Rosh Review- Endocrine
A 19-year-old woman presents to the emergency department with severe flushing,
tremors, and vision changes. Vital signs are BP 240/110 mm Hg, HR 104 beats per
minute, RR 20 breaths per minute, and T 100.4°F. She was recently found to have a
"mass on her kidney." Which of the following is the most appropriate course of treatment
in this patient? - ANS-Phentolamine followed by Labetolol!
Pheochromocytoma needs ALPHA blockade before BETA Blockade
in order to prevent un-blocked alpha receptors leading to Hypertensive Crisis!
Then Resection of adrenal tumor causing PHEOCHROMOCYTOMA
A 34-year-old man presents complaining of anterior neck pain for the past two days. He
had a few days of nasal congestion, a mild sore throat, and a cough three weeks before
the onset of neck pain. Physical exam reveals a diffusely enlarged and tender thyroid
gland. Which of the following is the most likely diagnosis? - ANS-Subacute Thyroiditis
(De Quervains)
Tx:
Propanol, Aspirin
A 35-year-old woman presents for several days of anterior neck pain radiating to her
ears, accompanied by dysphagia and "restlessness." She endorses a low-grade fever
and fatigue that is "lingering" from her recent flu-like illness. Physical exam shows a
tender, symmetrically enlarged thyroid. Laboratory studies show a normal complete
blood count, suppressed thyroid stimulating hormone, low antithyroid antibody titers,
and a high erythrocyte sedimentation rate.
What is diagnosis and treatment? - ANS-Subacute Thyroiditis! (De Quervian)
Tx:
Propanalol and Aspirin!
A 36-year-old man presents to your office for a physical exam. He has a family history of
diabetes and his body mass index is 30. Which of the following provides the best
screening for diabetes mellitus? - ANS-Fasting Plasma Glucose!
,A 44-year-old woman presents with generalized weakness in the proximal muscles,
fatigue, headache, weight loss, and abdominal pain with occasional constipation. She
has a history of nephrolithiasis one month ago. Physical exam is unremarkable.
Laboratory analysis is normal except for a serum calcium level of 10.9 (upper limit of
normal is 10.4). Which additional laboratory study should you order next? -
ANS-Parathyroid Hormone!
Hypercalcemia creates the stones, bones, psychogenic groans and abdominal
cramping/constipation
Tx:
Parathyroidectomy
A focused diabetic physical examination must include, at minimum, evaluation of which
areas? - ANS-Vital signs (autonomic neuropathy)
Fundoscopy (retinopathy)
Feet (diminished pulses, neuropathy)
An elevated thyroid peroxidase antibody (TPO) level is diagnostic for which thyroid
disorder? - ANS-Hashimoto's Thyroiditis!
At what self-monitored glucose level should patients be concerned about
hypoglycemia? - ANS-<70 gm/dL
How does diabetes mellitus cause polyuria? - ANS-Hyperglycemia spills over into the
kidney tubules, pulling water with it (osmotic diuresis).
Hypertriglyceridemia is commonly associated with which gastrointestinal disease? -
ANS-Acute Pancreatitis
In patients with rhabdomyolysis, what is the classic electrolyte abnormality that must
also be addressed? - ANS-Hyperkalemia!
In type 1 diabetes the C peptide level should be absent, normal or elevated? -
ANS-Absent
Elevated would indicate Insulinoma!
, Is anterior neck bruit associated with hyper or hypothyroid? - ANS-Hyperthyroid!
Along with:
Fine, thin, moist skin, prominent eyes with lid retraction (proptosis, or exophthalmos)
and a startled expression.
Metformin is first-line treatment in which type of diabetes mellitus? - ANS-Diabetes Type
II!
Insulin is treatment of choice for type I!
The adrenal cortex is responsible for the release of what important body factors? -
ANS-Mineralocorticoids (aldosterone)
Corticosteroids (cortisol)
Androgens (testosterone, estrogen)
Though primary adrenal insufficiency is usually due an autoimmune process in the
United States, it is occasionally due to which infectious process world-wide? -
ANS-Tuberculosis!
may result in development of primary adrenal insufficiency.
True or false: carpal tunnel is a common complication of hypothyroidism? - ANS-True
What abnormal levels are expected in someone with PCOS? - ANS-Increased LH!
Increased glucose levels (most commonly caused by insulin resistance), causing
Diabetes Type II
Also will see Acanthosis Nigrans!
