IM- Endocrine Flashcards by Beth A

Tx for prolactinoma with macroprolactinoma (>1cm) (2)

Dopaminergic agonists

Cabergoline & Bromocriptine

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In primary adrenal insufficiency, the effect on
Cortisol
ACTH
Aldosterone

Cortisol- LOW
ACTH- HIGH
Aldosterone- LOW

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In secondary/pituitary (central) adrenal insufficiency, the effect on
Cortisol
ACTH
Aldosterone

Cortisol- LOW
ACTH- LOW
Aldosterone- Normal

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4 presentation of Primary adrenal insufficiency

Hyperpigmentation
Hyperkalemia
Hyponatremia
Hypotension

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1 presentation of secondary & tertiary adrenal insufficiency

possible hyponatremia (mild symptom)

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Secondary adrenal insufficiency is caused by

Pituitary- chronic glucocorticoid therapy

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Tertiary adrenal insufficiency is caused by

hypothalamic- chronic glucocorticoid therapy

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Cause of primary adrenal insufficiency is

Autoimmune

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which MEN types are involved in Parathyroid adenoma?

MEN 1 & 2A

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Fatigue, constipation, abd pain, renal stones, bone pain, neuropsychiatric symoptoms

Primary hyperparathyrodism

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Labs to take for hyperparathyroidism (3)

Hypercalcemia
Elevated or inappropriately normal PTH
Elevated 24hr urinary calcium excretion

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FNA biopsy with large cells with ground glass cytoplasm, and pale nuclei containing inclusion bodies and central grooving consistent with ? Tx?

Papillary thyroid cancer

Surgical resection

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Exogenous thyroid hormone is characterized by

Low serum thyroglobulin level

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The key pathogenic factor in the development of Type 2 DM and associated abnormalities (hypertension and dyslipidemia )

Central-type obesity (insulin resistance)

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a fall in total and free T3 levels with normal T4 & TSH levels

Euthyroid sick syndrome (Low T3 syndrome)

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The 4 main substrates of gluconeogenesis are

alanine (gets converted to pyruvate)
glutamine
lactate
glycerol-3-phosphate

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5 causes of osteomalacia

malabsorption
intestinal bypass surgery
celiac sprue
chronic liver disease
chronic kidney disease

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Diagnose of osteomalacia 
AK &amp; PTH level?
Serum Calcium and Phosphorus level?
Urinary calcium level?
25 OH-D level?

AK & PTH level- High
Serum Calcium and Phosphorus level- Low
Urinary calcium level- Low
25 OH-D level- Low

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What are the x-ray findings in osteomalacia?

thinning of cortex with reduced bone density

- bilateral and symmetric pseudofractures (looser zones)

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Tx for unilateral adrenal adenoma (2)

Surgery

- Aldosterone antagonists (Spironolactone, eplerenone)

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Tx for bilateral adrenal hyperplasia

Aldosterone antagonists (Spironolactone, eplerenone)

3 agents used for Diabetic gastroparesis

Metoclopramide
Erythromycin
Cisapride

Proximal muscle weakness in the setting of clinical features of hyperthyroidism

Chronic hyperthyroid myopathy

Type of cancer that has increased incidence 60 times greater in patients with preexisting Chronic lymphocytic (Hashimoto’s) thyroiditis.

Thyroid lymphoma

_____ used to predict the risk of future food ulcers in a diabetic neuropathic foot

Monofilament testing

Level of prolactin that is diagnostic for prolactinoma is

>200ng/mL

What are included in MEN2B (3)

- Pheochromocytoma - Medullary thyroid cancer (Calcitonin) - Mucosal neuromas/Marfanoid habitus

What are included in MEN2A (3)

- Medullary thyroid cancer (calcitonin) - Pheochromocytoma - Mucosal neuromas/marfanoid habitus

What gene mutation is involved in MEN2

RET-proto-oncogene on chromosome 10

The most beneficial therapy to reduce the progression of diabetic nephropathy is

Strict blood pressure control (goal <130/80)

Postpartum adrenal insufficiency can be due to

primary (adrenal ) or secondary (pituitary)

40-45% of blood calcium is bound to

albumin and other proteins

With Primary polydipsia, Sodium level is

Low | Hyponatriemia

With central DI, Sodium level is

High | Hypernatremia

With nephrogenic DI, Sodium level is

normal

Primary hyperaldosteronism Renin- Aldosterone-

Renin- LOW | Aldosterone- HIGH

Secondary hyperaldosteronism

Renin- HIGH | Aldosterone- HIGH

Primary hyperaldosteronism causes (2)

- Aldosterone-Producing tumor | - Bilateral adrenal hyperplasia

Secondary hyperaldosteronism causes (4)

- Renovascular hypertension - Malignant hypertension - Renin-secreting tumor - Diuretic use

autonomous production of thyroid hormones from the hyperplastic thyroid follicular cells

Hyperthyroidism from toxic adenoma

3 ways to diagnoses Cushing syndrome

- 24hr urinary cortisol excretion - Late-night salivary cortisol assay - Low-dose dexamethasone suppression test

the 3 osteoclast activities from excess thyroid hormone are

- increased bone resorption - decrease bone density - increased fracture risk

Someone with elevated calcitonin and a lump in the neck, two diseases to consider

MEN2 - Medullary thyroid cancer - Pheochromocytoma (Check metanephrine)

flushing, watery diarrhea (tea colored), hypochlorhydria, mass on a pancreatic tail

VIPoma | Carcinoid is in the small intestine

3 treatments for Graves disease

- Antithyroid drugs (methimazole & PTU) - Radioiodine ablation - Surgery

SE for Antihtyroid drugs

agranulocytosis

SE for Methimazole (2)

1st trimester teratogen, cholestasis

SE for Propylthoiuracil (PTU)2

Hepatic failure, ANCA-associated vasulitis

SE for Radioiodine ablation (3)

- Permanent hypothyrodism - Worsening of ophthalmopathy - Possible radiation side effects

Diarrhea with foul-smelling and floating, abd cramp, wt loss, fatigue, diffuse bone pain, hgb 9.8, MCV 72. Dx? Ca, Ph, PTH levels?

Chronic GI disease (steotorrhea, celiac disease...)- VIt D deficiency Ca- LOW Ph- LOW PTH- HIGH