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Clinical Rotations > Inpatient EOR - Endo > Flashcards

Inpatient EOR - Endo Flashcards

1
Q

Lab test for acromegaly

A

IGF-1 elevated (does not suppress w/ glucose)

somatoriptoma>GH>IGF1

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2
Q

Tx acromegaly

A
  1. surg: TSS
  2. DA agonist (bromocriptine+cabergoline),
  3. octreotide (somatostatin analog, inhib GH secretion)
  4. GH receptor agonist (pegvisomany)
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3
Q

MCC Addison dz worldwide?

in developed countries?

A

infection worldwide,

developed = AI

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4
Q

Lab findings in Addison’s

- hormones AND lytes

A
  • high ACTH
  • low cortisol and aldosterone
  • hypoNa, hyperK
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5
Q

tx Addison

A

hydrocortisone and fludrocortisone

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6
Q

hyperpig, weakness, wt loss, orthostat

A

Addisons

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7
Q

hyperpig, proximal weakness, easy bruise, thin arms w/ big belly

A

Cushings

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8
Q

with Cushing’s, if HIGH dose dexamethasone suppression test showed no suppression, what would you think?

A
  • pituitary adenoma secreting ACTHA
  • adrenal tumor
    (if adrenal tumor, then ACTH low)
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9
Q

what is diabetes insipidus

A

body doesnt produce ADH

  • keep making dilute urine inappropriateing
  • hyperNa if can’t drink
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10
Q

DI dx

A
  • urine osmo <200 w/ fluid deprivation

- give desmopressin…. if response, it’s cetrnal; if no, it’s nephrogenic

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11
Q

tx nephrogenic DI

A

Na/protein restriction, hctz

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12
Q

tx DM nephropathy

A

ACE-I

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13
Q

cholesterol goals DM

A

LDL <100, HDL>40, TG<150

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14
Q

DM drug to d/c if hepatic, renal impairment or Cr>1.5

A

metformin

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15
Q

DM drug a/w wt gain

A

sulfonureas (G-ides)

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16
Q

DM drug a/w hepatitis

A

acarbose, miglitol

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17
Q

DM drug CI in CHF

A

pioglitazone (thiazolidinediones)

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18
Q

DM drug CI in gastroparesis

A

GLP1 agonist

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19
Q

DM drug a/w pancreatitis

A

DPP4 inhibitor

Dead poor pancreas (DPP)

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20
Q

DM drug a/w UTI

A 
SGLT2 inhib (canaiflozin)
flozin (urinary flow)
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21
Q

PHET sx of pheochromocytoma

what happens to BMs?

A

palpitation, HTN, Excess sweat, tachy

constipation

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22
Q

pheochromocytoma dx

A

^plasma metanephrine

^24h urine catecholaime

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23
Q

pheochromocytoma lyte abn

A

hypOkalema

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24
Q

pheochromocytoma tx

A

alpha blocker, then beta block, then sx

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25
Q

what are bone, groan, moan, stone

A

bone: fx
moan: AMS, psychosis
moan: constipation, N,V
stone: kidneys

also, “Ca kills the kick” hyperCa = dec. DTRs

26
Q

hyperCa EKG

A

short QT, long PR, wide QRS

27
Q

hyperCa tx

A

IVF, Lasix, calcitonin, bisphosphonate (put the Ca into the bone)

28
Q

if you have low Ca and low PTH you probably have

A

hypoPTHism

29
Q

low Ca and high PTH

A
  • renal dz
  • other lytes effecting (low Mg, high Phos, low albumin)
  • PPI
  • pancreatitis
  • random: liver dz, blood trans, rhabdo)
30
Q

hypoCa EKG

A

Long QT, peaked T

31
Q

What would Cushing’s due to K?

A

decrease - hyperaldeosteronism

32
Q

Effect of increasing pH on K (when the pt starts out acidotic)

A

Decrease 0.5 for every 0.1 increase in pH (K gets pushed into cells)

33
Q

drugs that cause hypoK

A
  • insulin
  • Digibind
  • B-agonist (albuterol)
  • renal excretion: diuretic, ampho, aminoglycoside, mannitol
34
Q

weak, rhabdo, cramps, arrythmias - what lyte abdnomality

A

hypoK

35
Q

hypoK EKG

A

long QT, flat T, U wave

36
Q

hyperK tx

A

Ca gluconate, insulin, albuterol, bicarb (drive K into cell)

37
Q

you know hyperK is d/t extracellular shift with what lab test (urine)

A

high urine K

38
Q

differentiate toxic diffuse goiter from toxic nodular goiter

A 
diffuse= graves' young F 20-40
nodular= older, rare, milder sx
39
Q

Name 5 causes of hypOvolemic hypernatremia

A
  • hyperglycemia (renal loss)
  • OSMOTIC diuretic (renal loss)
  • sweat, n/v/d
  • dehydration
40
Q

What’s a cause of ISOvolemic hyperNa

A

DI

41
Q

What’s a cause of HYPERvol hyperNa

A

mineralcorticoid excess, hypertonic saline

42
Q

What complication are you worried about with hyperNa

A

conc high out of cells… water shifts out of cells and brain cells shrink

43
Q

hyperNa tx

A

rehydrate, po if possible, don’t corrected more than 0.5/hour (cerebral edema), D5w or 1/2 NS

44
Q

what’s a cause of “fake” hyponatremia (you know it’s fake if you have normal or high serum osmol)

A

hyperglycemia (for every +100 blood glucose over 100, ad 1.6 to Na)

high protein and TG

45
Q

hypovolemic hyponatremia causes

A

renal loss - hctz, ace/arb, ksparing, RTA

extrarenal - n/v/d, pancreatitis, bleeds/burns

46
Q

isovol hyponatremia causes

A

SIADH, hypothyroid, post op

47
Q

hypervolemic hyponatremia w/ UNa <20

A

chf, cirrhosis, nephrosis

48
Q

hypervol hypoNa w/ UNa >20

A

renal failure

49
Q

what do you want to prevent when correcting hyponatremia

A

demyelination

if serum gets too concentrated, water will rush out of cells

50
Q

genetic mutation a/w hyperPTH

A

MEN1/2A

51
Q

tx for BOTH hyper and hypoPTH

A

Ca and Vit D

if hyper was due to deficiency, and not adenoma

52
Q

cardiac manifestation of hyperthyroid

A

tachy>high outpt HF

53
Q

hyperthyroid tx

A

radioactive iodine
methimazole or PTU (1st tri)
BB

54
Q

MC thyroid Ca type

A

papillary

55
Q

medullary thyroid Ca a/w what genetic

medullary = parafollicular cells, calcitonin secreting

A

MEN2,

56
Q

what kind of bone Ca a/w Paget’s

A

osteosarcoma

57
Q

big weak bones, kyphosis, +/- deafness

A

Paget’s

58
Q

tx: Paget’s

A

bisphosphonates

2nd choice: calcitonin

59
Q

MCC adenoma of pituitary

A

prolactinoma - decreased FSH, increased PL

60
Q

tx: pit adenoma

A

bromocriptine, cabergoline

Clinical Rotations (9 decks)

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