PANCE Endocrine Flashcards
1
Q
what disease is not enough cortisol
A
addisons
2
Q
what gland produces TRH
A
hypothalamus
3
Q
what is the best initial test for thyroid
A
TSH
4
Q
Thyroid stimulating Ab/ TSH receptor Ab these are specific for what condition
A
graves
5
Q
high TSA but normal T4 is what
A
subclinical hypothyroidsim
6
Q
what is the rason for decreased uptake on the radioactive iodine test
A
Graves or
thyroiditis
7
Q
what is sunclinical hypothroidsims at risk for
A
cardiovascular disease
8
Q
what do you treat subclinical hypothroidsim
A
TSH > 20
9
Q
what thyroid issue can cause menorrhagia
A
hypothyroid
10
Q
what is cretinsim
A
congenital hypohyroidism
11
Q
what is extream hyperthyroidism called
A
Thyroid storm
12
Q
what are the 4 treatments for Thyroid storm
A
- propylthiouracial (PTU)
- beta blockers
- glucocorticoids
- avoid asprin
13
Q
what is the MC cause of hyper thyroidism
A
GRAVES
14
Q
how do you treat graves
A
- radioactive iodine
- MME/ PTU
- beta blocker
- thyroidextom
15
Q
what medication do you give for hyper thyroid MME or PTU if they are pregnant
A
PTU
16
Q
what two medications cause hypothyroisism
A
- amiodarone
- lithium
17
Q
what is a risk for thyroid nodule
A
- extreme ages
- history of head and neck radiation
18
Q
what is the malignancy rate of thyroid cancers in Men and women
A
M: Malignant
W: non malignant
19
Q
what is the MC symptom of a thyroid nodule
A
asymptomatic
20
Q
thyroid nodule “rapid growth, fixed in place, no movement with swallowing”
A
- malignant
21
Q
what is the thyroid function with thyroid cancer
A
- euthyroid
22
Q
what is the best test for a thyroid nodule
A
FNA
23
Q
what is the MC type of thyroid nodule
A
follicular adenoma
24
Q
how often do you monitor a thyroid nodule
A
every 6 - 12 months
25
what is the MC type of thyroid carcinoma
papillary
26
what type of thyroid cancer is associated with radiation exposure
papillary
27
what is the MC thyroid cancer (malignant) in males
anaplastic
28
what is the MC type of thyroid nodules
follicular adenoma
29
what vitamin is required for CA to be absorbed
Vit- D
30
Increased parathyroid hormone does what to Ca in the blood
increases
31
what is the MC cause of primary parathyroisism
parathyroid adenoma
32
what is the MC cause of secondary hyper parathyroidism
- Dec Ca
- Inc PTH
CKD
33
what is the DTR with inc Ca
deceased
34
Tx for increased parathroid hormone
parathroidectomy
35
what EKG for hypothyroidism
prolonged QT
36
for osteoporosis do you look at the T score of the Z score
T: < -2.5
37
blue tinted sclerae and presenile deafness
OI
38
failing kidneys do not eliminate phosphate correctly what pathology
renal osteodystrophy
39
Brown cysts and "salt and pepper" appearance of the skull on X ray
renal osteodystrophy
40
a decrease in Vit D causes soft bones and what pathology
Rickets
41
what is the tx for rickets
Vit D
42
what is more common primary of secondary adrenal disorders
secondary.
| This is a failure of the pituitary gland to secerete ACTH
43
why is aldosterone intact with secondary ACTH
because it is stimulated by the RASS system
44
what is the MC cause of primary adrenal cortical (addisons)
steroid use
45
what is the MC cause of primary adrenal cortical insufficiency (addisons) disease
autoimmiue
| infection
46
what is an addisons crisis
this is when someone with adrenal cortical insufficiency does not have enugh cortisol (stress hormone) on board and shit starts to go south
47
what are the labs of addisons crisis
hyponaterima
hyperkalemia
hypoglycemia
48
where is the issue with crushing disease
pituitary
49
what is cushings syndrome
signs and symptoms related to cortisol excess
50
what are the three tumors that can cause cushings disease
- Puititary (disease)
- Small cell
- adrenal tumor
51
what is the test for cushings disease
dexamethasole supression test
52
what medicaion do you use with adrenal tumor
ketoconazole
53
whta is conn syndrome
too much aldosterone
54
what is the MC cause of too much aldosterone
idiopathic
55
what is the MC pituitary tumor
- prolactinoma
56
prolactinoma symptoms
amenorrhea
| golactorea
57
what hormone inhibits prolactin
dopamin
58
what is the best test to look at the pituitary
MRI
59
what does bromocriptine tx
- acromegaly
| - prolactinoma
60
what does octreotide tx
acromegaly
61
what is the postprandial glucose goal
< 180
62
what type of insuline is LOG
rapid
63
what is the MC cause of DKA and HHS
infection
64
what do you differentiate DKA
| HHS
DKA: Ketones
HHS: higher glusoe > 250
65
what are the three tx's (all required for DKA HHS)
- Fluids
- insulin
- Potassium
66
MEN 1 effects an overactivity of what 3 glands
Pituitary
pancreas
parathyroid
67
hyperparathyroid tx
1. hydration
| 2. bisphosphonates
68
Hyperparathyroidism cause MCC
Parathyroid neoplasm
69
Hyperparathyroidism DTR
decreased
70
● Hypoparathyroidism
| Tx
Vit D 8-8.6 mg,
Ca 1-2g/day,
Magnesium supplementation
71
- Chvostek sign
- Trousseau sign
are associated with what pathology
hypocalcermia
72
