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71 Cards in this Set
- Front
- Back
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Q. In Addisons disease what is the effect with a lack of Aldosterone?
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1. ORTHOSTATIC HYPERTENSION
2. Hyponaturemia and Hyperkalemia 3. SEVERE DEHYDRATION |
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Q. What are the serum Na and K levels in Addisons disease?
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Na+ < 130ml
K+ > 5 meq/L |
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Q. What are 3 effects of a lack of CORTISOL in Addisons disease?
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1. Hypoglycemia
2. Myocardial weakness (due to the hypoglycemia) 3. ACTH will increase; side effect increase MSH, HYPERPIGMENTATION |
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Q. What are SIGNS and Sx of Addisons disease?
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i.Increase skin pigmentation
ii.N/V, loss of appetite iii. Decrease tolerance to cold |
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Q. What are 3 etiologies of Secondary Adrenal Insufficiency?
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i. Tumors, Trauma
ii. Sheehans iii. D/C of Exogenous Steroids |
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Q. What are Sx of Secondary Adrenal Insufficiency?
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Same as Addisons EXCEPT NO HYPERPIGMENTATION, and NORMAL ELECTROLYTES
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Q. What Occurs with the ACTH Stim Test on a patient with Secondary Adrenal Insufficiency?
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Give ACTH and cortisol goes UP
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Q. What are 4 etiologies of Cushing Syndrome (Adrenocortical Hyperfunction)?
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a. Adrenal Adenomas
b. Pituitary Adenoma (Cushing’s Dz) c. ACTH Secreting Tumors d. Exogenous Steroids |
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Q. Name 3-5 Sx of Cushings Syndrome?
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1. bruises/purple striae
2. Proximal Muscle Weakness, bone loss 3. Hirsuitism and acne, psychosis 4. Hypernatremia, hypokalemia |
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Q. Name 4 Dx Test for Cushing Syndrome?
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1. Electrolyte imbalance
2. cortisol levels 3. dexamethasone suppression test 4. MRI of pituitary/adrenals |
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Q. Define Conns Syndrome (Primary Hyperaldosteronism)?
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Too much aldosterone is produced by the adrenal glands, which can lead to lowered levels of potassium in the blood.
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Q. Name 4 Sx of Conns Syndrome?
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i. HTN
ii. Fatigue, muscle weakness, palpitations iii. Headache, polyuria, polydipsia iv. Metabolic alkalosis |
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Q. Name 4 ways we diagnose Conns Syndrome?
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i. Screen ratio aldosterone/renin 20:1
ii. 24 hour urinary aldosterone to confirm iii. No effect on cortisol/glucose iv. CT scan for adrenal adenoma |
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Q. Name 5 Sx of Diabetes Type 1?
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1. Polyuria, Polydipsia
2. Severe fatigue 3. Blurred vision 4. Stupor 5. Abdominal Pain |
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Q. What is the Dx of Diabetes Type 1?
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Fasting Blood Glucose is greater than 126mg/dl on two separate occasions
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Q. What is the etiology of Diabetes Type 1?
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Genetics
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Q. What is the etiology of Diabetic Ketoacidosis?
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Insulin deficiency
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Q. What are 3 IMPORTANT Sx of Diabetic Ketoacidosis?
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1. KUSSMAUL RESPIRATION
2. Fruity odor breath, Coma 3. Somnolence (sleepy |
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Q. What are 3 LAB Findings in Diabetic Ketoacidosis?
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1. pH less than 7.3, glucose higher than 250mg/dl
2. Ketonuria 3. Hyperkalemia |
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Q. What is the Etiology of Diabetes Type 2?
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1. Insulin Resistance
2. Twin Occurence GREATER then 90% |
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Q. What is the INCIDENCE in Diabetes Type 2?
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**10x more common than Type I
High in Pediatric Population |
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Q. Name 2 Important Sx of Diabetes Type 2?
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1. Polydypsia,
2. Polyruria but MOSTLY ASX! |
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Q. How long does Dx take for Diabetes Type 2?
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5-7 Years
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Q. Name 5 complications of Diabetes Type 2?
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1. Microvascular dz, macrovasc. Dz.
2. Peripheral neuropathy. 3. Foot ulcer, 4. Infections, 5. Retinopathy, Nephropathy |
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Q. What is the etiology of hyperthyroidism?
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Ab against TSH that mimick TSH
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Q. What is the pathophysiology of Graves disease?
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Autoimmune antibodies to the TSH receptors causing continuous stimulation and enlargement of the gland
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Q. Name 4 Sx of Graves Disease?
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1. **Itchy PRETIBIAL MYXEDEMA
2. Pruritis 3. Goiter 4. Exophthalamos |
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Q. Name 3 Labs for Graves Disease?
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1. **TSH Test (WILL be Normal)
2. Increase T3 and T4 3. RAI Uptake Test |
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Q. What is the etiology of DeQuervains thyroiditis?
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Viral
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Q. What is the Sx of DeQuervains Thyoiditis?
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Gland swells and is Tender
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Q. What are the 4 lab results shown in DeQuervains Thyroiditis?
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1. Low RAIU
2. Increased T4 T3 3. Low TSH 4. **NO AB’S!! |
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Q. What is the Prognosis of DeQuervains Thyroiditis?
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Usually resolves in several weeks
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Q. What is the etiology of Hashimotos thyroiditis?
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AB against Thyroid
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Q. What is the best Lab for Hashimotos thyroiditis?
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TSH
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Q. How do we Dx Hashimotos thyroiditis?
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If T3 and T4 don’t increase, it’s hypothyroid
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Q. Name 3-5 Sx of Hashimotos thyroiditis?
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1. Lethargy
2. Dry skin, 3. Hair loss 4. Constipation, weight gain 5. Facial puffiness, periorbital edema, macroglossia, intolerance to cold |
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Q. What is the main Sx in Cretinism?
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DELAYED GROWTH IN KIDS
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Q. At what age should thyroid replacement start?
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The first 3 MONTHS OF LIFE
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Q. What is the Incidence of Myxedema Coma?
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(Rare) ELDERLY people in the WINTER
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Q. What are 3 Sx of myxedema coma?
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i. Profound Hypothermia
ii. Severe respiratory depression iii. Bradychardia |
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Q. What is the incidence of papillary carcinoma?
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MOST COMMON. WORSE IN 30s and 40s.
The YOUNGER the WORSE |
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Q. How does Papillary Carcinoma Spread?
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Lymphatogenously
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Q. What hormone is secreted in medullary carcinoma?
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Calcitonin
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Q. What syndrome is Medullary Carcinoma apart of?
Which FORM is the worst? |
Man 2 Syndrome
Sporadic Form is the WORST |
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Q. How is follicular carcinoma Metastized?
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It is Metastisized HEMATOGENOUSLY
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Q. What are 2 Sx of anaplastic carcinoma?
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1. Rapid onset of mass/pain
2. Hoarseness |
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Q. What is the prognosis of anaplastic carcinoma?
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80% die in a year
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Q. What is the etiology of Primary Hyperparathyroidism?
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Single adenoma in PT gland
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Q. What is the etiology of Secondary Hyperparathyroidism?
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Chronic renal failure, dietary deficiency of Vitamin D or Calcium
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Q. What are 4 Sx of Secondary Hyperparathyroidism?
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1. Tetany, seizures, prolonged QT interval
2. Chvostek’s sign + 3. Trousseau + 4. HYPOCALCEMIA |
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Q. What is the etiology Hypoparathyroidism?
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Due to Thyroid surgery, RARE—right away after that surgery
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Q. What is 4 Sx of Hypoparathyroidism?
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1. Hypocalcemia with tetany, 2. seizures,
3. prolonged QT wave, 4. muscle spasms Present: Short Stature, Round Face |
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Q. What 2 hormones do the posterior pituitary release, and what are there actions?
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ADH: Increases water reabsorption in the collecting ducts. Vasoconstrictive.
Oxytocin: uterine contractions |
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Q. Is Oxytocin regualted by Negative or Positive Feedback?
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POSITIVE FEEDBACK
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Q. What is the etiology in Anterior Lobe Hypopituitarism?
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Non secreting neoplasm, infection
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Q. How does Sheehans present in Anterior Lobe Hypopituitarism?
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Sudden onset b/c of vascular process, postpartum arterial spasm.
Diplopia, ptosis visual field defect |
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Q. What are 5 Sx of Anterior Lobe Hypopituitarism?
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1. Amenorrhea,
2. no lactation, 3. testicular atrophy impotence, 4. no pubic hair growth 5. Pituitary dwarfism in kids |
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Q. What is the etiology of hyperpituitarism?
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80% prolactin secreting adenoma, infection of granulomas
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Q. What are 2 Sx of hyperprolactinemia in hyperpituitarism?
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1. Decreased dopamine, synthesis, renal insufficiency, stress
2. Galactorrhea, amenorrhea, hot flashes, HA (if a tumor), BITEMPORAL HEMIANOPIA. |
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Q. How do we Dx hyperpituitarism?
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CT Scan or MRI of sella turcica
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Q. Define Gigantism?
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Abnormally large growth due to an excess of growth hormone during childhood, BEFORE the BONE growth PLATES have CLOSED
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Q. What is the cause Diabetes Insipidus?
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Idiopathic
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Q. What is the water deprivation test outcome in CENTRAL (NS) Diabbetes Insipidus?
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Increased urine osmol. With exogenous ADH
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Q. What is the water deprivation test outcome in Nephrogenic (NS) Diabbetes Insipidus?
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No response to exogenous ADH
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Q. What are 2 Sxm of Diabbetes Insipidus?
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1. polydypsia/polyuria
2. Urine volume greater than 15L/day |
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Q. What is the most common Karyotype in Turners Syndrome?
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45 XO
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Q. What are 4 Sx of Turners Syndrome?
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1. Coarctation
2. Bicuspid aortic valve 3. NORMAL IQ 4. hypertension |
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Q. What is the most common Karyotype in Klinefelters Syndrome?
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47XXY
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Q. What are 4 common clinical Findings in Klinefelters Syndrome?
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1. Male external genitalia with small testicles
2. Gynecomastia 3. LOW IQ 4. Decreased facial hair |
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Q. What is the inheritance pattern of Kallman SYndrome?
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X linked recessive disorder that affects males
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Q. What are 3 clinical findings of Kallman Syndrome?
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1. Undescended testes
2. Delayed puberty 3. Micropenis |
