Unicorns and glitter bunnies (miscellaneous) Flashcards
What is the age definition for precocious puberty?
girls: before 8
boys: before 9
mean, girls: 10.5
mean, boys: 11.5
What is the most common cause of secondary amenorrhea in females of childbearing age?
pregnancy
What other hormone should be tested when testing testosterone for low libido/ED?
prolactin
What is the most common cause of hyponatremia in hospitalized patients?
SIADH
What are the female and male congenital syndromes that cause hypergonadotropic hypogonadism?
F: Turner syndrome
M: Klinefelter syndrome
What do we call congenital resistance to PTH?
pseudohypoparathyroidism
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?
Chvostek sign
hypoparathyroidism → hypocalcemia
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?
Trousseau phenomenon
hypoparathyroidism (→ hypocalcemia)
Your patient has Chvostek sign, Trousseau phenomenon, and short fourth metacarpals. What do you suspect?
pseudohypoparathyroidism
You told your patient they have Metabolic Syndrome, because they have 3 of what 5 criteria?
- central obesity (waist circumference > 88 cm F, > 102 cm M)
- Triglycerides > 150
- HDL < 50 (F) / < 40 (M)
- HTN
- Fasting plasma glucose >= 100 or previously diagnosed DM2
What is the trio of symptoms that is usually associated with DM1?
- polyuria
- polydipsia/polyphagia
- weight loss
What is the specific problem in MODY (maturity-onset diabetes of the young)?
Hyperglycemia due to impaired secretion of insulin when glucose is around
What’s the recommended macronutrient profile for DM2 diets?
45-65% carbs
25-35% fats
10-35% protein
What is the leading cause of death among patients with DM2?
cardiovascular disease
What are the Whipple criteria for hypoglycemia?
- hx of hypoglycemia symptoms
- associated fasting blood glucose < 45
- immediate recovery upon administration of glucose
Give me 4 symptoms, 4 PE findings, and 4 lab values for diabetic ketoacidosis.
~polyuria/polydipsia, fatigue, N/V, Kussmaul respirations
~dehydration, fruity breath, hypotension + tachy, hypothermia
~BG > 250, acidosis, bicarb < 15, ketones in serum
What will you note on GA in a patient with lactic acidosis?
hyperventilation
How will you distinguish osteoporosis from osteomalacia VIA LAB VALUES?
osteoporosis:
serum PTH, calcium, phosphorous, alk phos usually normal
osteomalacia:
serum calcium, albumin, phosphate, PTH - low
alk phos - elevated
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?
Paget disease of bone
bisphosphanates
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?
osteogenesis imperfecta
What is your next step in evaluating a non-pregnant woman, age 35, with secondary amenorrhea, with no laboratory abnormalities?
10-day course of progestin
Absence of withdrawal menses usually indicates a lack of estrogen or a uterine abnormality.
What is the therapy/treatment for Turner syndrome?
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)
MEN 1, MEN 2A, MEN 2B:
facial angiofibromas?
hyperparathyroidism?
mucosal neuromas?
medullary thyroid cancer?
pheochromocytoma?
pituitary adenoma?
facial angiofibromas - MEN 1
hyperparathyroidism - MEN 2A
mucosal neuromas - MEN 2B
medullary thyroid cancer - 2A, 2B
pheochromocytoma - 2A, 2B
pituitary adenoma - MEN 1
What is the standard initial screening test for thyroid function?
T4 (total serum thyroxine)
What is testing TSH useful for?
detecting hyperthyroidism
What might serum thyroglobulin be tested in?
marker for thyroid cancer
T score ranges
>= -1: normal
-1 to -2.5: osteopenia
< -2.5: osteoporosis
< -2.5 w/ fracture: severe osteoporosis
What would you give beta blockers for?
symptoms of hyperthyroidism
Which can and cannot be used to treat thyroid storm?
propylthiauracil
methimazole
propylthiauracil can be used to treat thyroid storm
methimazole cannot be used in thyroid storm
Thyroid supplements are good to use in patients who want to lose weight.
T/F
False.
Ineffective and potentially toxic
In what demographic should you not prescribe levothyroxine?
postmenopausal women, men > 60
What is the starting dose for levothyroxine in a newly-diagnosed patient with hypothyroidism?
25 mcg
When might it be good to use liothyronine?
~mood modification in patients not achieving good results on T4 alone
~rapid onset (good for myxedema, unlike slow-onset levothyroxine)
Name two sulfonylureas.
glyburide
glipizide
Sulfonylureas: weight gain, loss, or neutral?
weight gain
Who cannot take metformin?
patients with renal disease
What is a great feature about metformin?
does not cause hyperinsulinemia
What is the black box warning for metformin?
may cause lactic acidosis
What vitamin may metformin interfere with the absorption of?
B12
Metformin: weight loss, gain, neutral?
weight loss
What is an important thing for patients to know about alpha-glucosidase inhibitors?
Works by blocking/delaying absorption of carbohydrates, so hypoglycemia cannot be treated with glucose/carbs
What is a contraindication for thiazolidinediones?
heart failure
What must be monitored periodically when taking thiazolidinediones?
hepatic function
What kind of emergency kit should be provided to every DM patient on insulin therapy?
parenteral glucagon emergency kit
What is a serious potential side effect of glucocorticoids?
osteoporosis
Name three medication therapies for post-menopausal bone loss.
bisphosphanates
selective estrogen receptor modulator
calcitonin
