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IM > nephrology > Flashcards

nephrology Flashcards

1
Q

rx used for gastroparesis

A

prokinetic metoclopromide, erythromycin, cisapride

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2
Q

elevate T4 and low TSH + TPO Ab

A

Hashimotos thyroiditis, sx tx with Propranolol

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3
Q

Medullary thyroid cancer with elevated calcitonin. What more to check?

A

Could be part of MEN type 2a or 2b, associated with pheo so check urine catecholamines

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4
Q

Wt loss, tachycardia, tremor, lid retraction

A

Thyrotoxicosis - jacks up cardiac system with increased HR, HTN, pulse pressure and output

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5
Q

3 types of thyroiditis

A

chronic autoimmune, painless, subacute

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6
Q

Diffuse goiter, + TPO antibody, variable radioiodine uptake

A

Chronic autoimmune thyroiditis/Hashimoto

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7
Q

Hyperthyroid, painful/tender goiter, elevated ESR and CRP, low radioiodine uptake

A

Subacute thyroiditis

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8
Q

Cabergoline, Bromocriptine

A

Tx of prolactinoma

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9
Q

Why check serum protein electrophoresis (SPEP) in hypercalcemia

A

Would be + in MM

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10
Q

Hyperaldosteronism leads to hypo_____

A

HIGH aldosterone = HYPO kalemia

Aldosterone SAVES SODIUM, PASSES POTASSIU

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11
Q

chronic fatigue, weakness, weight loss, hypotension, hyperpigmentation/vitiligo, hyponatremia, and hyperkalemia with a low-normal cortisol level

A

primary adrenal insufficiency/ Addison disease

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12
Q

A girl comes in for a near syncopal event and is found to be hypotensive with hyperpigmentation in palmar creases. Labs show low sodium and high potassium. What test should you do to confirm the diagnosis?

A

Likely primary adrenal insufficiency/addison disease - ACTH test

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13
Q

Test for acromegaly

A

IGF-1

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14
Q

Tx for hyperprolactinemia

A

Dopamine agonist - Cabergoline or Bromocriptine

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15
Q

Suspect hypothyroidism, what is the most likely causes

A

Haushimoto Thyroiditis

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16
Q

5 causes of HYPERthyroidism

A 
Graves disease
Subacute thyroiditis
Painless "silent" thyroiditis
Exogenous thyroid hormone use
Pituitary adenoma
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17
Q

Hyperthyroidism + proptosis and myxedema + elevated uptake or RAI

A

GRAVES DISEASE

18
Q

Hyperthyroidism + tender thyroid

A

Subacute thyroiditis

19
Q

MEN1

A

Pituitary Adenomas
Primary Hyperparathyroidism
Pancreatic/gastrointestinal neuroendocrine tumors

20
Q

Symptoms of primary hyperparathyroidism

A

hypercalcemia - polyuria, kidney stones, decreased bone density

21
Q

Types of Pancreatic/GI neuroendocrine tumors in MEN1

A

Gastrinoma
Insulinoma
VIPoma
Glucagonoma

22
Q

A woman with known chronic hypotension and hyperpigmented skin comes in with abdominal pain, shock, fever, AMS

A

Acute adrenal crisis in PAI

23
Q

Hyperthyroid sx + tender thyroid + postviral + low radioiodine uptake

A

Subacute thyroiditis

24
Q

Why increase levo dose in women on estrogen containing BC, HRT, or pregnant?

A

Estrogen increases TBG decreasing the effective amount of thyroid

25
Q

Irregular menses + hirsutism + weight gain

A

PCOS - weight loss, birth control, clomid

26
Q

Fatigue, delayed reflexes, myalgias, proximal muscle weakness, elevated serum CK and ESR

A

hypothyroid myopathy

27
Q

Pt has hypercalcemia - what lab to follow?

A

PTH to determine if hypercalcemia is PTH dependent or independent

28
Q

Acute or severe illness + fall in total and free T3 levels with normal T4 and TSH

A

Euthyroid sick syndrome, “low T3 syndrome”

29
Q

Medullary thyroid cancer, pheochromocytoma, marfanoid habitus, mucosal neuromas

A

MEN 2B

30
Q

Are pts with chronic lymphocytic Hashimoto thyroiditis at increased risk for Thyroid lymphoma?

A

Yep

31
Q

HTN, mild hypernatremia, metabolic alkalosis, suppressed plasma renin activity, +/- hypokalemia

A

primary hyperaldosteronism - hypokalemia sometimes doesn’t present until diuretic use

32
Q

proximal muscle weakness, muscle atrophy, hyper/hypothyroid symptoms

A

thyroid myopathy

33
Q

List two rxs that can be used for tx of hyperaldosteronism

A

eplerenone and spironolactone - block the effects of aldosterone

34
Q

A pt has cushinoid appearance and has been using glucocorticoids chronically for years. Is it likely that this person has HPA disturbance with resultant central adrenal insufficiency?

A

Yes - measure morning cortisol (low) and ACTH (low)

35
Q

What do you expect ACTH and Aldosterone to be in central vs primary adrenal insufficiency?

A 
central = low ACTH and normal Aldosterone
primary = high ACTH and low Aldosterone
36
Q

Low K, high Na, high HCO3, high Aldo, low renin

A

primary hyperaldosteronism

37
Q

Does hyperaldosteronism lead to metabolic alkalosis

A

yes

38
Q

how to differentiate large vs small nerve injury in DM

A 
small = positive symptoms like pain, paresthesias, allodynia
large = negative symptoms like numbness, loss of proprioception and vibration, diminished ankle reflexes
39
Q

test to differentiate central vs peripheral DI

A

demospressin after water restriction

40
Q

3 different tests to use in initial evalution of Cushing syndrome

A

confirm hypercortizolism:
late-night salvary cortisol assay
24 hr urine free cortisol measurement
overnight low-dose dexamethasone test

IM (17 decks)

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