Term
| What is the 24-hour cortisol test used for? |
|
Definition
| used to DIAGNOSE cushing's syndrome |
|
|
Term
| What is the "1mg overnight dexamethasone test" used for? |
|
Definition
| used to DIAGNOSE cushing's syndrome |
|
|
Term
| When and what is ACTH serum concentration used for? |
|
Definition
| used to LOCATE the source of cushing's syndrome |
|
|
Term
| When working up Cushing's syndrome, and tests point to a pituatary source but the scanning is indeterminant then what? |
|
Definition
perform INFERIOR PETROSAL SINUS SAMPLING
(MRI and CT are not good at diagnosing endocrine disorders) |
|
|
Term
| What are the most accurate tests to evaluate for Addison disease? |
|
Definition
1. Cosnytropin (synthetic ACTH) stimulation test
2. CT scan of the adrenal gland |
|
|
Term
| What is the Cosyntropin Stimulation Test? |
|
Definition
| measure the levels of cortisol before and after the administration of cosynotropin. If there is adrenal insufficiency, there will be no rise in cortisol level. |
|
|
Term
| With congenital adrenal hyperplasia, 21-hydroxylase deficiency subtype, what will be increased in the serum? |
|
Definition
| 17-hydroxyprogesterone + hypOtension + elevated androgen levels |
|
|
Term
| What will be seen in 11-hydroxylase deficiency? |
|
Definition
| adrenal androgens + hypERtension |
|
|
Term
| What will be seen with 17-hydroxylase deficiency? |
|
Definition
| hypERtension + LOW androgen levels |
|
|
Term
| If you suspect acromegaly what is the best initial test? |
|
Definition
| Insulinlike growth factor |
|
|
Term
| What is the most accurate test for acromegaly? |
|
Definition
| Glucose challenge test - suppression of GH by giving glucose (excludes acromegaly) |
|
|
Term
| What is the treatment for acromegaly? |
|
Definition
1. surgical resection with transphenoidal removal
2. octreotide
3. Cabergoline or bromocriptine
4. Pegvisomant |
|
|
Term
| Will facticious hypoglycemia (exogenous insulin administration) have auto-antibodies to insulin? |
|
Definition
|
|
Term
| A pt with hyperprolactinemia is unresponsive to bromocriptine, what is the best next step? |
|
Definition
| cabergoline (this is tried before attempting surgery) |
|
|
Term
| How long after starting Synthroid should a pt's TSH be rechecked? |
|
Definition
|
|
Term
| What is the order of operations for someone with a thyroid nodule? |
|
Definition
1. TSH and ultrasound ?
2. If TSH is high - FINE NEEDLE BIOPSY
3. If TSH is low - SCINTIGRIPHY |
|
|
Term
| What are cold thyroid nodules? |
|
Definition
| Cold = do not produce hormone |
|
|
Term
| What are hot thyroid nodules? |
|
Definition
| Hot = hyperfunctional (overproduction of thyroid hormone) |
|
|
Term
| Pheochromocytoma is associated with which MEN syndromes? |
|
Definition
|
|
Term
| What level should HbA1c be maintained at? |
|
Definition
|
|
Term
| What is the next step after FNA of a thyroid nodule that shows benign tissue? |
|
Definition
| follow with US in six months |
|
|
Term
| What is the next step after FNA of a thyroid nodule that shows atypia? |
|
Definition
| follow up in six months with FNA, if still atypical a surgical consult is warranted |
|
|
Term
| What is the next step after FNA of a thyroid nodule that shows follicular neoplasm? |
|
Definition
| surgical consult is warranted |
|
|
Term
| What is the next step after FNA of a thyroid nodule that is suspicious? |
|
Definition
| surgical consult is warrnated |
|
|
Term
| What is the next step after FNA of a thyroid nodule that is malignant? |
|
Definition
|
|
Term
| What is the treatment for nephrogenic diabetes insipidus? |
|
Definition
1. Sodium restriction
2. HCTZ
3. amlodipine |
|
|
Term
| Which type of thyroid cancer will cause an increase in calcitonin? |
|
Definition
|
|
Term
| What is the most common type of thyroid cancer? |
|
Definition
| papillary thyroid carcinoma - presents with calcified psammoma bodies and Orphan Annie nucleus. |
|
|
Term
| Where is the most common place for a gastrinoma? |
|
Definition
|
|
Term
| What is the next step in a diabetic pt who comes in with increased morning glucose? |
|
Definition
| measure glucose at 3 AM before changing the insulin regimen |
|
|
Term
|
Definition
| hyperglycemia in the morning due to morning release of growth hormone which acts as an insulin receptor antagonist. Therefore pts will be HYERPGLYCEMIC during the 3AM test. |
|
|
Term
| What is the somogyi effect? |
|
Definition
| overtreatment causes the pt to be hypOglycemic during the 3 AM test. The body responds by activating gluconeogenesis resulting in hyperglycemia by morning time. |
|
|
Term
| Dawn phenomenon is treated by . . . |
|
Definition
| increasing the evening basal insulin |
|
|
Term
| If you suspect Conn Syndrome what is the first test you order? |
|
Definition
| Sodium loading test - if the test does not suppress aldosterone to below 10 then the test is positive for Conns. CT is the next step. |
|
|
Term
| In thyroid storm always give PTU or methimazole before . . . |
|
Definition
| iodine, because PTU and methimazole block production of thyroid hormone. Giving iodine before these may exacerbate an increase in thyroid hormone production |
|
|
Term
| Reactive hypoglycemia occurs postprandially and is most common in individuals with . . . |
|
Definition
| gastric surgery (this includes vagotomy) |
|
|
Term
| What is reactive hypoglycemia? |
|
Definition
| large ingestion of glucose causes increased insulin release, which causes hypoglycemia and accompanied increase in sympothetic tone |
|
|
Term
| What neoplasms are found in MEN Type I? |
|
Definition
(3 Ps)
Parathyroid
Pancreatic islet cells
Pituatary gland |
|
|
Term
| How will MEN type I manifest? |
|
Definition
hypercalcemia
gastrinomas (Zollenger Ellison Syndrome)
insulinomas
prolactinomas
acromegaly |
|
|
Term
| What MEN syndromes have pheochromocytoma and thyroid carcinoma? |
|
Definition
MEN Type IIA
MEN Type IIB |
|
|
Term
| What MEN Syndrome has mucosal neuromas? |
|
Definition
|
|
Term
| Primary hyperPARAthyroidism is most commonly caused by . . . |
|
Definition
|
|
Term
| MEN Type IIA affects what three organs? |
|
Definition
parathyroid
meducllary thyoid
pheochromcytoma |
|
|
Term
| What MEN syndromes will have medullary carcinoma? |
|
Definition
|
|
Term
| Which MEN syndrome presents with a marfanoid body habitus? |
|
Definition
|
|
Term
| If a pt has a glucagonoma then they likely also have . . . |
|
Definition
| necrotizing migratory erythema |
|
|
Term
| pts with glucagonoma will have what change in their amino acids? |
|
Definition
| decreased (due to gluconeogeneis) |
|
|
Term
| What is the treatment of choice for insulinoma? |
|
Definition
surgery
(if pts cannot undergo therapy Diazoxide works) |
|
|
Term
| What is the confirmatory test for insulinoma? |
|
Definition
|
|
Term
| What vaccinations do newly diagnosed diabetics receive? |
|
Definition
|
|
Term
| subacute granulomatous thyroiditis is . . . |
|
Definition
|
|
Term
| subacute lymphocytic thyroiditis is . . . |
|
Definition
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