Endo Ck

mikenakhla's version from 2016-05-21 16:05


Question Answer
• What are the three treatment options for Graves? Which one can worsen opthalmopathy in graves?Surgery, radiation, and PTU or methimazole. Radiation can worsen opthalmopathy
• First step when someone has hypertension and hypokalemia?measure plasma aldo/renin ratio, if elevated, adrenal suppression tests and imaging if positive
• Anorexia, fatigue, GI complaints, hypotension and hyperpigmentation of palmar creasesaddison's disease (adrenal failure). You get hyponatremia and hyperkalemia b/c no aldo
• Secretion of calcitonin with this type of thyroid cancermedullary
• Invasion of capsule and blood vessels differentiates which two thyroid conditions?follicular cancer and follicular adenoma
• Pituitary apoplexy?hemorrhage of pituitary gland, a potential complication of pituitary adenoma
• PTU and methimazole can have this side effectagranulocytosis
• Women with adrenal mass and excessive hair on face and acne. What is likely elevated in her blood?DHEA-S due to androgen producing adrenal tumor
• Erectile dysfunction and gynecomastia with low T3 and T4 but normal TSH. Also unintentional weight loss and fatigue. What do you think of?chronic liver disease, low albumin, explaining low total T3 and T4. The hypogonadism occurs because of the cirrhosis.
• Pregnancy effects on thyroid binding globulin?increases
• What decreases thyroid binding globulin?nephrotic syndrome, steroid use, cirrhosis
• Sick euthyroid syndromeslightly hypothyroid in setting of other medical illness, slightly elevated TSH, slightly low T4
• Lung cancer and cushing syndrome?small cell lung cancer secreting ACTH
• Hypotension, hyperkalemia, hyperpigmentationaddison's disease
• Postop patient who crashes after surgery and hx of steroid therapy?addison's disease - give steroids immediately. They're adrenal function is suppressed b/c of iatrogenic steroid treatment
• Diagnosis of addison's disease?ACTH stimulation test
• 21 hydroxylase deficiency? 17? 11?21 is increased androgens (virilization), 17 is increased aldo, 11 is both
• 2 classic Malignancies with hypercalcemia?multiple myeloma, squamous cell cancer
• Bone dysplasia, café au lait spots, precocious puberty, ovarian cystsmccune albright syndrome
• Hypertension, hypokalemia, hypernatremia, edema with an adrenal neoplasmconn syndrome (hyperaldosteronism) commonly due to adrenal mass
• Treatment for nephrogenic DI?give diuretic. That's counterintuitive but it has a paradoxical effect of decreasing urine output
• ADH secreting lung cancer?small cell
• How is SIADH treated? What if they have seizures? What if water restriction fails?water restriction and stop IV fluids. Give hypertonic saline if patient is having active seizures. Give demeclocycline (antibiotic that causes DI).
• Bilateral carpal tunnel syndrome and feeling tired, dry skinhypothyroidism.
• Metabolic abnormalities with hypothyroidism?hyperlipidemia, hyponatremia and elevations in CK and AST/ALT
• MEN 1 vs 2A vs 2B?1 is Parathyroid adenoma, enteroPancreatic, Pituitary . 2A is MTC, Pheo, parathyroid. 2B is MTC, Pheo, and neuromas or marfanoid habitus
• Patients with hashimoto's are at increased risk of developing which type of thyrid cancerlymphoma
• Lid lag, tachycardia, hypertension, high fever, tremors, altered mental status after surgery, trauma, infection, eg. What is this and what do you do?think thyroid storm. Treat sx with beta blockers then give PTU, Iodine solution to block thyroid hormone release, and steroids to decrease T4 to T3 conversion in periphery
• Elevated CK and myopathy, always rule this out first before progressing to other testshypothyroidism
• Homocystinuria increased DVT and PE risk, what do you give?anticoagulation and B6
• Hypothyroidism can cause what metabolic abnormality?elevated cholesterol. Treat with levothyroxine
• Marfanoid habitus is consistent with which MEN?2B, which is MTC, Pheo, and mucosal/intestinal neuromas
• Testing for primary hyperaldosteronism? These patients have easily induced hypokalemia after starting what drug?Renin and aldo activity/concentration (Aldo/renin ratio). Diuretics can easily induce hypokalemia in these people
• Rapidly developing hyperandrogenism with virilization is indicative ofandrogen secreting tumor from the ovary or adrenals.
• Elevated testosterone levels with normal DHEAS in a woman indicate which source? What about DHEAS levels elevated and normal testosterone?ovarian, adrenals
• Treatment of SIADH?fluid restriction, hypertonic saline if severely symptomatic or persistent after fluid restriction

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