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General Surgery > PANCE Endocrine > Flashcards

PANCE Endocrine Flashcards

1
Q

what disease is not enough cortisol

A

addisons

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2
Q

what gland produces TRH

A

hypothalamus

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3
Q

what is the best initial test for thyroid

A

TSH

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4
Q

Thyroid stimulating Ab/ TSH receptor Ab these are specific for what condition

A

graves

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5
Q

high TSA but normal T4 is what

A

subclinical hypothyroidsim

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6
Q

what is the rason for decreased uptake on the radioactive iodine test

A

Graves or

thyroiditis

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7
Q

what is sunclinical hypothroidsims at risk for

A

cardiovascular disease

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8
Q

what do you treat subclinical hypothroidsim

A

TSH > 20

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9
Q

what thyroid issue can cause menorrhagia

A

hypothyroid

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10
Q

what is cretinsim

A

congenital hypohyroidism

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11
Q

what is extream hyperthyroidism called

A

Thyroid storm

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12
Q

what are the 4 treatments for Thyroid storm

A
  1. propylthiouracial (PTU)
  2. beta blockers
  3. glucocorticoids
  4. avoid asprin
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13
Q

what is the MC cause of hyper thyroidism

A

GRAVES

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14
Q

how do you treat graves

A
  • radioactive iodine
  • MME/ PTU
  • beta blocker
  • thyroidextom
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15
Q

what medication do you give for hyper thyroid MME or PTU if they are pregnant

A

PTU

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16
Q

what two medications cause hypothyroisism

A
  • amiodarone

- lithium

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17
Q

what is a risk for thyroid nodule

A
  • extreme ages

- history of head and neck radiation

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18
Q

what is the malignancy rate of thyroid cancers in Men and women

A

M: Malignant
W: non malignant

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19
Q

what is the MC symptom of a thyroid nodule

A

asymptomatic

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20
Q

thyroid nodule “rapid growth, fixed in place, no movement with swallowing”

A
  • malignant
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21
Q

what is the thyroid function with thyroid cancer

A
  • euthyroid
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22
Q

what is the best test for a thyroid nodule

A

FNA

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23
Q

what is the MC type of thyroid nodule

A

follicular adenoma

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24
Q

how often do you monitor a thyroid nodule

A

every 6 - 12 months

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25
Q

what is the MC type of thyroid carcinoma

A

papillary

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26
Q

what type of thyroid cancer is associated with radiation exposure

A

papillary

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27
Q

what is the MC thyroid cancer (malignant) in males

A

anaplastic

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28
Q

what is the MC type of thyroid nodules

A

follicular adenoma

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29
Q

what vitamin is required for CA to be absorbed

A

Vit- D

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30
Q

Increased parathyroid hormone does what to Ca in the blood

A

increases

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31
Q

what is the MC cause of primary parathyroisism

A

parathyroid adenoma

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32
Q

what is the MC cause of secondary hyper parathyroidism

  • Dec Ca
  • Inc PTH
A

CKD

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33
Q

what is the DTR with inc Ca

A

deceased

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34
Q

Tx for increased parathroid hormone

A

parathroidectomy

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35
Q

what EKG for hypothyroidism

A

prolonged QT

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36
Q

for osteoporosis do you look at the T score of the Z score

A

T: < -2.5

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37
Q

blue tinted sclerae and presenile deafness

A

OI

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38
Q

failing kidneys do not eliminate phosphate correctly what pathology

A

renal osteodystrophy

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39
Q

Brown cysts and “salt and pepper” appearance of the skull on X ray

A

renal osteodystrophy

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40
Q

a decrease in Vit D causes soft bones and what pathology

A

Rickets

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41
Q

what is the tx for rickets

A

Vit D

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42
Q

what is more common primary of secondary adrenal disorders

A

secondary.

