Endo

Front 1

What growth factor does GH stimulate?

Back 1

IGF-1 (insulin growth factor-1)

Front 2

Where is GH secreted from?

Back 2

anterior pituatary

Front 3

What affect does IGF-1 have on growth hormone?

Back 3

Inhibits growth hormone secretion from the anterior pituatary

Front 4

What is the single best test for the diagnosis of acromegaly?

Back 4

IGF-1

Front 5

After diagnosing Acromegaly with IGF-1 what would be the next step in managment?

Back 5

MRI of the pituatary

Front 6

What is the medical/surgical management of a pituatry adenoma?

Back 6

< 10 mm Transsphenoidal resection
>Bromocriptine and Octreotide

Front 7

1. A group of signs and symptoms associated with abnormally elevated levels of cortisol or ACTH?

2. Anterior pituatary over secretes ACTH due to a small benign pituatary adenoma?

Back 7

1. Cushing syndrome
2. Cushing Disease

Front 8

What are the cortisol levels in:
1. Cushing disease?
2. Addisons disease?

Back 8

1. Cushing lot of cortisol
2. Addisons autoimmune destruction of the adrenals

Front 9

What is the treatmnt of cushing disease?

Back 9

Transsphenoidal resection

Front 10

What is the treatment of an adrenal adenoma?

Back 10

Adrenalectomy

Front 11

Which medications can cause diabetes insipidus?

Back 11

1. Lithium
2. Amphotericin B

Front 12

What are the two types of diabetes insipidus?

Back 12

1. Central
2. Nephrogenic

Front 13

Name the drug that is a synthetic analog of somatostatin?

Back 13

Octreotide

Front 14

What effect does octeotride(somatostatin) have on growth hormeone and IGF-1.

Back 14

Hormone Suppresion

Front 15

What fluid should be give in to a patient with central diabetes insipidus?

Back 15

D5 in water until patient can consume regular water on own

Front 16

Should you give a diabetes insipudus patient sodium solutions?

Back 16

No

Front 17

What is the treatment for Diabetes insipidus?

Back 17

exogenous vassopressin

Front 18

Approximately how long does it take for retinopathy to occur after the new onset of diabetes mellitus?

Back 18

1. 3 to 5 years

Front 19

What is the treatment for retinal neovacularization

Back 19

laser photocoagulation

Front 20

What is another name for primary hyper-aldosteronism (adrenal hyper secretion)?

Back 20

Conns syndrome

Front 21

What must be considered in a patient that has unexplained hypokalemia and hypernatremiua? His ekg presents with a flattened T wave and a U wave.

Back 21

Conns syndrome (adrenal hypersecretion)

Front 22

What labs or tests are needed to confirm hyperaldosteronism?

Back 22

1. elevated plasma and urine aldosterone levels
2. decrease serum renin level

Front 23

What would be seen in renin-aldosterone level in secondary aldosteronism and what is a frequent cause?

Back 23

both renin and aldosterone is elevated.

Front 24

What is the treatment for hypokalemia/ metabolic alkalosis?

Back 24

potassium sparring diuretic (spironolactone)

Front 25

What is another name for a patient toxic multi-nodular goiter?

Back 25

Plummer's disease

Front 26

What is the primary treatment for Graves disease? What medication can you give to treat the adrenergic symptoms while awating resolution of hyperthyroidism?

Back 26

1. radioactive 131I thryroid ablation
2. propanolo

Front 27

IgE mediated, Atopy, Allergic, Asthma, and Anaphylaxis

Back 27

Type 1 hypersensitivity (immediate)

Front 28

Myasthenia Gravis, Erythroblastosis, Autoimmune hemolytic anemia, Thrombocytopenia, Goodpasture's, Grave's(MEATGG) IgM or IgG (compliment)

Back 28

Type 2 (cytotoxic antibody dependent)

Front 29

Serum sickness, Arthus Reaction, Systemic Lupus, Erythmetosis (SLE) IgG (compliment)

Back 29

Type 3 (Immune complex)

Front 30

Multiple sclerosis, Mantoux test, contact dermaitits, chronic transplant reaction, T-cells

Back 30

Type 4 delayed type hypersensitivity(DTH)

Front 31

Which hypersensitivity is cell mediated immune memory response?

