Term
What is the diagnostic test for DI.
How is NDI differentiated from CDI?
What is the threatment for bother |
|
Definition
Water deprivation test
Central DI responds to Vasopressin
CDI: long term vasopressin
neph DI: correct the underlying cause; responds to hydrochlorothiazide, amiloride and NSAIDS |
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Term
| What is the treatment of Acromegally? |
|
Definition
Surgery; Transphenoidal resection of pituitary in 70% of cases
then
Medicaiton: Carbergolin: DA inhibits GH release
Octriotide and lanreotide: Somatostatin inhibitors
Radiotherapy: used only in those who do not respond to surgery or meds
S |
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Term
What are some s&S of Acromegally?
BIT?
MAT? |
|
Definition
Increased hat/shoe size, carpal tunnle, coarse facial features.
BIT: level of IGF-1
MAT: glucose suppression test, normally glucose should suppress GH levels
MRI should be done only after lab findings.
also test prolactin levels |
|
|
Term
Many causes of Hyperprolactinemia are not adenomas
what are the roles of:
T3 T4
Growth hormone
and Dopamine
in terms of Prolactin secretion |
|
Definition
lower T3/4 increases TRH which increases Prolactin
Prolactin is Cosecreated with GH
Dopamine inhibits Prolactin secreation |
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Term
What do women present with with hyperprolactinemia?
Men? |
|
Definition
galactoria, amenorrhea, infertility
erectile disfuntion, decreased libedo, gynoclomastia rarely galactorhea |
|
|
Term
what is the BIT for Hyper prolactinemia ( besides prolactin)
then what?
What is the treatment |
|
Definition
Pregnancy test, Thyroid function, BUN/Creatine(kidney disease elevates prolactin), Liver function test.
MRI is done after secondary causes are excluded
Dopamine agonists: Cabergoline is better than bromocriptine
Surgery: for those note responding to meds
Radiation rare |
|
|
Term
What is the treatment for Hypothyroidism
what is the treatment for thyroid strom (acute hypothyroidism?) |
|
Definition
Hormone replacement (thyroxin)
---------------
Propranolol blocks target organ effect, inhibits conversion of T3 to T4.
Thiourea: methimazole and propythiouracil, blocks hormone production,
Iodinated contrast material( iopanoic acid and ipodate
Steroids
Radioactive iodine |
|
|
Term
| When should you biopsy a thyroid gland |
|
Definition
greater than 1 cm biopsied with fine needle aspirate if normal thyroid.
If hyper functioning no need to biopys |
|
|
Term
What is the main cause of hypercalcemia?
What is the EKG findings?
What is the treatment of HyperCa? |
|
Definition
Primary hyper para thyroid
Short QT syndrome
Treat the source (Surgery), Saline hydration at high volume, loops,
then Bisphosphonates: zoledronic acid, pamidronate, calcitonin |
|
|
Term
What are the bisphosphonates?
what is the relationship btw albumin and Ca++
what lab values indicate primary hyper PTH?
how do you test for ectopic PTH |
|
Definition
Zoledronic Acid and pamidronate
when albumin goes up Ca goes down
HI PTH low Phosphate
Test for PTHrp |
|
|
Term
what is the most common cause of Hypocalcemia?
How do you adjust for albumin?
what are the S&S of Hypocalcemia x5 |
|
Definition
Primary Hypoparathyroidism due to surgical removal of the Parathyoroid.
for every point decrease in albumin the calcium decreases by .8
Chvostek sign ( facial nerve hyerexcitebility)
Carpopedal spasms
Perioral numbness
Mental irritabilty
Trousseau's sign with cuff
Seizers |
|
|
Term
If the PTH is low on Hypo parathyroidism what do you think?
What is the treatment for Hypoparathyriodism and Hypoglycemia |
|
Definition
Parathyroid surgery
Replace Ca and Vit D, oral at first. intravascular if severe. |
|
|
Term
what is the BIT for Cushings syndrome? x2
After that what test is done and why? |
|
Definition
24 hour urine cortisol or a Overnight low dose dexamethasone suppression test? suppression is normal
If cushings syndrome do ATCH levels to see if cushings disease/ ectopic or Primary Hypercorticalism (from gland) |
|
|
Term
| What is the findings for Cushings disease on High dose dexamethasone test? |
|
Definition
Hi Dose DM suppression = Cushings disease
Lo dose DM suppression = Cushing's syndrome |
|
|
Term
An all Endocrine disorders when should Imaging be done?
What is the treatment of Hyper corticalsim? |
|
Definition
After labs
Surgically remove the sorce
Pituitary- transsphenoidal
Adrenal- laproscopicaly
remove tumor |
|
|
Term
| What does Cortisol do to blood lab values? |
|
Definition
increased:
WBC's,
GLU
lipids
Na
Decreased:
K+ leading to alkalosis
Ca leading to osteoporosis
decreased inflammation responce |
|
|
Term
how should a incidentaloma of the adrenals be evaluated? x4
What is the cause of Addison's disease 80% of the time? |
|
Definition
check:
Metanephrines for pheo
Rinin and aldosterone for HYper ald
overnight low dose DM for Cushings
autoImmune |
|
|
Term
What are the labratory findings for Addisons disease?
what is the ATCH from the pituitary and the Adrenal glands |
|
Definition
Hypogly
HyperK
Met acid
HypoNa
High BUN
from pit- hi
from adren- low |
|
|
Term
| What is the next best Step for someone in Acute adrenal Crisis? |
|
Definition
Treat not Test:
Replace steroids with hydrocortisone,
Fludrocortisone- has mineral like effect |
|
|
Term
what is the most common cause of Hyperaldosteronism?
what are the rest from?
What is the main Associations with Primary Hyperald? |
|
Definition
80% solitary adenoma
rest hilateral hyperplasia
High bloodpressure + hypokalcemia = prim hyper aldo |
|
|
Term
What is the BIT for primary hyperaldo?
MAT:
Then what? |
|
Definition
Hi Plasma aldosterone:Plasma rinin ratio
MAT: Sample adrenal venous blood has hi aldosteron
then CT scan |
|
|
Term
| what is the treatment of primary hyper aldosteronism? |
|
Definition
unilateral adenoma resected by laparoscopy
bilateral hyperplasia is treated with eplernone or spirolactone |
|
|
Term
what is the BIT for pheochromocytoma? then what?
What is the Treatment for pheo? |
|
Definition
Free metanephrans 24 hour urine collection
CT/MRI after biochem
tx: Phenoxybenzamine (alphablocker) intially then CCB and Beta Blockers
Surgically remove |
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