● Hyperthyroidism
| 1 MCC
Graves
73
Peroxidase antibodies, thyroglobulin antibodies what pathology
graves
74
Hyperthyroidism TX 2
propylthiouracil (PTU, DOC preg),
| methimazole (MMI);
75
what is the 1st med given in a thyroid strorm
- propanolol
76
what medication for a thyroid storm do you give after a PTU
iodine
77
● Subacute Thyroiditis
| labs
TSH (low),
| T3/T4 (high),
78
very tender thyroid gland with or without fever (hallmark)
- Subacute Thyroiditis caused by coxaxkie
79
○ S/S: tender thyroid gland, fever, pharyngitis, overlying erythema
○ Cause: gram-positive bacteria (staph aureus)
| - Suppurative Thyroiditis
80
Suppurative Thyroiditis tx
○ surgical drainage w/ fluctuation
81
● Drug Induced Thyroiditis
| 1
amiodarone
82
- thyrotropin receptor-blocking antibodies
Hashimoto Thyroiditis
83
○ Cause: dense fibrous tissue development; sclerosing cholangitis, retroperitoneal fibrosis, orbital pseudotumor
what pathology
● Fibrous Thyroiditis (Riedel)
84
Fibrous Thyroiditis (Riedel) tx
Tamoxifen
85
Myxedema Crisis/Coma tx
Thyroxine IV
86
Myxedema Crisis/Coma This is what
severe hypothyroidism
87
Cushing syndrome dx
24hr urine collection (free cortisol >125);
| overnight dexamethasone suppression
88
low 8:00 AM plasma cortisol <3,
addisons
89
Cause: pituitary adenoma (GH excess)
● Acromegaly/gigantism
90
Acromegaly/gigantism tx
somatostatin analogs (octreotide
91
IGF-1 (low), GH (low);
● Dwarfism
92
how do you treat central DI
HCTZ w/ potassium or amiloride
93
how do you treat nephrogenic DI
Desmopressin acetate
94
Insulin to carb ratio
1 unit insulin for 10-15g carbs
95
gemfibrozil function 2
lower TG;
| raise HDL
96
what is the best initial test for thyroid
TSH
97
2 causes of hypo thyroid
- iodine deficiency
| - hashimotos
98
what is congenital hypo thyroid
cretinsim
99
thyroid stimulating ab what dx
graves
100
what is the MC thyroid nodule
follecular adenoma (benign)
101
what is the MC type of malignant thyroid cancer
papillary
102
best tx for thyroid nodule malignant
surgery
103
best inital test for thyroid cancer
FNA
104
what is the MC cause of secondary hyperparathyroidism
CKD
105
what two pathologies in endocrine have decreased DTR's
- hypothyroid
| - hyperPARA thyroid
106
tx for hyperparathyroisism
removal
107
what are the MC reasons for addisons (primary adrenoc ortico insuffiency)
- infection
| - autoimmune
108
what are the MC reasons for secondary adrenoc ortico insuffiency)
Pituitary issue
exogenous steroids
109
what are the 3 labs that go with addisons
hyponatremia
hypoglycemia
hyperkalemia
110
do you need aldosterone in addisons disease
yes
111
menorrhagia is associated with what type of thyroid disorder
hypothyroidism
112
How do you treat graves (20
1. MME / PTU
| 2. Iodine
113
what meds kill the thyroid
1. Amiodarone
| 2. Lithium
114
how do you treat
| - Hashimotos Thyroditis
levo (check every 6 weeks)
115
what are the 2 risk factors for a thyroid nodule
- extreme ages
| - radiation to the neck
116
what is the MC type of thyroid nodule
follicular adenoma
117
what is the MC type of thyroid cancer
papillary
118
what is the worst type of thyroid cancer
anaplastic
119
what are the 2 MC reasons for hypoparathroidism
- iatrogenic
| - autoimmune
120
what are the DTR's with hypoparathyroisism
- increased
121
- how do you treat
| - hypoparathyroisism
calcium
122
"blue- tinted sclerae and presenile deafness"
OI
123
what is the serum Ca levels in the blood with renal osteodystrophy
low ca
- also has low PTH
- high phosphate
124
tx for renal osteodystrophy
phosphate binders
125
radio-graphs
- "looserlines"
- "psudo fracture lines"
osteomalesia / rickets
126
osteomalesia / rickets Tx
Vit D
127
what class is sevelamer
- phosphate binder
128
what is the cause of primary chronic adrenocortical insufficiency
- This is at the adrenals
- autoimmune
- infection
129
what is the MC cause of secondary adrenocortical insufficiency
- withdrawal of steroids
130
how do you test for adrenocortical insufficiency
ACTH stimulation
131
how do you treat addisons CRISIS (3)
FLUIDS
Glucocorticoids
Fludocortisone
132
what is the lab with Cushings disease
- increased ACTH
133
what is the one condition that will be suppressed with dexamethasone suppression test
cushings disease
134
what are the 3 causes of endogenous cushings
- Disease (puititary tumor, Inc ACTH)
- small cell acth tumor
- adrenal tumor
135
what is the MC cause of cushings syndrome
iatrogenic
136
catecholamine secreting adrenal tumor
- Pheochromocytoma
137
what are the symptoms of
Palpitations
Hypertension
Excessive sweating
138
what medication do you not want to initiate with a Pheochromocytoma
beta blocker
139
what are teh 2 tx for prolactinoma
- carbergoline
| - bromocripitine
140
prolactinoma symptoms
- ammenorrhea
| - golactorrea
141
what is the ending for sulfonylurea
Ide
142
what DM do you NOT want to give to CHF MI
Thiazolidinediones
143
who can not get metformin
hepatic or renal impairment
144
what medication slows gastric emptying
GLP -1 "tide:
