Medicine Shelf 4 - Endocrine And Metabolic

Front 1

Plummer Vinson vs Plummer

Back 1

plummer vinson is acid disorder with upper esophageal webs

plummer is a multinodular toxic goiter

Front 2

patchy uptake on thyroid scan

Back 2

plummer's disease - multinodular toxic goiter

Front 3

upper esophageal webs

Back 3

plummer vinson

Front 4

diffuse uptake on thyroid scan

Back 4

Grave's disease

Front 5

antibody in graves

Back 5

thyroid-stimulating IgG antibody

Front 6

T3 and T4 in Graves? Plummers?

Back 6

increased in both

Front 7

are both T3 and T4 elevated in hyperthyroidism

Back 7

can be, but only T3 needs to be

Front 8

conditions that raise TBG (thyroid binding globulin)

Back 8

pregnancy
liver disease
oral contraceptives
aspirin

Front 9

if TBG increases, what happens to T4? T3?

Back 9

low radioactive T3 uptake

Front 10

what does radioactive T3 uptake tell us?

Back 10

status of TBG (thyroid binding globulin) in that T3 will be taken up if there's no room for it on TBG (i.e., if either there is too little TBG or too much T4 already binding)

Front 11

side effect of PTU and methimzazole

Back 11

agranulocytosis

Front 12

causes of thyroid storm

Back 12

infection
DKA
stress (trauma, surgery, illness, childbirth)

Front 13

mortality of thyroid storm

Back 13

20

Front 14

diseases associated with Hashimotos

Back 14

lupus
pernicious anemia

Front 15

autoimmune hypothyroidism?

Back 15

Hashimotos

Front 16

antimicrosomal Ab

Back 16

Hashimotos

Front 17

tx for thyroiditis

Back 17

NSAIDS or steroids

Front 18

painful tender thyroid gland

Back 18

subacute (viral, granulomatous) thyroiditis

Front 19

painless thyroiditis

Back 19

subacute lymphocytic thyroidtis

Front 20

antiperoxiase ab

Back 20

Hasihomotos

Front 21

antithyroglobulin ab

Back 21

Hashimotos thyroiditis

Front 22

fibrous tissue and hardening in thyroid

Back 22

Riedel's thyroiditis

Front 23

diagnosing a thryoid nodule

Back 23

FNA

Front 24

malignancy of cold nodules

Back 24

benign (as is warm)

Front 25

malignancy of hot nodules

Back 25

also benign (as is cold)

Front 26

medullary thyroid nodules associated with

Back 26

MEN II

Front 27

syndromes associated with thyroid papillary cancer

Back 27

Gardner's
Cowden's

Front 28

aggressive variant of thyroid follicular cancer

Back 28

Hurthle's cell

Front 29

thyroid cancers in order of worsening prognosis

Back 29

papillary
follicular
medullary
anaplastic

Front 30

type of thyroid cancer after radiation exposure

Back 30

papillary

Front 31

type of thyroid cancer producing calcitonin

Back 31

medullary

Front 32

tx for papillary carcinoma

Back 32

lobectomy with isthmusectomy

Front 33

tx for follicular

Back 33

total thyroidectomyiodine ablation

Front 34

tx for medullary carcinoma of thyroid

Back 34

ectomy plus radiation therapy (not usually successful)

Front 35

medications increasing prolactin

Back 35

estrogen
H2 blockers
metoclopramide
verapamil

Front 36

tx for prolactinoma

Back 36

bromocriptine
cabergoline

Front 37

much increased IGF-1

Back 37

acromegaly

Front 38

med to suppress GH

Back 38

octreotide

Front 39

decreased ADH

Back 39

diabetes insipidus

Front 40

tx for central diabetes insipidus

Back 40

desmopressin

Front 41

rx for nephrogenic diabetes insipidus

Back 41

thiazides (which deplete body of sodium so that sodium and water are reabsorbed)

