

Addisonian Crisis

A

Fever, N&V, Abd pain Hypotension, Hyperpigmentation in palmar creases Polydipsia

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2
Q

What oral hypoglycemic agent is contraindicated for men with Cr >1.5 and women >1.4?

A

Metformin. Contraindicated in renal dz.

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3
Q

MEN I (Wermer’s Syn)

A

Pituitary tumor Parathyroid hyperplasia Pancreatic Islet cell tumor

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4
Q

MEN IIA (Sipple Syn)

A

Medullary thyroid ca. Pheochromocytoma Parathyroidism

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5
Q

MEN IIB

A

Medullary thyroid ca. Pheochromocytoma Marfanoid

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6
Q

Hereditary Angioedema

A

C1 Inhibitor Deficiency –> non-inflamm. edema of face, limbs, genitals, colic Dx: Dec. C4

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7
Q

Familial Hypocalciuric HyPERcalcemia Dx:

A

AutoDom Ca-sensing-Receptor gene mutation wherein higher Ca2+ concentrations are needed to inhibit PTH release and Ca2+ reabsorption Dx: Ca >10 Hypocalciuria = Ca2+/Cr ratio 2.0

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8
Q

Insulinomas are usually suggested by what triad?

A

Whipple’s triad: 1. hypoglycemia 2. low glucose 3. relief of S&S when glucose is raised

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9
Q

Labs seen in Whipple’s triad

A
  1. Low glucose 2. High insulin, C-peptide, and pro-insulin
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10
Q

What would C-peptide levels be in surreptitious injection of insulin?

A

Low C-peptide. (C-peptide means body was making insulin)

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11
Q

Hashimoto Thyroiditis (Hypothyroidism) keywords

A

Enlarged non-tender thyroid Widespread destruction of follicles Anti-TPO, eosinophilic Hurthle cells Inc. risk thyroid lymphoma and papillary thyroid ca.

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12
Q

What is it called when the thyroid is functioning normally but does not receive stimulus from the pituitary to produce more hormone?

A

2ndary hypothyroidism

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13
Q

Dermatologically, how would primary adrenal insufficiency manifest? Why does this happen?

A

Darkening of the skin. Low Na+, High K+ There is an increase in production of ACTH to compensate for lack of aldosterone production.

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14
Q

2ndary adrenal insufficiency and 2ndary hypothyroidism together suggests?

A

Pituitary insufficiency most likely d/t pituitary tumor

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15
Q

In Carcinoid Syndrome, what neurotransmitter is most responsible for diarrhea?

A

Serotonin

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16
Q

What is the most common cause of thyroid cancer? Keywords? Tx? AE?

A

Papillary thyroid carcinoma. Orphan annie eyes, psamomma bodies in follicular cells Tx: Radioactive Iodine AE: drymouth/sialadenitis

17
Q

From where do most carcinoid tumors originate?

A

Small bowel

18
Q

Lupus nephritis Lab values

A

normal CRP Elevated ESR Decreased serum C3 and C4

19
Q

Glipizide, Glyburide, Glimepiride, Tolbutamide belong in what class? MOA? Adverse SE?

A

Sulfonylureas. Increase endogenous insulin secretion ! hypoglycemia, weight gain, sulfa allergy, disulfiram-like rxn for tolbutamide

20
Q

Rosiglitazone, Pioglitazone belong in what class? MOA? Adverse SE?

A

Thiazolidinediones. Increase insulin sensitivity. ! Edema, weight gain, hepatotoxicity, bone loss, not for heart failure pts.

21
Q

Acarbose, Miglitol belong in what class? MOA? Adverse SE?

A

Alpha-Glucosidase Inhibitors. Decrease intestinal absorption of carbs ! Flatulence, hypoglycemia

22
Q

Sitagliptin belongs in what class? MOA? Adverse SE?

A

DPP-4 Inhibitors. Inhibits degradation of GLP-1

23
Q

Exenatide belongs in what class? MOA? Adverse SE?

A

Incretins. Is a GLP-1 agonist. ! Pancreatitis

24
Q

How would Graves’ Disease appear on RAIU?

A

diffuse (homogenous) uptake

25
Q

When is methimazole allowable to treat hyperthyroidism in the pregnant woman?

What is a serious side effect?

A

2T (2nd trimester)

AE: Agranulocytosis

26
Q

When is PTU allowable to treat hyperthyroidism in the pregnant woman?

A

1T (1st trimester). Generally, however, PTU is the one you pick in pregnancy.

27
Q

Congenital Hypothyroidism S&S d/t?

A

poor feeding, constipatioin, large anterior fontanelle, macroglossia, umbilical hernia, MR d/t iodine deficiency, inborn errors of metabolism, thyroid dysgenesis

28
Q

Myxedema Coma S&S Dx Tx?

A

hypothermia, bradycardia, hypoTN, hyponatremia, hypoglycemia Dx: Check cortisol prior to treating Tx: IV synthroid, Hydrocortisone

29
Q

Thyroid Nodule Workup

A
30
Q

Medullary Thyroid Ca. keywords

A

C-(calcitonin) Cells MEN 2A, MEN 2B

31
Q

Milk Alkali Syndrome

A

ingestion of large amounts of Ca and alkali leading to hypercalcemia, fatigue, confusion, arrhythmias, constipation

32
Q

Cushing’s Signs and Symptoms Workup

A
33
Q

Hypervitaminosis D (d/t granulomas) Labs

A

Increased Ca, Increased Phosphorus Decreased PTH 1,25 Vit D

34
Q

Diabetes Workup

A
35
Q

Adrenal Insufficiency Workup

A
36
Q

Conn Syndrome Workup

A
37
Q

Giant Cell Arteritis is often associated with what condition?

Tx of Giant Cell Arteritis

A

Polymyalgia Rheumatica

Tx: High dose Oral Steroids

38
Q

Subacute (DeQuervain’s) Thyroiditis S&S

Tx?

A

Post-URI with tender lump in neck on swallowing

Tx: NSAIDS

39
Q

Systemic lupus erythematosus (SLE) is associated with what renal disease?

Tx with?

A

Renal Tubular Acidosis Type I (RTA I), a Non-AGap Met. Acidosis

Tx: Sodium Bicarb

COMLEX 2 (19 decks)

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