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Stuff Thats Would Be Cool To Remember > Internal Medicine Endocine > Flashcards

Internal Medicine Endocine Flashcards

1
Q

DDx for HIRSUTISM 6

A
  1. Poly cystic ovary Syndrom
  2. Cushing Syndrom
  3. CAH
  4. Androgen secreting tumor
  5. Medication
  6. Ideopathic
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2
Q

Frequent Causes for hypercalcemia 4

A
  1. Hyperparathyroidism
  2. PTH ectopic (lung kindey ovary tumor)
  3. Local stimulation of bone resorption Multiple myeloma
  4. Osteolyitc tumors
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3
Q

Occurring causes for hypercalcemia 4

A
  1. Granulaomatous diseases: Sarcoidosis
  2. Drugs: Vit D
  3. Thyrotoxicosis
  4. Immobilization
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4
Q

Tx of hypercalcemia?

A
  1. General (ca free diet etc)
  2. Stimulate Urin excretion
  3. Inhibition of bone resorption
  4. Treat underlying condition
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5
Q

Ca Level of hypercalcemia ?

A

More then 2.6 mmol/L se Ca

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6
Q

Clinical symptoms of Hypercalcemia (5 systems)

A
  1. Heart: hypertension, bradycardia extrasystole
  2. GI: nausea, thirst
  3. Renal: Polyuria, nephrolithastasis
  4. CNS: concentration loss, mental change
  5. Muscle weakness
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7
Q

Se Ca level in hypocalcemia?

A

Less then 2.25 mmol/L

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8
Q

Causes for Hypocalcemia? 6

A
  1. Congenital (DiGeorge sy)
  2. Post operative Hypoparathyroidosm
  3. PTH resistance
  4. Vit D deficiency (Liver , malabsorption etc)
  5. Drugs (inhibition of bone resorption)
  6. Acute pancreatitis
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9
Q

What causes Vit. D defficneincy?

A 
Malnutrition 
Malabsorption 
Lack of sunshine 
Cirrhosis 
Uremia
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10
Q

Symptoms of Hypocalcemia

A
  1. Long QT sy
  2. Conduction blocks
  3. Irritability
  4. Tonic spasms
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11
Q

To of Hypocalcemia

A

Ca-Chlorate for spasm

Stabilizes Ca by Vit d deficiency

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12
Q

Limits for normal glucose tolerance in OGTT?

A
  1. 0 fasting

7. 8 post pranndial

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13
Q

Limits for impaired fasting glucose IFG?

A

7 fasting

7.8 post intus

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14
Q

Limits for impaired glucose tolerance IGT?

A

7 fasting

11.1 post

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15
Q

Limits for DM in OGTT

A

More the 7 fasting

More then 11.1 post

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16
Q

What is LADA?

A

Lateness auto immune diabetics in adults

It’s a subtype of type 1 dm

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17
Q

What is MODY?

A

Maturity onset diabetes of the young

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18
Q

What is druginduced diabetes?

A

Glucocorticoid
Thyroid hormone
Beta. Andre eric agosints

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19
Q

Which diseases are associated with DM? 6

A
  1. Acromegaly
  2. Pancreatitis
  3. Cushings
  4. Hyperthyroidism
  5. Pheochomocytoma
  6. Glucagonoma
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20
Q

Diet changes in DM

A
  1. Low sugar
  2. High starch
  3. High fiber
  4. Low fat
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21
Q

Oral antidiabetic drugs 3

A
  1. Metformin
  2. Sulfonylureas
  3. Glitazones
22
Q

What does Metformin do?

A 
Best Tx for DMT2
Activates AMP kinase deacreasing gluconeoegnisi 
Increases insulin sensitivity 
Cardiovascular protection 
Side effect: anorrexia
23
Q

How do sulfonyureas work?

A

Vs DM
Acts on beta cells to increase insulin secreation
Not effective if no beta cells left
May induce hypoglycemia

24
Q

How does glitazone work?

