Kaplan- Endo Flashcards
stopped just before 31
a 52 y.o. woman with heat intolerance, exopthalmos and sinus tachycardia likely has what disease
what is the mechanism?
Grave’s disease:
hyperthyroidism is caused by autoantibodies against TSH receptor that activate it
how is Grave’s disease differentiated from Hashimoto’s thyroiditis in terms of symptomology and type of immune reaction
Grave’s causes hyperthyroidism, Hashimoto’s causes hypothyroidism
Graves is type II noncytotoxic hypersensitivity reaction
Hashimoto’s is a type IV cytotoxic hypersensitivity reaction
what are the three P’s of multiple endocrine neoplasia type 1
neoplasias of the parathyroid, pituitary, and pancreas
what’s the range of normal prolactin
normal prolactin < 20ng/mL
which hormone is responsible for regulating plasma sodium concentration with varying salt intake
ADH, not aldosterone
ADH is very sensitive to changes in plasma sodium and responds rapidly to increase water reabsorption in response to increased sodium
aldosterone can only uptake salt and water and in equal amounts so this doesn’t help regulate conc.
what is the thyroid gland like in Hashimoto’s
enlarged and uniformly firm due to chronic inflammation
what antibodies characterize Hashimoto’s thyroiditis
anti-thyroid peroxidase and anti-thyroglobulin
do angiofibromas and lipomas tend to occur more with MEN type 1 or 2
what about pituitary adenomas
angiofibromas and lipomas=type 1
pituitary adenomas=also type 1
a child with short stature, shortened 4th and 5th metacarpals, low serum Ca2+, high serum phosphate and high serum PTH likely has a defect in what molecule
what’s the disease
stimulatory Gs protein PTH receptor leading to failure to raise cAMP in response to PTH
this disease is pseudohypoparathyroidism (defective PTH receptor leading to low Ca)
what are normal levels for serum Ca2+
8.4-10.2 mg/dL
what are Trousseau and Chvostek’s signs and what imbalance do they signify
Trousseau: carpal spasm after application of BP cuff
Chvostek: facial muscle upon tapping in front of the ear
these signs suggest hypocalcemia
activity of which enzyme –that catalyzes the rate limiting step in fatty acid synthesis– is upregulated by insulin
acetyl CoA carboxylase
why might a euthyroid pregnant woman with palpitations, heat intolerance and weight gain have high T4 and normal TSH
- estrogen in pregnancy causes an increase in TBG such that free T4 remains the same, but total serum T4 increases
- TSH is normal because free levels of thyroid influence its secretion, not bound levels
- palpitations and heat intolerance are normal in pregnancy
what are four treatments that would be given to manage a patient with DKA
- insulin therapy
- IV fluids (to manage dehydration)
- dextrose (to prevent hypoglycemia during Tx)
- potassium (to prevent hypokalemia during Tx)
what kind of diabetes monotherapy would you prefer to use in a patient with comorbid kidney disease and heart disease
a second generation sulfonylurea such as glipizide, glyburide or glimeburide
(can’t use metformin due to acidosis toxicity, can’t use glitazones/ thiazolidinediones due to cardiac tox)