Treat:
Metformin, Weight loss, Spironolactone, OCPs
What antiarrhythmic medication can cause hyperthyroidism? - ANS-Amiodarone
What are diagnostics and treatment for Diabetes Insipidus? - ANS-Diagnostics:
Central:
A 19-year-old woman presents to the emergency department with severe flushing,
tremors, and vision changes. Vital signs are BP 240/110 mm Hg, HR 104 beats per
minute, RR 20 breaths per minute, and T 100.4°F. She was recently found to have a
"mass on her kidney." Which of the following is the most appropriate course of treatment
in this patient? - ANS-Phentolamine followed by Labetolol!
Pheochromocytoma needs ALPHA blockade before BETA Blockade
in order to prevent un-blocked alpha receptors leading to Hypertensive Crisis!
Then Resection of adrenal tumor causing PHEOCHROMOCYTOMA
A 34-year-old man presents complaining of anterior neck pain for the past two days. He
had a few days of nasal congestion, a mild sore throat, and a cough three weeks before
the onset of neck pain. Physical exam reveals a diffusely enlarged and tender thyroid
gland. Which of the following is the most likely diagnosis? - ANS-Subacute Thyroiditis
(De Quervains)
Tx:
Propanol, Aspirin
A 35-year-old woman presents for several days of anterior neck pain radiating to her
ears, accompanied by dysphagia and "restlessness." She endorses a low-grade fever
and fatigue that is "lingering" from her recent flu-like illness. Physical exam shows a
tender, symmetrically enlarged thyroid. Laboratory studies show a normal complete
blood count, suppressed thyroid stimulating hormone, low antithyroid antibody titers,
and a high erythrocyte sedimentation rate.
What is diagnosis and treatment? - ANS-Subacute Thyroiditis! (De Quervian)
Tx:
Propanalol and Aspirin!
A 36-year-old man presents to your office for a physical exam. He has a family history of
diabetes and his body mass index is 30. Which of the following provides the best
screening for diabetes mellitus? - ANS-Fasting Plasma Glucose!
,A 44-year-old woman presents with generalized weakness in the proximal muscles,
fatigue, headache, weight loss, and abdominal pain with occasional constipation. She
has a history of nephrolithiasis one month ago. Physical exam is unremarkable.
Laboratory analysis is normal except for a serum calcium level of 10.9 (upper limit of
normal is 10.4). Which additional laboratory study should you order next? -
ANS-Parathyroid Hormone!
Hypercalcemia creates the stones, bones, psychogenic groans and abdominal
cramping/constipation
Tx:
Parathyroidectomy
A focused diabetic physical examination must include, at minimum, evaluation of which
areas? - ANS-Vital signs (autonomic neuropathy)
Fundoscopy (retinopathy)
Feet (diminished pulses, neuropathy)
An elevated thyroid peroxidase antibody (TPO) level is diagnostic for which thyroid
disorder? - ANS-Hashimoto's Thyroiditis!
At what self-monitored glucose level should patients be concerned about
hypoglycemia? - ANS-<70 gm/dL
How does diabetes mellitus cause polyuria? - ANS-Hyperglycemia spills over into the
kidney tubules, pulling water with it (osmotic diuresis).
Hypertriglyceridemia is commonly associated with which gastrointestinal disease? -
ANS-Acute Pancreatitis
In patients with rhabdomyolysis, what is the classic electrolyte abnormality that must
also be addressed? - ANS-Hyperkalemia!
In type 1 diabetes the C peptide level should be absent, normal or elevated? -
ANS-Absent
Elevated would indicate Insulinoma!
, Is anterior neck bruit associated with hyper or hypothyroid? - ANS-Hyperthyroid!
Along with:
Fine, thin, moist skin, prominent eyes with lid retraction (proptosis, or exophthalmos)
and a startled expression.
Metformin is first-line treatment in which type of diabetes mellitus? - ANS-Diabetes Type
II!
Insulin is treatment of choice for type I!
The adrenal cortex is responsible for the release of what important body factors? -
ANS-Mineralocorticoids (aldosterone)
Corticosteroids (cortisol)
Androgens (testosterone, estrogen)
Though primary adrenal insufficiency is usually due an autoimmune process in the
United States, it is occasionally due to which infectious process world-wide? -
ANS-Tuberculosis!
may result in development of primary adrenal insufficiency.
True or false: carpal tunnel is a common complication of hypothyroidism? - ANS-True
What abnormal levels are expected in someone with PCOS? - ANS-Increased LH!
Increased glucose levels (most commonly caused by insulin resistance), causing
Diabetes Type II
Also will see Acanthosis Nigrans!
Treat:
Metformin, Weight loss, Spironolactone, OCPs
What antiarrhythmic medication can cause hyperthyroidism? - ANS-Amiodarone
What are diagnostics and treatment for Diabetes Insipidus? - ANS-Diagnostics:
Central:
