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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
what are bone, groan, moan, stone
bone: fx moan: AMS, psychosis moan: constipation, N,V stone: kidneys also, "Ca kills the kick" hyperCa = dec. DTRs
26
hyperCa EKG
short QT, long PR, wide QRS
27
hyperCa tx
IVF, Lasix, calcitonin, bisphosphonate (put the Ca into the bone)
28
if you have low Ca and low PTH you probably have
hypoPTHism
29
low Ca and high PTH
- renal dz - other lytes effecting (low Mg, high Phos, low albumin) - PPI - pancreatitis - random: liver dz, blood trans, rhabdo)
30
hypoCa EKG
Long QT, peaked T
31
What would Cushing's due to K?
decrease - hyperaldeosteronism
32
Effect of increasing pH on K (when the pt starts out acidotic)
Decrease 0.5 for every 0.1 increase in pH (K gets pushed into cells)
33
drugs that cause hypoK
- insulin - Digibind - B-agonist (albuterol) - renal excretion: diuretic, ampho, aminoglycoside, mannitol
34
weak, rhabdo, cramps, arrythmias - what lyte abdnomality
hypoK
35
hypoK EKG
long QT, flat T, U wave
36
hyperK tx
Ca gluconate, insulin, albuterol, bicarb (drive K into cell)
37
you know hyperK is d/t extracellular shift with what lab test (urine)
high urine K
38
differentiate toxic diffuse goiter from toxic nodular goiter
``` diffuse= graves' young F 20-40 nodular= older, rare, milder sx ```
39
Name 5 causes of hypOvolemic hypernatremia
- hyperglycemia (renal loss) - OSMOTIC diuretic (renal loss) - sweat, n/v/d - dehydration
40
What's a cause of ISOvolemic hyperNa
DI
41
What's a cause of HYPERvol hyperNa
mineralcorticoid excess, hypertonic saline
42
What complication are you worried about with hyperNa
conc high out of cells... water shifts out of cells and brain cells shrink
43
hyperNa tx
rehydrate, po if possible, don't corrected more than 0.5/hour (cerebral edema), D5w or 1/2 NS
44
what's a cause of "fake" hyponatremia (you know it's fake if you have normal or high serum osmol)
hyperglycemia (for every +100 blood glucose over 100, ad 1.6 to Na) high protein and TG
45
hypovolemic hyponatremia causes
renal loss - hctz, ace/arb, ksparing, RTA extrarenal - n/v/d, pancreatitis, bleeds/burns
46
isovol hyponatremia causes
SIADH, hypothyroid, post op
47
hypervolemic hyponatremia w/ UNa <20
chf, cirrhosis, nephrosis
48
hypervol hypoNa w/ UNa >20
renal failure
49
what do you want to prevent when correcting hyponatremia
demyelination | if serum gets too concentrated, water will rush out of cells
50
genetic mutation a/w hyperPTH
MEN1/2A
51
tx for BOTH hyper and hypoPTH
Ca and Vit D | if hyper was due to deficiency, and not adenoma
52
cardiac manifestation of hyperthyroid
tachy>high outpt HF
53
hyperthyroid tx
radioactive iodine methimazole or PTU (1st tri) BB
54
MC thyroid Ca type
papillary
55
medullary thyroid Ca a/w what genetic medullary = parafollicular cells, calcitonin secreting
MEN2,
56
what kind of bone Ca a/w Paget's
osteosarcoma
57
big weak bones, kyphosis, +/- deafness
Paget's
58
tx: Paget's
bisphosphonates | 2nd choice: calcitonin
59
MCC adenoma of pituitary
prolactinoma - decreased FSH, increased PL
60
tx: pit adenoma
bromocriptine, cabergoline

Clinical Rotations (9 decks)

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