Kendo 200-250

Front 1

Q200. Etiology of Hypopituitraism; (3)

Back 1

A200. Tumors;; Medical/surgical destruction;; Sheehan's syndrome

Front 2

Q201. Dx: 36-yo woman complains of amenorrhea for 1 year, increasingly bad HA, clumsiness and sporadic nipple discharge; beta-hCG levels are normal

Back 2

A201. Prolactinoma

Front 3

Q202. Drugs that inhibit DA and as a result, cause hyperprolactinemia; (6)*

Back 3

A202. The Prolactin Has Magnified My C-cups: TCAs;; Prochlorperazine;; Haloperidol;; Methyldopa;; Metoclopramide: Cimetidine

Front 4

Q203. Difference b/t Central DI and Nephrogenic DI with respect to ADH

Back 4

A203. Central DI: inadequate pituitary secretion of ADH; Nephrogenic DI: lack of renal response to ADH

Front 5

Q204. Etiology of Central DI; (4, 3 are systemic)

Back 5

A204. PENS:; 1. Posterior pituitary damage (tumor, trauma, etc); 2. Encephalitis;; 3. Neurosyphillis;; 4. Sarcoidosis

Front 6

Q205. Dx: Psychiatric disorder of compulsive water drinking common in young to middle aged women; polyuria and dilute urine. How is it distinguished from DI?

Back 6

A205. Psychogenic Polydipsia; difference with DI: PP has a low plasma osmolality

Front 7

Q206. Etiology of Nephrogenic DI aside from Drugs, renal Dz and electrolyte disorders

Back 7

A206. Sickle cell

Front 8

Q207. (3) Drugs that can cause nephrogenic DI

Back 8

A207. "Liquid DM": Lithium;; Demeclocycline;; Methoxyflurane

Front 9

Q208. Dx: polyuria (3-15 L/day); thirst; dilute urine (sp gravity < 1.005)

Back 9

A208. DI

Front 10

Q209. Dx test for DI; (3)

Back 10

A209. 1. plasma Osmolality: High; 2. Exogenous ADH: leads to Water deprivation; 3. Infusion of hypertonic saline: no response

Front 11

Q210. Compare the urine osmolality before and after the infusion of exogenous ADH in: 1. Normal patient; 2. Central DI patient; 3. Nephrogenic DI patient

Back 11

A210. Normal: High urine Osm -> high urine Osm; Central DI: Low urine Osm -> high urine Osm; Nephrogenic DI: Low urine Osm -> low urine Osm

Front 12

Q211. Tx for Central DI

Back 12

A211. Desmopressin (DDAVP)

Front 13

Q212. Tx for Nephrogenic DI

Back 13

A212. Thiazide Diuretics

Front 14

Q213. Definition: Excess production of ADH

Back 14

A213. SIADH

Front 15

Q214. basic Etiology of SIADH; (3)

Back 15

A214. PIE:; Pharmacologic stimulation of hypo-pit axis;; Idiopathic overproduction of axis;; Ectopic production from tumors

Front 16

Q215. what (2) tumors cause SIADH?

Back 16

A215. Small cell lung CA; Pancreatic CA

Front 17

Q216. what are the Idiopathic causes of the overproduction of ADH in SIADH?; (5 in 2 categories)

Back 17

A216. CNS: encephalitis, trauma, stroke; Pulmonary Dz: TB, pneumonia; *any problem to Lungs or Brain (+ Pancreatic CA) can cause SIADH!

Front 18

Q217. (4) Pharmacologic causes of SIADH

Back 18

A217. Carbamazepine;; Chlorpropamide;; Clofibrate;; Vincristine

Front 19

Q218. (4)* other causes, aside from small cell and pancreatic cell cancer, of ADH secretion

Back 19

A218. Adrenal failure;; Renal failure;; Edema;; Fluid loss

Front 20

Q219. Dx: hyponatremia; low serum osmolality; high urinary sodium; urine osmolality > serum

Back 20

A219. SIADH

Front 21

Q220. Tx for SIADH; (2 with fluids, 1 drug)

Back 21

A220. Fluid restriction;; Hypertonic saline in severe HypoN;; Demeclocycline (lowers CD response to ADH)

Front 22

Q221. Definition: Disease of impaired bone mineralization

Back 22

A221. Osteomalacia; (Mineralization = Malacia)

Front 23

Q222. Osteomalacia in children

Back 23

A222. Rickets

Front 24

Q223. Basic etiology of Osteomalacia; (4)

Back 24

A223. Decreased Calcium absorption;; Dietary Calcium deficiency;; Vitamin D deficiency;; Hypophosphatemia

Front 25

Q224. Causes of dietary Calcium deficiency; (3)*

Back 25

A224. Malabsorption syndromes;; Gastrectomy;; Dumping syndrome

Front 26

Q225. Main Causes of Vitamin D deficiency; (2)

Back 26

A225. Hepatobiliary and Pancreatic diseases (loss of bile acids or pancreatic lipase reduce absorption of fat-soluble vitamins);; Renal Osteodystrophy

Front 27

Q226. Causes of Hypophosphatemia; (2)

Back 27

A226. Renal Tubular Acidosis;; Falconi's syndrome

Front 28

Q227. Dx: Bone pain, weakness, difficulty walking: broad-based waddling gait with short strides; thoracic kyphosis