This is a failure of the pituitary gland to secerete ACTH

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43
Q

why is aldosterone intact with secondary ACTH

A

because it is stimulated by the RASS system

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44
Q

what is the MC cause of primary adrenal cortical (addisons)

A

steroid use

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45
Q

what is the MC cause of primary adrenal cortical insufficiency (addisons) disease

A

autoimmiue

infection

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46
Q

what is an addisons crisis

A

this is when someone with adrenal cortical insufficiency does not have enugh cortisol (stress hormone) on board and shit starts to go south

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47
Q

what are the labs of addisons crisis

A

hyponaterima
hyperkalemia
hypoglycemia

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48
Q

where is the issue with crushing disease

A

pituitary

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49
Q

what is cushings syndrome

A

signs and symptoms related to cortisol excess

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50
Q

what are the three tumors that can cause cushings disease

A
  • Puititary (disease)
  • Small cell
  • adrenal tumor
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51
Q

what is the test for cushings disease

A

dexamethasole supression test

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52
Q

what medicaion do you use with adrenal tumor

A

ketoconazole

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53
Q

whta is conn syndrome

A

too much aldosterone

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54
Q

what is the MC cause of too much aldosterone

A

idiopathic

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55
Q

what is the MC pituitary tumor

A
  • prolactinoma
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56
Q

prolactinoma symptoms

A

amenorrhea

golactorea

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57
Q

what hormone inhibits prolactin

A

dopamin

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58
Q

what is the best test to look at the pituitary

A

MRI

59
Q

what does bromocriptine tx

A
  • acromegaly

- prolactinoma

60
Q

what does octreotide tx

A

acromegaly

61
Q

what is the postprandial glucose goal

A

< 180

62
Q

what type of insuline is LOG

A

rapid

63
Q

what is the MC cause of DKA and HHS

A

infection

64
Q

what do you differentiate DKA

HHS

A

DKA: Ketones
HHS: higher glusoe > 250

65
Q

what are the three tx’s (all required for DKA HHS)

A
  • Fluids
  • insulin
  • Potassium
66
Q

MEN 1 effects an overactivity of what 3 glands

A

Pituitary
pancreas
parathyroid

67
Q

hyperparathyroid tx

A
  1. hydration

2. bisphosphonates

68
Q

Hyperparathyroidism cause MCC

A

Parathyroid neoplasm

69
Q

Hyperparathyroidism DTR

A

decreased

70
Q

● Hypoparathyroidism

Tx

A

Vit D 8-8.6 mg,
Ca 1-2g/day,
Magnesium supplementation

71
Q
  • Chvostek sign
  • Trousseau sign
    are associated with what pathology
A

hypocalcermia

72
Q

● Hyperthyroidism

1 MCC

A

Graves

73
Q

Peroxidase antibodies, thyroglobulin antibodies what pathology

A

graves

74
Q

Hyperthyroidism TX 2

A

propylthiouracil (PTU, DOC preg),

methimazole (MMI);

75
Q

what is the 1st med given in a thyroid strorm

A
  • propanolol
76
Q

what medication for a thyroid storm do you give after a PTU

A

iodine

77
Q

● Subacute Thyroiditis

labs

A

TSH (low),

T3/T4 (high),

78
Q

very tender thyroid gland with or without fever (hallmark)

A
  • Subacute Thyroiditis caused by coxaxkie
79
Q

○ S/S: tender thyroid gland, fever, pharyngitis, overlying erythema

A

○ Cause: gram-positive bacteria (staph aureus)

- Suppurative Thyroiditis

80
Q

Suppurative Thyroiditis tx

A

○ surgical drainage w/ fluctuation

81
Q

● Drug Induced Thyroiditis

1

A

amiodarone

82
Q
  • thyrotropin receptor-blocking antibodies
A

Hashimoto Thyroiditis

83
Q

○ Cause: dense fibrous tissue development; sclerosing cholangitis, retroperitoneal fibrosis, orbital pseudotumor

what pathology

A

● Fibrous Thyroiditis (Riedel)

84
Q

Fibrous Thyroiditis (Riedel) tx

A

Tamoxifen

85
Q

Myxedema Crisis/Coma tx

A

Thyroxine IV

86
Q

Myxedema Crisis/Coma This is what

A

severe hypothyroidism

87
Q

Cushing syndrome dx

A

24hr urine collection (free cortisol >125);

overnight dexamethasone suppression

88
Q

low 8:00 AM plasma cortisol <3,

A

addisons

89
Q

Cause: pituitary adenoma (GH excess)

A

● Acromegaly/gigantism

90
Q

Acromegaly/gigantism tx

A

somatostatin analogs (octreotide

91
Q

IGF-1 (low), GH (low);