Front 42

cuses of nephrogenic DI

Back 42

hypokalemia
hypercalcemia
lithium
demeclocycline
pyelonephritis
congenital

Front 43

result of dramatic hyponatremia

Back 43

cerebral edema

Front 44

hyponatrema with volume contraction

Back 44

hypovolemic

Front 45

effect of calcium levels on QT

Back 45

decreased Ca prolongs QT

Front 46

basal ganglia calcifications

Back 46

hypo PTH

Front 47

low Ca
high Phos
decreased PTH
decreased urine cAMP

Back 47

hypoparathyroidism

Front 48

bone disease in hyperPTH

Back 48

osteitis fibrosa cystica

Front 49

most common cause of secondary hyperparathyroidism

Back 49

chronic renal failure

Front 50

chloride/phos > 33:1

Back 50

primary hyperparathyroidism

chloride is high because of renal bicarb wasting

Front 51

producers of ectopic ACTH

Back 51

SCLC
bronchial carcinoid
thymoma

Front 52

HTN with episodes of severe HTN

Back 52

pheo

Front 53

pounding headach
inappropriate severe sweating

Back 53

pheo

Front 54

best indicators of pheos

Back 54

metanephrine
VMA, normetanephrine

Front 55

rx treatment for pheo

Back 55

phenoxybenzamine (beta blocker)

Front 56

preop rx for pheo

Back 56

beta blockers (phenoxybenzamine)

Front 57

MEN I (Wermer)

Back 57

Parathyroid hyperplasia
Pancreatic islet cell tumor (ZE, insulinoma)
Pituitary tumors

3 Ps

Front 58

MEN IIA (Sipple's)

Back 58

Medullary thyroid carcinoma
Pheo
HyperParathyroid

Front 59

MEN IIB/III

Back 59

Mucosal neuromas (nasopharynx, oropharynx...)
Medullary thyroid
Marfanoid
Pheo

Front 60

which d/o in both MEN II and III

Back 60

Medullary
Pheo

Front 61

Addison's tx

Back 61

glucocorticoid AND
fludrocortisone

Front 62

most common cause of Addisons in entire world? Western world?

Back 62

TB
autoimmune

Front 63

most common cause of adrenal insufficiency

Back 63

abrupt cessation of exogenous glucocorticoids

Front 64

inheritance pattern of congenital adrenal hyperplasia

Back 64

AR

Front 65

high levels of 17 )H hydroxyprogesterone in serum

Back 65

CAH (by 21 or 11 hydroxylase

Front 66

HbA1C target

Back 66

<7

Front 67

action of sulfonylureas

Back 67

stimulate pancreas to make insulin

Front 68

action of acarbose

Back 68

reduces glucose absorption from gut

Front 69

action of thiazolidinediones

Back 69

reduce insulin resistance

Front 70

action of metformin

Back 70

increases insulin sensitivity

Front 71

tx for diabetes nephropathy

Back 71

ACEi

Front 72

tx for diabetes retinopathy

Back 72

photocoagulation

Front 73

effect of acidosis on K

Back 73

K+ shifts out of cells

Front 74

effect of insulin on K

Back 74

hypokalemia

Front 75

tx of DKA

Back 75

insulin
fluids
K

Front 76

level of hyperosmolarity

Back 76

>320

Front 77

when to use D50 in DKA? HHS?

Back 77

at 250

Front 78

when to start SC insulin in DKA tx

Back 78

when patient starts eating

Front 79

what to test in unexplained hypoglycemia

Back 79

plasma insulin level
c peptide
anti-insulin antibodies
plasma and urine sulfonylurea levels

Front 80

tx fo hypoglycemia in alcoholics

Back 80

thiamine before glucose avoids Wernicke

Front 81

increased insulin
decreased glucose
increased C peptide
increased proinsulin

Back 81

insulinoma

Front 82

much increased insulin
decreased glucose
decreased C peptide
decreased proinsulin

Back 82

surreptitious insulin

Front 83

increased insulin
decreased glucose
increased C peptide
normal proinsulin

Back 83

sulfonylurea abuse

Front 84

blood glucose below 50
hypoglycemia with fasting
glucose relieves symptoms

Back 84

Whipple's triad = insulinoma

Front 85

Zollinger Ellison

Back 85

gastrinoma

Front 86

test for Zollinger Ellison

Back 86

secretin injection test

Front 87

gallstones
diabetes
steatorrhea

Back 87

somatostatinoma
(rare, malignant pancreatic tumor)
poor prognosis

Front 88

watery diarrhea
dehydration
hypokalemia
acidosis
achlorhydria
hyperglycemia
hypercalcemia

Back 88

VIPoma