Back 28

A227. Osteomalacia; (Rickets in children)

Front 29

Q228. What do blood tests show to Dx Osteomalacia?; (3)

Back 29

A228. Labs:; 1. Low - nml Calcium;; 2. Low - nml Phosphate;; 3. High Alk-phos (possible high PTH)

Front 30

Q229. Tx for Osteomalacia; (2)

Back 30

A229. Tx underlying disorder;; Calcium and Vitamin D supplements

Front 31

Q230. Definition: Systemic disorder resulting in a reduction of bone mass that leads to increased risk of fracture

Back 31

A230. Osteoporosis

Front 32

Q231. Risk factors for Osteoporosis; (6)

Back 32

A231. Elderly Female;; Post-menopause;; Family Hx;; Smoking;; Thin body;; Sedentary lifestyle

Front 33

Q232. Pathophysiology of Osteoporosis

Back 33

A232. Reduction of bone mass occurs due to an imbalance b/t bone acquisition and bone reabsorption;; without change in the ratio of mineral to organic bone

Front 34

Q233. Histology of Osteoporosis

Back 34

A233. Decreased cortical thickness and number (and size) of cancellous bone trabeculae; (especially horizontal)

Front 35

Q234. When does osteoporosis usually become symptomatic?; (2) types

Back 35

A234. when Fracture occurs:; Vertebral body fracture;; Hip fracture

Front 36

Q235. Dx lab blood test results for Osteoporosis

Back 36

A235. Everything is normal: Serum Ca++ and PO4- are usu normal;; Alk-phos is normal unless there is a fracture, then it's increased

Front 37

Q236. How is bone mineral density measured?; (2) Dx results

Back 37

A236. Dual X-ray Absorptiometry (DEXA) scan; T-score < -2.5 = Osteoporosis; T-score -2.5 to -1 = Osteopenia

Front 38

Q237. Differential in Osteoporosis; (4)*

Back 38

A237. Malignancy;; Hyperparathyriodism;; Osteomalacia;; Padget's disease of the bone

Front 39

Q238. Prevention and Tx for Osteoporosis; (4)

Back 39

A238. Dietary Calcium and Weight-bearing exercises;; Estrogen replacement therapy;; Calcitonin;; Bisphosphonates (Alendronate) with Vitamin D and Calcium supplements

Front 40

Q239. Definition: Chronic Dz of adult bone in which localized areas of bone becomes hyperactive, and the normal bone matrix is replaced by softened and enlarged bone

Back 40

A239. Padget's Disease of the bone

Front 41

Q240. If Alkaline Phos is elevated, what is the next step?; (2)

Back 41

A240. Send GGT to determine if it is Hepatic (elevated GGT) or bone (not elevated); or Check to see if it is heat-labile (Bone), where hepatic is not

Front 42

Q241. Histology: Hyperactive bone turnover with enlarged multinucleated osteoclasts

Back 42

A241. Padgets Disease of the bone

Front 43

Q242. Dx: 45-yo male is found to have an elevated alkaline phosphatase during a routine blood test. No other abnormalities were found. Further workup reveals the enzyme to be heat labile

Back 43

A242. Padget's Disease of the bone

Front 44

Q243. Radiologic finding: area of hyperlucency of the bone surrounded by a hyperdense border

Back 44

A243. Padget's Disease of the bone

Front 45

Q244. Tx for Padget's Disease of the Bone for: 1. Pain relief; 2. Anatomic deformity or impingement; 3. to Decrease bone reabsorption; 4. to assist with cardiac failure or neurologic deficits

Back 45

A244. 1. Pain = Indomethacin; 2. Deformity = Osteotomy of the bone; 3. Decrease Reabsorption = Bisphosphonates; 4. Assist in CardiacNeuro = Calcitonin

Front 46

Q245. What is the Normal serum Calcium range?

Back 46

A245. 8.5 - 10.2 mg/dL

Front 47

Q246. Etiology of Hypocalcemia; (8)*

Back 47

A246. IV STRAP:; Insufficient PTH;; Vitamin D deficiency;; Sepsis / Severe Mg deficiency;; Toxins;; Rhabdomyolysis;; Albright's Osteodystrophy (Pseudohypoparathyroidism);; Pancreatitis

Front 48

Q247. Osteoporosis Risk factors; (8)*

Back 48

A247. FACELESS:; Family history;; Alcohol;; Corticosteroids;; Elderly Female;; Low Calcium;; Estrogen low (Menopause);; Smoking;; Sedentary lifestyle

Front 49

Q248. First sign/Sx of Hypocalcemia; Name and describe (2) other common signs seen in PE

Back 49

A248. first sign:; Circumoral Paresthesia; Chvostek's sign: Facial muscle spasm with tapping of the facial nerve; Trousseau's sign: Carpal spasm after occluding blood flow in forearm with BP cuff

Front 50

Q249. What is seen with EKG for Hypocalcemia?

Back 50

A249. Prolonged QT and ST intervals; (also peaked T-waves can be seen as in HyperK)

Front 51

Q250. How can Calcium correct for Hypoalbuminemia?

Back 51

A250. Adjust Calcium upward by 0.8mg/dL for each 1.0g/dL of albumin below normal