A

Reduces insulin resistance
Reduces hepatic glucose production
Weight gain side effect

25
Q

Complications of DM 6

A
  1. Chronic pyelonephritis
  2. Stroke
  3. Diabetic retinopathy
  4. Diabetic nephrophaty
  5. Neuropathy
  6. Cardiovascular diseases
26
Q

How to diagnose diabetes insipitus? 4

A

1 High plasma osmolarity, low Urin osmollality
2 High plasma sodium
3 High 24h Urin volume
4 Water deprivation test

27
Q

How to treat diabetes insipitus?

A

Desmopressin (ADH analogue)

28
Q

What is the outcome of SIADH?

A

Retention of water

Hyponatremia

29
Q

What causes SIADH? 4

A
  1. Tumors (SCLC)
  2. Pulmonary leasion (pneumonia)
  3. CNS causes (meningitis)
  4. Metabolic causes (alcohol withdrawal)
30
Q

Clinical compilations of hypothyroidism? 6

A
  1. Tiredness, depressed, lazy
  2. Hoarse voice
  3. Puffy face
  4. Myxedema
  5. Mental slowness
  6. Anemia
31
Q

Treatment of hypothyroidism?

A

Levothyroxine 50ug/day

32
Q

Causes fro hyperthyroidism? 4

A
  1. Graves
  2. Toxic multinodular goiter
  3. Solitary toxic adenoma
  4. Thyroiditis
33
Q

Specific signs for Graves’ disease (5)

A
  1. Graefe sign
  2. Möbius sign
  3. Dalrymple sign
  4. Stellwags soign
  5. Jules sign
34
Q

What is graefe sign?

A

Immobility and lagging of upper eyelid

35
Q

What is möbius sign?

A

Inability to maintain convergence of the eyes

36
Q

What is dalrymple sign?

A

Widened palpebral open eyes

37
Q

What is stellwags sign?

A

Infrequent and incomplete blinking

38
Q

What is Jules sign?

A

Palpebral or periorbital edema

39
Q

What are the characteristics of a thyroid Strom? 4

A
  1. Hyperpyrexia
  2. Tachycardia
  3. Restlessness
  4. Cardiac + liver failure
40
Q

Types of thyroiditis? 6

A
  1. Active (suppurative)
  2. Subacute painful
  3. Granulomatous DeQuervains
  4. Subacute painless
  5. Chronic hashimotos
  6. Chronic fibrous Riedels
41
Q

How do we diagnose Subacute Painless thyroiditis?

A

RAIU test- during hyperthyroidism period it’s suppressed (hypothyroid phase its increased)
= radioactive iodine uptake

42
Q

Diagnosis of Hashimotos?

A

Serum Anti TPO AB

Initial toxic then hypothyroidism

43
Q

Tx of hasimotoas?

A

Levothyroxine

44
Q

Thyroid malignancies: 4

A
  1. Papillary ca 70% good
  2. Follicular ca 20% good
  3. Anaplastic ca 5% poor
  4. Medullary ca 2% poor

Only anaplastic with radiotherapy. All others total thyroidectomy

45
Q

Confirmation tests for cortisol excess?

A
  1. Over night dexamethasone test
  2. 24h excretion of free cortion
  3. CRH test combination with dexa
46
Q

Differential diagnosis of Chushings disease and ectopic ACTH production?

A

CRH stimulation test:
Chsuaings disease— elevation of ACTH
Ectopic— No change

47
Q

Etiology for primary hyperaldosteronism:

A

Conns Syndrom

  1. Bilateral adrenal hyperplasia 70%
  2. Adrenal adenoma 30%

DOC overproduction due to 11oh deficiency

48
Q

Reasons for conns syndrome

A
  1. Ideopathic hyperplasia 65%
  2. Aldosterone producing adenoma 30%
  3. Familial 1%
  4. Aldo producing carcinoma 1%
49
Q

Clinical symptoms of conns 4

A
  1. HTN
  2. Hypokalemia
  3. Hypernatremia
  4. Alkalosis
50
Q

Hormone level testing for hyperaldosteronism

A
  1. Postural test: lay 4h, add drug stand for 4h
  2. Plasma aldosterone test
  3. Salt suppression test
51
Q

Classic triade for pheochromocytoma

A

Headache
Profuse sweating
Palpüitaion

52
Q

Diagnostic test for pheochromocytoma?

A

Urin test: Metanephrines (more specific) or vma

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