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Endocrine / MSK / Repro > Week 2 > Flashcards

Week 2 Flashcards

1
Q

What is the radiology mode of choice for examining thyroid nodules?

A

ultrasound

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2
Q

What does a positive TSI indicate?

A

Grave’s disease

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3
Q

Does TSH respond immediately to medications?

A

No, takes about 6 weeks to see changes in TSH

Therefore, you should use Free T4 testing instead

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4
Q

What is the most common cause of a goiter / hypothyroidism worldwide?

A

iodine deficiency

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5
Q

Does pregnancy normally cause a goiter?

A

no

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6
Q

If both lab values are moving in the same direction (ex: TSH and T4), what does this indicate?

A

this indicates a secondary, upstream problem rather than a primary (ex: thyroid) problem

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7
Q

What serves as adjuvant therapy for differentiated thyroid cancer?

A

radioactive iodine

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8
Q

Which type of thyroid nodules hot or cold have a higher risk of malignancy?

A

cold

a cold nodule should be biopsied through fine needle aspiration (FNA)

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9
Q

What does radioactive iodine uptake in the thyroid look like when you are taking amiodarone?

A

it is decreased because amio competes for binding sites on the thyroid and less radioactive iodine is uptaken

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10
Q

In thyroiditis what does radioactive uptake look like?

A

undetectable

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11
Q

In thyroiditis what does TSH / free T4 look like?

A

low TSH and high T4

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12
Q

Which thyroid cancers are associated with increased levels of TBG?

A

Papillary and follicular thyroid carcinoma

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13
Q

What causes edema of the face? Which thyroid disorder is this associated with?

A

glycosaminoglycans

hypothyroidism

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14
Q

If you are taking exogenous iodine what does the radioactive iodine uptake scan look like?

A

not much uptake

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15
Q

How long after radioactive iodine should you avoid pregnancy?

A

6 months

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16
Q

What are the 3 different treatment options for hyperthyroidism?

A

Antithyroid drugs (ATD), radioactive iodine, surgery

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17
Q

What is the effect of bisphosphonates on bone density?

A

decrease osteoclast activity which increases bone density

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18
Q

What are the most common side effects of bisphosphonates?

A

GI side effects such as GERD

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19
Q

What makes the diagnosis of osteoporesis regardless of T-scores?

A

fragility fractures

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20
Q

Describe the different diagnoses provided by DEXA scan

A

Osteoporosis is defined as T score of −2.5 or less

Osteopenia is defined as a T score of between −1 and −2.5.

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21
Q

What is the first line treatment of osteoporosis?

A

Bisphosphonates

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22
Q

What is the most common cause of primary hypothyroidism?

A

Hashimotos

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23
Q

Which type of pituitary adenoma can produce hormones?

A

microadenoma

24
Q

What can distinguish Graves from other causes of hyperthyroidism?

A

the presence of eye symptoms

25
Q

What does asymmetry of thyroid point to?

A

toxic adenoma

26
Q

What should you do first when treating patients with thyrotoxicosis?

A

Beta-blockade

27
Q

Which beta blockers are cardioselective?

A

A-BEAM

atenolol, esmolol, metoprolol, …

28
Q

After you ablate a thyroid with iodine what do you need?

A

levothyroxine to treat the hypothyroidism

29
Q

What are the effects on thyroid hormone on the bones?

A

increased bone formation

30
Q

What does FRAX tell you?

A

if osteopenia needs treatment

31
Q

Acarbose

A

alpha glucosidase inhibitor that is only associated with mild decreases in A1c

significant GI side effects

31
Q

Which diabetes drugs are the only drugs associated with weight loss?

A

GLP-1 agonists

-tide drugs

32
Q

Pioglitazone

A

a type of thiazolidinedione that is associated with weight gain and fluid retention

33
Q

What are the effects of hyperglycemia on appetite?

A

increased appetite

34
Q

What 3 conditions does DM cause in the micro-vasculature?

A

1) Retinopathy

2) Diabetic neuropathy

3) Microvasculature of the glomerulus

35
Q

What type of drug is metformin?

A

decreases gluconeogenesis

36
Q

How do glitazones work?

A

improve peripheral sensitivity to insulin

37
Q

How do sulfonyureas / meglitinides work?

A

stimulate pancreatic insulin secretion

(C-peptide will also be raised)

38
Q

What is the MOA of SGLT-2 inhibitors?

A

prevent glucose reabsorption in the PCT and therefore more is excreted in urine

39
Q

What is the ending of SGLT-2 inhibitors?

A

-flozin

40
Q

If you have an insulinoma will C-peptide also be increased?

A

yes

41
Q

What lab values do you see with an mesenchymal tumor ? Why?

A

hypoglycemia with low insulin and low C-peptide

these tumors secrete other factors that cause hypoglycemia like IGF-2. Therefore the insulin and C-peptide production would be lowered

42
Q

what are the 2 long acting forms of insulin?

A

glargine

insulin degludec

43
Q

what are the 3 forms of short acting insulin?

A

lispro

aspart

glulisine

44
Q

what are the intermediate forms of insulin?

A

regular insulin

NPH insulin

45
Q

What imaging should you use for thyroid or parathyroid?

A

start with ultrasound and then move to CT

46
Q

What imaging should you use for adrenal glands?

A

CT scan

47
Q

What imaging should you use for pituitary gland?

A

MRI

48
Q

If you see a thyroid gland that is not as white/dense as normal, what are you suspecting?

A

iodine deficiency

49
Q

What does ectopic thyroid tissue look like?

A

3 lobes of thyroid (one might be sitting anterior midline of neck)

this will all be denser / white in color! Since it is made of thyroid tissue

50
Q

What does a cyst look like?

A

this will be darker and more the color of water than thyroid tissue

51
Q

What organ is most likely to cause metastatic disease to the adrenal glands?

A

lung

52
Q

What does calcification on the adrenal glands point to?

A

infection or hemorrhage

can be Waterhouse-Friedman syndrome

53
Q

What are signs of a pituitary adenoma on MRI?

A

will look like it has a head and body like a snowman

this points to a pituitary adenoma

54
Q
A

Endocrine / MSK / Repro (8 decks)

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