Back 31

Type 4

Front 32

Which diabetic medication reduces glucose by delaying glucose production?

Back 32

Acarbose (glucosidse inhibitor)

Front 33

Which diabetic medication works by increasing insulin secretion?

Back 33

glypizide (sulfonureas)

Front 34

Which diabetic medication lowers glucose by decreasing hepatic glucose production, and increasing glucose utilization?

Back 34

metformin (biguanide)

Front 35

1 ton in lbs

Back 35

2000000 lbs in tons

Front 36

Which diabetic medication reduces glucose by delaying glucose production?

Back 36

Acarbose (glucosidse inhibitor)

Front 37

Which diabetic medication works by increasing insulin secretion?

Back 37

glypizide (sulfonureas)

Front 38

Which diabetic medication lowers glucose by decreasing hepatic glucose production, and increasing glucose utilization?

Back 38

metformin (biguanide)

Front 39

Which diabetic medication decreases insulin resistance, increases glucose utilization?

Back 39

pioglitizone (thiazolidinidione)

Front 40

Classic presentation is epigastric pain radiating to the back.

The pain typically lessons when the patient leans forward or lies in a fetal position

Back 40

Acute pancreatitis

Front 41

The two most common causes of pancreatitis?

Back 41

Cholelithiasis and alcohol abuse

Front 42

Name the sign hemorrhagic pancreatitis that causes bleeding into the flanks

Back 42

Grey Turner sign

Front 43

Name the sign hemorrhagic pancreatitis that causes bleeding into the flanks

Back 43

Grey Turner sign

Front 44

Name the sign hemorrhagic pancreatitis causes bleeding into the umbilical area

Back 44

Cullen sign

Front 45

Risk factors for gallstones

Back 45

The four F's, Fat, Female , Fertile, Forties

Front 46

Epigastric pain often severe, which often radiates directly to the back, nausea, vomiting, chills, fever. Pain worsened by eating and laying down. Name the disease.

Back 46

Acute pancreatitis

Front 47

How do you diagnose acute pancreatitis.

Back 47

Amylase and lipase more than three times the upper limit of normal lipase is more specific because amylase may return to normal after 48 to 72 hours

Front 48

What is the next step when you suspect acute pancreatitis?

Back 48

Normal saline bolus, then consider pain meds, patient should be NPO.

Labs: amylase, lipase, CBC, CMP

Front 49

When diagnosing acute pancreatitis which lab is more specific Amylase or Lipase?

Back 49

Lipase is more specific because Amylase may return to normal within 48-72 hours

Front 50

Upon diagnosis of acute pancreatitis what is the next best step?

Back 50

Abdominal CT scan is the next best step this gives the best indication of the severity of pancreatitis

Front 51

After diagnosing acute pancreatitis and doing an abdominal CT scan on the patient what is the next step if the patient is a female over 40 obese and still menstruating?

Back 51

Right upper quadrant ultrasound since his patient has risk factors for gallstones if the cause is gallstones a Coley cystectomy should be undertaken

Front 52

What is the Ransoms Criteria for Acute Pancreatitis on admission. Remember The mnemonic WALLS

Back 52

WBC more than 16000

Age more than 55

Liver AST more than 250

LDH more than 350

Sugar, Glucose more than 200

0-2 severe pancreatitis unlikely

3-5 severe pancreatitis likely

Remember the number one criteria for severity is not Ransons criteria it is an abdominal CT scan.

Front 53

Treatment for subacute painful thyroiditis?

Back 53

Supportive therapy

Front 54

In addition to insulin and fluid replacement with Saline which electrolyte is commonly infused in a type two diabetic patient who arrives in the emergency department in a hyperglycemic hyperosmolar nonketotic state?

Back 54

Potassium

Front 55

Name the associated disease for the following tests?

1. Cosyntropin stimulation test

2. Dexamethasone suppression

3. Vasopressin challenge test

Back 55

1. Cosyntropin stimulation test

(Addison's disease)

2. Dexamethasone suppression

(Cushing Syndrome)

3. Vasopressin challenge test

(Diabetes Insipidus)