Usmle Step 3 Endocrine

Front 1

Diabetic Retinopathy

Back 1

Cotton-wool spots -nonspecific, but common in DM. With progression, neovascularization --> vitreous hemorrhage --> retinal detachement. NOTE - AV nicking is more common in HTN, but often co-morbid in diabetics

Front 2

Congenital Hypothyroid Features

Back 2

Feeding problems, jaundiced mottled skin, hypotonia, course face, protruding tongue, hoarse cry.

Front 3

Galactosemia

Back 3

Jaundice, hepatosplenomegaly, seizures, hypoglycemia, cataracts, vomiting after milk consumption; GIVE galactose-free foods.

Front 4

Phenylketonuria

Back 4

AR, light hair, mousy odor, seizures, vomiting, dermatitis, growth retardation.

Front 5

Cerebral Edema

Back 5

Presents with abdominal pain, n/v/polyuria, lethargy. Usually precipitated by cessation of insulin intake, or surgery, or DKA. TREAT with mannitol acutely, then correct electrolyte imbalance.

Front 6

DKA --> Cerebral Edema

Back 6

TREAT initially with insulin + saline or LR. As glucose and potassium fall, they must be replaced.
If glucose drops too fast, Cerebral edema develops. Lower serum glucose at rate of 50-100mg/dl/hour.

Front 7

Adrenal Insuff

Back 7

Presents with hypotension, confusion. May occur in minor urinary or respiratory tract infections. (e.g. recent cough/fever) other findings may include loss of mineralocorticoid action: high/normal potassium, low/normal sodium, increased creatinine.)

Front 8

Acromegaly

Back 8

Adult with elevated IGF-1 level, acral enlargement, course facial features, protuberant jaw. DIAGNOSE with MRI of pituitary. TREAT with transphenoidal resection

Front 9

Thyroid nodule

Back 9

if Euthyroid, male --> suspect malignancy. Other risk factors include - firm, fixed nodule; MANAGE suspected malignancy with FNA.

Front 10

Thyroid workup

Back 10

Front 11

Prolactinoma

Back 11

Bitemporal hemianopsia, erectile dysfunction, loss of libido, elevations of prolactin. Often, medication induced. If truly a macroadenoma, get MRI pituitary and bromocriptine may be used temporarily.

Front 12

Grave's disease -

Back 12

aka thyroid ophtalmopathy. Cigarette smoking has been linked to disease severity. Diplopia results frominfiltration of extraocular muscles. Exophtalmos may be unilateral

Front 13

1' Hyperparathyroidism

Back 13

Results from parathyroid producing too much PTH --> hypercalcemia, maybe hypophosphatemia; TREAT with surgical evaluation; "STONES, BONES, and ABDOMINAL GROANS"

Front 14

2' Hyperparathyroidism

Back 14

Results from renal disease and hypocalcemia/phosphatemia, leading to secondary hyperparathyroidism. TREAT underlying disease, maybe vitamin D.