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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
Complications of DM 6
1. Chronic pyelonephritis 2. Stroke 3. Diabetic retinopathy 4. Diabetic nephrophaty 5. Neuropathy 6. Cardiovascular diseases
26
How to diagnose diabetes insipitus? 4
1 High plasma osmolarity, low Urin osmollality 2 High plasma sodium 3 High 24h Urin volume 4 Water deprivation test
27
How to treat diabetes insipitus?
Desmopressin (ADH analogue)
28
What is the outcome of SIADH?
Retention of water | Hyponatremia
29
What causes SIADH? 4
1. Tumors (SCLC) 2. Pulmonary leasion (pneumonia) 3. CNS causes (meningitis) 4. Metabolic causes (alcohol withdrawal)
30
Clinical compilations of hypothyroidism? 6
1. Tiredness, depressed, lazy 2. Hoarse voice 3. Puffy face 4. Myxedema 5. Mental slowness 6. Anemia
31
Treatment of hypothyroidism?
Levothyroxine 50ug/day
32
Causes fro hyperthyroidism? 4
1. Graves 2. Toxic multinodular goiter 3. Solitary toxic adenoma 4. Thyroiditis
33
Specific signs for Graves’ disease (5)
1. Graefe sign 2. Möbius sign 3. Dalrymple sign 4. Stellwags soign 5. Jules sign
34
What is graefe sign?
Immobility and lagging of upper eyelid
35
What is möbius sign?
Inability to maintain convergence of the eyes
36
What is dalrymple sign?
Widened palpebral open eyes
37
What is stellwags sign?
Infrequent and incomplete blinking
38
What is Jules sign?
Palpebral or periorbital edema
39
What are the characteristics of a thyroid Strom? 4
1. Hyperpyrexia 2. Tachycardia 3. Restlessness 4. Cardiac + liver failure
40
Types of thyroiditis? 6
1. Active (suppurative) 2. Subacute painful 3. Granulomatous DeQuervains 4. Subacute painless 5. Chronic hashimotos 6. Chronic fibrous Riedels
41
How do we diagnose Subacute Painless thyroiditis?
RAIU test- during hyperthyroidism period it’s suppressed (hypothyroid phase its increased) = radioactive iodine uptake
42
Diagnosis of Hashimotos?
Serum Anti TPO AB | Initial toxic then hypothyroidism
43
Tx of hasimotoas?
Levothyroxine
44
Thyroid malignancies: 4
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
Confirmation tests for cortisol excess?
1. Over night dexamethasone test 2. 24h excretion of free cortion 3. CRH test combination with dexa
46
Differential diagnosis of Chushings disease and ectopic ACTH production?
CRH stimulation test: Chsuaings disease— elevation of ACTH Ectopic— No change
47
Etiology for primary hyperaldosteronism:
Conns Syndrom 1. Bilateral adrenal hyperplasia 70% 2. Adrenal adenoma 30% DOC overproduction due to 11oh deficiency
48
Reasons for conns syndrome
1. Ideopathic hyperplasia 65% 2. Aldosterone producing adenoma 30% 3. Familial 1% 4. Aldo producing carcinoma 1%
49
Clinical symptoms of conns 4
1. HTN 2. Hypokalemia 3. Hypernatremia 4. Alkalosis
50
Hormone level testing for hyperaldosteronism
1. Postural test: lay 4h, add drug stand for 4h 2. Plasma aldosterone test 3. Salt suppression test
51
Classic triade for pheochromocytoma
Headache Profuse sweating Palpüitaion
52
Diagnostic test for pheochromocytoma?
Urin test: Metanephrines (more specific) or vma

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