A

● Dwarfism

92
Q

how do you treat central DI

A

HCTZ w/ potassium or amiloride

93
Q

how do you treat nephrogenic DI

A

Desmopressin acetate

94
Q

Insulin to carb ratio

A

1 unit insulin for 10-15g carbs

95
Q

gemfibrozil function 2

A

lower TG;

raise HDL

96
Q

what is the best initial test for thyroid

A

TSH

97
Q

2 causes of hypo thyroid

A
  • iodine deficiency

- hashimotos

98
Q

what is congenital hypo thyroid

A

cretinsim

99
Q

thyroid stimulating ab what dx

A

graves

100
Q

what is the MC thyroid nodule

A

follecular adenoma (benign)

101
Q

what is the MC type of malignant thyroid cancer

A

papillary

102
Q

best tx for thyroid nodule malignant

A

surgery

103
Q

best inital test for thyroid cancer

A

FNA

104
Q

what is the MC cause of secondary hyperparathyroidism

A

CKD

105
Q

what two pathologies in endocrine have decreased DTR’s

A
  • hypothyroid

- hyperPARA thyroid

106
Q

tx for hyperparathyroisism

A

removal

107
Q

what are the MC reasons for addisons (primary adrenoc ortico insuffiency)

A
  • infection

- autoimmune

108
Q

what are the MC reasons for secondary adrenoc ortico insuffiency)

Pituitary issue

A

exogenous steroids

109
Q

what are the 3 labs that go with addisons

A

hyponatremia
hypoglycemia
hyperkalemia

110
Q

do you need aldosterone in addisons disease

A

yes

111
Q

menorrhagia is associated with what type of thyroid disorder

A

hypothyroidism

112
Q

How do you treat graves (20

A
  1. MME / PTU

2. Iodine

113
Q

what meds kill the thyroid

A
  1. Amiodarone

2. Lithium

114
Q

how do you treat

- Hashimotos Thyroditis

A

levo (check every 6 weeks)

115
Q

what are the 2 risk factors for a thyroid nodule

A
  • extreme ages

- radiation to the neck

116
Q

what is the MC type of thyroid nodule

A

follicular adenoma

117
Q

what is the MC type of thyroid cancer

A

papillary

118
Q

what is the worst type of thyroid cancer

A

anaplastic

119
Q

what are the 2 MC reasons for hypoparathroidism

A
  • iatrogenic

- autoimmune

120
Q

what are the DTR’s with hypoparathyroisism

A
  • increased
121
Q
  • how do you treat

- hypoparathyroisism

A

calcium

122
Q

“blue- tinted sclerae and presenile deafness”

A

OI

123
Q

what is the serum Ca levels in the blood with renal osteodystrophy

A

low ca

  • also has low PTH
  • high phosphate
124
Q

tx for renal osteodystrophy

A

phosphate binders

125
Q

radio-graphs

  • “looserlines”
  • “psudo fracture lines”
A

osteomalesia / rickets

126
Q

osteomalesia / rickets Tx

A

Vit D

127
Q

what class is sevelamer

A
  • phosphate binder
128
Q

what is the cause of primary chronic adrenocortical insufficiency

A
  • This is at the adrenals
  • autoimmune
  • infection
129
Q

what is the MC cause of secondary adrenocortical insufficiency

A
  • withdrawal of steroids
130
Q

how do you test for adrenocortical insufficiency

A

ACTH stimulation

131
Q

how do you treat addisons CRISIS (3)

A

FLUIDS
Glucocorticoids
Fludocortisone

132
Q

what is the lab with Cushings disease

A
  • increased ACTH
133
Q

what is the one condition that will be suppressed with dexamethasone suppression test

A

cushings disease

134
Q

what are the 3 causes of endogenous cushings

A
  • Disease (puititary tumor, Inc ACTH)
  • small cell acth tumor
  • adrenal tumor
135
Q

what is the MC cause of cushings syndrome

A

iatrogenic

136
Q

catecholamine secreting adrenal tumor

A
  • Pheochromocytoma
137
Q

what are the symptoms of

A

Palpitations
Hypertension
Excessive sweating

138
Q

what medication do you not want to initiate with a Pheochromocytoma

A

beta blocker

139
Q

what are teh 2 tx for prolactinoma

A
  • carbergoline

- bromocripitine

140
Q

prolactinoma symptoms

A
  • ammenorrhea

- golactorrea

141
Q

what is the ending for sulfonylurea

A

Ide

142
Q

what DM do you NOT want to give to CHF MI

A

Thiazolidinediones

143
Q

who can not get metformin

A

hepatic or renal impairment

144
Q

what medication slows gastric emptying

A

GLP -1 “tide:

General Surgery (30 decks)

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