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16 Cards in this Set
- Front
- Back
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what is the dawn phenomenon?
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Hyperglycemia due to normal nocturnal release of counterregulatory hormones which increase insulin resistance and blood glucose levels. Treat by increasing evening NPH insulin
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What is the Somogyi effect?
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Rebound hyperglycemia due to excess exogenous insulin which causes hypoglycemia overnight and subsequent release of counterregulatory hormones that cause a rise in blood glucose levels. Treat by decreasing evening NPH insulin.
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What are the screening recommendations for diabetes?
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With no risk factors, test HgbA1C at age 45 and every 3 years if it is < 5.7%
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What are the screening recommendations for people with impaired fasting glucose (111-125) or impaired glucose tolerance
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Frequent retesting? WTF
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what features are seen only in Graves disease?
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exophthalmos, pretibial myxedema, thyroid bruits
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What is thyroid storm and how do you treat it?
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Can present with AF, fever, and delirium. Treat with IV propanolol and steroids. High dose potassium iodide may also be helpful (SSKI)
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What is myxedema coma and how is it treated?
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Severe hypothyroidism with decreased mental status, hypothermia, and other parasympathetic symptoms. Treat urgently with IV levothyroxine and IV hydrocortisone
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What should you check if medullary thyroid carcinoma is suspected?
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Calcitonin levels
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What is seen in Paget's disease?
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Increased serum alk phos with normal calcium and phosphate levels. 1% risk of osteosarcoma
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What clinical features are seen in acromegaly?
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Carpal tunnel syndrome, OSA, DM2, heart disease (diastolic dysfunction), hypertension, arthritis
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How do you interpret the water deprivation test?
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In patients with central and nephrogenic DI, patients excrete a high volume of inappropriately dilute urine.
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What electrolyte abnormalities are seen in SIADH?
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Urine osmolality > 50-100 in the setting of serum hypoosmolarity, urine Na > 20, serum uric acid < 4
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What is the MCC of adrenal insufficiency worldwide?
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TB
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How do you diagnose adrenal insufficiency?
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8 am plasma cortisol levels and a synthetic ACTH stimulation test. If plasma cortisol < 3 in the absence of exogenous glucocorticoid administration, AI is diagnosed
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What are the 4 S's of adrenal crisis management?
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Salt, steroids, support, search for cause
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What other test besides CT/MRI can you get for pheo?
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Nuclear MIBG scan to localize extra-adrenal lesions and metastatic disease
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