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  1. best initial rx for gh secreting pit adenoma?
    transphenoidal resection
  2. sx for aaa?
    • >5.5cm
    • symptomatic
    • enlarging
    • ruptured
  3. specific diagnoistic test and result for each hormone deficiency?
    low TSH, Low thyroxine
    Low acth, low cortisol
    Low FSH, low LH
    low GH
    low prolactin
    • no elevation due to TRH
    • no cortisol elevation due to cosyntropin
    • no test
    • no response to arginine or GRH
    • no response due to TRH
  4. causes of nephrogenic DI?
    2 electrolyte disturbances causing DI?
    • lithium
    • sickle cell
    • myeloma
    • hypercalcemia
    • hypokalemia
  5. DIagnostic test for DI?
    • vasopressin infusion for central Di
    • correction of eletrolyte imbalance like high calcium, low potassium, diuretics and nsaids
  6. best initial test?
    most accurate test for increased GH from a pituaitary adenoma?
    • IGF levels
    • glucose suppression test--GH should be suppressed by high glucose
  7. Rx for pituitary adenoma secreting GH?
    when is radiation therapy used?
    • Transphenoidal resection
    • Dopamine agonists like cabergoline
    • octeotride
    • pegvisomant--gh receptor antagonist
    • when surgery or meds are not effective
  8. 4 causes of hyperprolactinemia?
    • high GH
    • high TRH
    • low dopamine
    • pregnancy
    • kidney failure
    • liver failure
  9. best initial test for hyperprolactinemia?
    when is an MRI done?
    • TFT
    • LFT
    • BUN/Creatinine
    • exluce medication
    • pregnancy
    • after all of the above causes are excluded
  10. Rx for hyperprolactinemia?
    when is transphenoidal surgery done?
    • dopamine agonist
    • when meds dont work
  11. most common cause of hypothyrodism?
    hashimotos thyroditis
  12. What processes are slowed down in hypothyrodism?
    everything except for menstrual flow
  13. BEst initial test for thyroid disorders?
  14. What is only cause of Hyperthyrodism that has elevated TSH?
    Pituitary Adenoma
  15. What hyperthyrodism disorder has a high RAIU?
    Grave's disease
  16. Most accurate test for Grave's disease?
    anti-tsh antibodies
  17. What is the only use for radioactive iodine to destroy the gland?
    Graves disease
  18. Best initial therapy for graves ophthalmopathy?
  19. Management of acute hyperthyrodism and thyroid storm?
    • propranolol
    • methimazole or PTU
    • iodinated contrast
    • steroids
    • radioactive iodine
  20. next step in management of a thyroid nodule?
    • TFT
    • if normal
    • biopsy
  21. most common cause of hypercalcemia?
  22. Rx of acute hypercalcemia?
    if the hypercalcemia persists?
    • saline hydration with loop diuretic
    • bisphosphonates
    • add calcitonin
  23. what effect does calcium have on QT interval?
    short QT interval
  24. Rx of hyperfunctioning parathyroid glands?
    Surgical Removal
  25. causes of hypocalcemia?
    • low magnesium
    • kidney failure
    • hypoparathyrodism
    • low vitamin D
  26. what effect does calcium have on the ekg?
    • low calcium--short qt
    • high calcium--long qt
  27. most common cause of hypercorticolism?
    acth overproduction
  28. best initial test for hypercorticolism or cushing syndrome is?
    • 24 hour urine cortisol
    • 1mg dexamethasone overnight suppression test
  29. what is the best initial test for determining the cause of hypercorticolism?
  30. next best step if ACTH level is elevated in the picture of hypercorticolism?
    • MRI of pituitary
    • biopsy of petrosal venous sinus
    • ┬áif the above are unequivical..scan the chest for an ectopic source of ACTH
  31. 3 steps in ruling out the need to remove adrenal lesions that are found accidentally on a ct?
    • metanephrines--r/o pheo
    • renin and aldosterone--r/o hyperaldosteronism
    • 1mg dexamethasone suppresion test--r/o hypercorticolism
  32. Most common cause of Addison disease?
  33. most specific test of adrenal function?
  34. Best initial test for hyperaldosteronism?
    plasma level of aldosterone/renin
  35. You should never start with what kind of diagnostic test in endocrinology?
    imaging study
  36. most accurate test for a an adrenal adenoma producing hyperaldosteronism?
    adrenal vein showing high levels of aldosterone
  37. how is bilateral hyperplasia of the adrenal producing high aldosterone treated?
    with spironolactone or eplerenone
  38. Best initial test for pheochromocytoma?
    More accurate test?
    When is ct imaging of the adrenals done?
    • Plasma metanephrine
    • 24 hour urine metanephrine
    • after biochemical markers are found such as plasma and urine metanephrines
  39. Best initial Rx for pheochromocytoma?
  40. Definition of DM?
    • fasting glucose over 125mg/dl on 2 separate occasion
    • 1 fasting glucose over 200 with symptoms
  41. best initial therapy for dm?
  42. What dm meds are contraindicated in chf?
  43. Rx of DKA?
    saline hydration +insulin + potassium
  44. How is diabetic retinopathy treated?
    laser photocoagulation
  45. When is ACEI started in a patient with DM?
    at trace or microalbuminuria?
    microalbuminuria---<300mg/24 of protein
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