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Clin Med ENDOCRINE - Ashley > Unicorns and glitter bunnies (miscellaneous) > Flashcards

Unicorns and glitter bunnies (miscellaneous) Flashcards

1
Q

What is the age definition for precocious puberty?

A

girls: before 8
boys: before 9

mean, girls: 10.5

mean, boys: 11.5

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2
Q

What is the most common cause of secondary amenorrhea in females of childbearing age?

A

pregnancy

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3
Q

What other hormone should be tested when testing testosterone for low libido/ED?

A

prolactin

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4
Q

What is the most common cause of hyponatremia in hospitalized patients?

A

SIADH

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5
Q

What are the female and male congenital syndromes that cause hypergonadotropic hypogonadism?

A

F: Turner syndrome

M: Klinefelter syndrome

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6
Q

What do we call congenital resistance to PTH?

A

pseudohypoparathyroidism

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7
Q

Your patient has facial muscle contractions when tapping the facial nerve near the ear.

What sign is this and what is the endocrine disorder you may see it in?

A

Chvostek sign

hypoparathyroidism → hypocalcemia

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8
Q

After placing and inflating the BP cuff on your patient, their wrist and MCP joints flex.

What sign is this and what disorder do you suspect?

A

Trousseau phenomenon

hypoparathyroidism (→ hypocalcemia)

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9
Q

Your patient has Chvostek sign, Trousseau phenomenon, and short fourth metacarpals. What do you suspect?

A

pseudohypoparathyroidism

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10
Q

You told your patient they have Metabolic Syndrome, because they have 3 of what 5 criteria?

A
  1. central obesity (waist circumference > 88 cm F, > 102 cm M)
  2. Triglycerides > 150
  3. HDL < 50 (F) / < 40 (M)
  4. HTN
  5. Fasting plasma glucose >= 100 or previously diagnosed DM2
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11
Q

What is the trio of symptoms that is usually associated with DM1?

A
  1. polyuria
  2. polydipsia/polyphagia
  3. weight loss
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12
Q

What is the specific problem in MODY (maturity-onset diabetes of the young)?

A

Hyperglycemia due to impaired secretion of insulin when glucose is around

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13
Q

What’s the recommended macronutrient profile for DM2 diets?

A

45-65% carbs

25-35% fats

10-35% protein

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14
Q

What is the leading cause of death among patients with DM2?

A

cardiovascular disease

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15
Q

What are the Whipple criteria for hypoglycemia?

A
  1. hx of hypoglycemia symptoms
  2. associated fasting blood glucose < 45
  3. immediate recovery upon administration of glucose
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16
Q

Give me 4 symptoms, 4 PE findings, and 4 lab values for diabetic ketoacidosis.

A

~polyuria/polydipsia, fatigue, N/V, Kussmaul respirations

~dehydration, fruity breath, hypotension + tachy, hypothermia

~BG > 250, acidosis, bicarb < 15, ketones in serum

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17
Q

What will you note on GA in a patient with lactic acidosis?

A

hyperventilation

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18
Q

How will you distinguish osteoporosis from osteomalacia VIA LAB VALUES?

A

osteoporosis:

serum PTH, calcium, phosphorous, alk phos usually normal

osteomalacia:

serum calcium, albumin, phosphate, PTH - low

alk phos - elevated

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19
Q

Your patient is a 42 yo M with bone pain, kyphosis, bowed tibias, and hearing problems. You obtain radiographs and find dense, expanded bones.

What do you suspect?

What is your treatment?

A

Paget disease of bone

bisphosphanates

20
Q

Your patient is a 9 month old baby whose parents are suspected of child abuse due to the baby’s frequent fractures. Upon physical exam you note blue sclerae and hearing impairment.

What do you suspect?

A

osteogenesis imperfecta

21
Q

What is your next step in evaluating a non-pregnant woman, age 35, with secondary amenorrhea, with no laboratory abnormalities?

A

10-day course of progestin

Absence of withdrawal menses usually indicates a lack of estrogen or a uterine abnormality.

22
Q

What is the therapy/treatment for Turner syndrome?

A

Daily injections of GH + androgen for four years before epiphyseal growth plates close

Estrogen after 12 years old to initiate puberty

HRT therapy once growth stops (estrogen/progestin)

23
Q

MEN 1, MEN 2A, MEN 2B:

facial angiofibromas?

hyperparathyroidism?

mucosal neuromas?

medullary thyroid cancer?

pheochromocytoma?

pituitary adenoma?

A

facial angiofibromas - MEN 1

hyperparathyroidism - MEN 2A

mucosal neuromas - MEN 2B

medullary thyroid cancer - 2A, 2B

pheochromocytoma - 2A, 2B

pituitary adenoma - MEN 1

24
Q

What is the standard initial screening test for thyroid function?

A

T4 (total serum thyroxine)

25
Q

What is testing TSH useful for?

A

detecting hyperthyroidism

26
Q

What might serum thyroglobulin be tested in?

A

marker for thyroid cancer

27
Q

T score ranges

A

>= -1: normal

-1 to -2.5: osteopenia

< -2.5: osteoporosis

< -2.5 w/ fracture: severe osteoporosis

28
Q

What would you give beta blockers for?

A

symptoms of hyperthyroidism

29
Q

Which can and cannot be used to treat thyroid storm?

propylthiauracil

methimazole

A

propylthiauracil can be used to treat thyroid storm

methimazole cannot be used in thyroid storm

30
Q

Thyroid supplements are good to use in patients who want to lose weight.

T/F

A

False.

Ineffective and potentially toxic

31
Q

In what demographic should you not prescribe levothyroxine?

A

postmenopausal women, men > 60

32
Q

What is the starting dose for levothyroxine in a newly-diagnosed patient with hypothyroidism?

A

25 mcg

33
Q

When might it be good to use liothyronine?

A

~mood modification in patients not achieving good results on T4 alone

~rapid onset (good for myxedema, unlike slow-onset levothyroxine)

34
Q

Name two sulfonylureas.

A

glyburide

glipizide

35
Q

Sulfonylureas: weight gain, loss, or neutral?

A

weight gain

36
Q

Who cannot take metformin?

A

patients with renal disease

37
Q

What is a great feature about metformin?

A

does not cause hyperinsulinemia

38
Q

What is the black box warning for metformin?

A

may cause lactic acidosis

39
Q

What vitamin may metformin interfere with the absorption of?

A

B12

40
Q

Metformin: weight loss, gain, neutral?

A

weight loss

41
Q

What is an important thing for patients to know about alpha-glucosidase inhibitors?

A

Works by blocking/delaying absorption of carbohydrates, so hypoglycemia cannot be treated with glucose/carbs

42
Q

What is a contraindication for thiazolidinediones?

A

heart failure

43
Q

What must be monitored periodically when taking thiazolidinediones?

A

hepatic function

44
Q

What kind of emergency kit should be provided to every DM patient on insulin therapy?

A

parenteral glucagon emergency kit

45
Q

What is a serious potential side effect of glucocorticoids?

A

osteoporosis

46
Q

Name three medication therapies for post-menopausal bone loss.

A

bisphosphanates

selective estrogen receptor modulator

calcitonin

Clin Med ENDOCRINE - Ashley (8 decks)

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