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*DOOS 2 > Lab Study Guide- Endocrine > Flashcards

Lab Study Guide- Endocrine Flashcards

1
Q

What labs would you check in primary testicular failure? (primary hypogonadism)

A

LH, FSH, testosterone, semen analysis

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2
Q

Decreased sperm count
Decreased LH
Decreased FSH
Decreased testosterone

A

Hypothalamic-pituitary abnormality

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3
Q

What should you measure next with hypothalamic-pituitary abnormality?

A

Measure prolactin

MRI of hypothalamic pituitary region

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4
Q

Decreased sperm count
Increased LH or FSH
Decreased or normal testosterone

A

Primary testicular abnormality

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5
Q

Decreased sperm count
Normal testosterone and LH
Normal or increased FSH
Sperm Present

A

Acquired Primary Hypogonadism

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6
Q 
Decreased sperm count
Normal testosterone and LH
Normal or increased FSH 
Sperm Absent
Absent Seminal Fluid frutose
A

Congenital absence of seminal vesicles and vas deferans

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7
Q 
Decreased sperm count
Normal testosterone and LH
Normal or increased FSH 
Sperm Absent
Present Seminal Fluid frutose
Normal testicular biopsy
A

Ductal obstruction

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8
Q 
Decreased sperm count
Normal testosterone and LH
Normal or increased FSH 
Sperm Absent
Present Seminal Fluid frutose
Abnormal testicular biopsy
A

Spermatogenic failure

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9
Q 
Decreased sperm count
Increased LH or FSH
Decreased or normal testosterone
No testes
Increased testosterone on hCG stimulation
A

Cryptorchidism

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10
Q 
Decreased sperm count
Increased LH or FSH
Decreased or normal testosterone
No testes
No increased testosterone on hCG stimulation
A

Anorchia

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11
Q

Decreased sperm count
Increased LH or FSH
Decreased or normal testosterone
Small, firm Testes present

A

Klinefelter’s

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12
Q

Decreased sperm count
Increased LH or FSH
Decreased or normal testosterone
Postpubertal size testes (normal and soft)

A

Acquired primary hypogonadism

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13
Q

Normal OGTT 2 hours postprandial

A

<140mg/dl

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14
Q

OGTT 2 hours postprandial diagnostic of DM

A

> or equal 200mg/dl

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15
Q

Diagnosis of impaired glucose tolerance if 2 hour postload OGTT

A

> or equal 140 and <200

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16
Q

If a nodule is “hot” after radionuclide scan, what should you do?

A

clinical follow-up with or without treatment depending on whether the patient is euthyroid or thyrotoxic

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17
Q

If a nodule is warm or cold after radionuclide scan and has suspicious cytology, what should you do?

A

raises question of cancer and necessitates surgical excision

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18
Q

What is a cold nodule?

A

Cold nodules are nonfunctioning; malignancy is associated with a cold nodule

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19
Q

What are warm or hot nodules?

A

Functioning thyroid nodules

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20
Q

Normal total T4

A

4.5-10.9 mcg/mL

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21
Q

Normal free T4

A

0.8-2.7 ng/dL

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22
Q

Normal total T3

A

60-181 ng/dL

23
Q

Normal TSH

A

.5-4.7 ng/dL

24
Q

Elevated total T4, elevated free T4, elevated T3, decreased TSH

A

Hyperthyroidism

25
Q

What will labs look like for hypothyroidism?

A

Low Total T4
Low Free T4
Low total T3
High TSH

26
Q

What is the most definitive test for thyroid cancer?

A

serum thyroglobulin measurements

27
Q

What is diagnostic for diabetes insipidus?

A

DDAVP (synthetic vasopressin) intranasally that causes a 50% greater increase in urine osmolality

28
Q

When you are diagnosed with DI by DDAVP what test should be done?

A

Evaluation of the pituitary and hypothalamus via MRI

29
Q

Urine osmolality < plasma osmolality and <45% increase in urine osmolality for ____________ diabetes insipidus

A

nephrogenic DI

30
Q

What are the parameters for diagnosis of neurogenic DI?

A

Urine osmolality > plasma osmolality

>50% increase in urine osmolality

31
Q

What would you expect to see on labs if a DM patient is having nephropathy?

A

Proteinuria and HTN

32
Q

_______ is inaccurate guide to degree of GFR impairment when screening for diabetic nephropathy

A

Measurement of SCr

33
Q

In diabetic nephropathy, screening for proteinuria should be performed __________, starting at time of diagnosis for Type 2 and ________ after diagnosis in Type 1

A

Annually

5 years after dx

34
Q

What is the simplest method for screening microalbuminuria?

A

Ratio of protein (albumin) to Cr in random spot urine specimen (measurement correlates closely with 24 hour urinary protein estimates)

35
Q

What would microalbuminuria be in 24 hours urinary protein estimates?

A

<300gm/24hours

36
Q

What is the best tests to measure hypopituitarism?

A

IGF-1, plasma testosterone, TSH, Free T4, plasma cortisol response to synthetic ACTH

37
Q

Diagnosis of pituitary tumors is confirmed by

A

MRI

38
Q

What is Fine needle aspiration the initial evaluation of choice for?

A

Thyroid nodule patients

39
Q

After FNA, you should do what for cystic and solid thyroid masses?

A

Ultrasound- assists in evaluating for size and cystic components
Thyroid nuclear scans- to confirm functional state

40
Q

Metastatic and follicular tumors associated with ______ serum thyroglobulin

A

Increase

41
Q

Medullary tumors show what on labs?

A

increased serum calcitonin

CEA antigen

42
Q

Thyroid US is useful for?

A

differentiating solid nodules vs cystic nodules (may help guide FNA as well)

43
Q

FNA is useful for?

A

used to obtain thyroid cells for cytologic evaluation (differentiate benign vs. malignant disease)

44
Q

What is the testing sequence for thyroid nodule?

A

FNA (if cytology is malignant- surgery)
If benign- observe x1 year and follow up US
If suspicious on US- radionucleotide scan of nodule uptake

45
Q

Metformin is C/I with what 2 lab findings?

A

Cr >1.5

Hepatic insufficiency

46
Q

When can someone not be on Rosiglitazone and Pioglitazone (TZDs)?

A

ALT >2.5x ULN

47
Q

What drug needs dose adjustments for CrCl?

A

DDP-4 Inhibitors (sitagliptin, saxagliptin)

48
Q

If triclycerides >500mg/dL, what drug is C/I?

A

Colesevelam (WelChol)

49
Q

With GLP-1 (Exenatide), you should use precaution if CrCl is what?

A

<30

50
Q

Who should you never give TZD (rosiglitazone, pioglitazone) to?

A

NYHA class III or IV HF

51
Q

When do you need to be on a statin if DM?

A

If HDL < 40 or high LDL

52
Q

What is the goal BP of a diabetic?

A

130/80

Treat with ARB or ACEI

53
Q

What is goal BP of DM patient with renal insufficiency and proteinuira >1g/24hours?

A

125/75

54
Q

What labs should you get for premature menopause?

A

Elevated FSH
Elevated serum gonadotropin
Low serum estradiol
Estrogen deficiency symptoms (hot flashes, dry vagina)

*DOOS 2 (11 decks)

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