Pance endocrine round 2 8/15 Flashcards
where is CRH produced and what effect does it have
- hypothalamus
- produce more ACTH
what is the location of a primary disorder
at the gland level
what effect does an adrenal adeonoma have on cortisol
increase
anti thyrogloblin antobody what pathology
hashimotos
thyroid stimulating antibodies what pathology
graves
what are the three meds you give for a thyroid storm
- PTU
- Beta blocker
- Glucocorticoids
thyroid brui think what
graves
what is the MC type of thyroid nodules
follicular adenoma
how often do you monitor a thyroid nodule with US
every 6- 12 months
what is the MC type of thyroid cancer
papillary
what is another name for Vit D
Calcitrol
what is the MC cause of hyperparathyroidism
patrathyrois adnenoma
what are the DTR with hypercalcemia
decreased
what are the DTR with hypothroid
decreased
what are the 2 MCC of hypoparathyroidism
- surgery
- autoimmune
what are the 3 big physical exam signs of hyperparathyrod hormone
- trousseau’s
- chvosteks
- Increased DTR
how do you tx hypoparathyroidism
- Ca gluconate
- Vit D
what part of the EKG is effected by calcium
QT interval
hypocalcemia what effect of QT
long
3 tx for hypercalcemia
- saline
- fursemide
- bisphosphenates
inc PTH and hypocalcemia what pathology
renal osteodystrophy
- brown tumors
- salt pepper on X ray skull
renal osteodystrophy
how do you tx riskets
- vit D (ergocalciferol)
what kidney disease has too much phosphate
- renal osteodystrophy
how do you tx renal osteodystrophy 2
- phosephate binders
- sevelamer
what gland produces ACTH
pituitary
what is the main cause of chronic adrenocortico insufficiency (primary: addisons, Secondary: pituitary)
Secondary: pituitary
what is the 2 main primary adrenocortico insufficiency (addiosns caused)
- autoimune
- infection
what is the main secondary adrenocortico insufficiency
- exogenous steroid use
what are the 4 metabolic disorders associated with addidosns
hyponatremia
hypoglycemia
hyperkalemia
metabolic acidosis
how do you tx primary adrenocortico insufficiency
hydrocortisone + fludrocortisone
how do you tx secondary adrenocortico insufficiency
hydrocotisone
what is the cause of addisons criss
abrupt withdrawl of glucocorticoids
how do you tx adisosn crisis
- IV fluids
- hydrocortisone, fludrocortisone
what is the metabolic cause of cushings disease
- Increased ACTH
what is the potassium change with cushings
- hypokalemia
what is the cause of cushings disease
- pituitary ademonia (secretes ACTH)
what are the two main tests for cushings
- 24 hr free cortisol in urine
- dexamethasone supression
how do you tx a cortisol secereting ACTH tumor
ketoconazole
how do you tx cushings diease
- transphenodial surgery
what are the two causes of hyperaldosteroneism
- Conn syndrome
- renal artery stenosis
catacholaime secreting tumor
- Pheo
what are the symptoms of pheo
- palpitations
- headache
- excessive sweating
how do you dx a pheo
- 24 hr catacholamine collection
how do you tx pheo
- complete adrenalactomy
what medication do not not start with when tx a pheo
- beta blocker
what hormones are secreted by the posterior puitary
- ADH
- Oxytocin
what hormone is a prolactin agonist
- dopamine
what two medications are dopamine agomist
- cabergoline
- bromocriptine
how do you tx acromegaly
octreotide
what hormone is produced with somatotropinoma
growth hormone
what are the two presentations of hyperprolactinemia
- ammenorrhea
- galactorrhea
what are the four medications that cause gyncomyastia
Spironalactone
cematadine
ketoconazole
finesteride
what is the fasting glucose level for DM
126
what are the two causes of DKA
infection
non compliance with insulin
what element do you always give with DKA
postassium
where is the problem with cushings disease
-pituitary
what 2 meds are anti thyroid
- MME
- PTU
what are the 3 tx for graves
- iodine
- MME / PTU
- Beta blockers
what is the MCC of hyperparathyroidism
parathyroid adenoma
what are the 3 P with MEN
parathyroid
pancreius
puititary
what MEN is associated with pho
- MEN 2
3 tx for HYPERcalcemia
- Fluids
- fursemide
- bisphosphenates
1 tx for HYPOcalcemia
- calcium gluconate
what are the DTR with HYPERcalcemia
decreased DTR
what is the DTR with GBS
decreased
DTR with Hyperthyroid
increased
what are - trousseau's - chvosteks - Increased DTR associated with
HYPOcalcemia
Flat T waves
U waved
HYPOkalemia
peaked T waved
HYPERkalemia
what are the 3 tx for HYPER-Kalemia
- calcium gluconate (stabilized the membrane)
- Insulin
- albuterol
what adrenal insufficiency disorder still produces aldosterone and why
secondary because secondary is with the pituary and this means ACTH is not produced however aldosterone will be produced with the kidney
aldoderone is what type of corticoid
mineral corticoid
what is an eg of a mineral corticoid
fludrocortizone
weight gain
hypokelemia
acanthosis nigracans
cushings
what are the three endogenous causes for cushings
- cushings disease (puitary adenoma)
- ectopic ACTH
- adrenal tumor
test for cushings
dexamenthaosne supression
test for adisons
ACTH stimulation
how do you tx acromegaly 2 meds
- bromocriptine
- Octreotide
what are the two subjective reports for prolactin tumor
- amenorrhea
- galactorrhea
prolactin tumor tx 2
carbogaline
bromocriptine
4 meds that cause gyncomaystia
- spironalactone
- Finesteride
- cematatide
- ketoconazole
