Endocrinology 1

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HuskerDevil
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94511
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Endocrinology 1
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2011-07-18 23:42:09
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DPAP2012 Endocrinology
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Endocrinology flashcards made by previous students
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  1. polydipsia
    excessive thirst
  2. polyuria
    excessive urination
  3. early sign of type II DM
    nocturia
  4. Type II DM has a strong __
    genetic predisposition
  5. two things to check each time a diabetic visits the office
    blood pressure and feet
  6. least common type of diabetes
    type 1
  7. __% of diabetics are type I
    5-10
  8. __% of diabetics are type II
    90-95
  9. type I diabetes is caused by __ destruction
    beta cell
  10. __ can destroy beta cells
    pancreatitis or autoimmunity
  11. most common type of diabetes
    type II
  12. patients with __ diabetics have insulin resistance
    type II
  13. formerly called juvenile onset diabetes
    type I
  14. formerly called adult onset diabetes
    type II
  15. women with gestational diabetes can have
    big babies
  16. women with gestational diabetes have a __% chance of developing type II diabetes
    50
  17. Habitual physical inactivity
    lazy
  18. diabetes risk factors age greater than __
    45
  19. women with polycystic ovary syndrome have increased __
    androgen levels
  20. HDL < or = __mg/dl is a diabetes risk factor
    35
  21. triglycerides > or = __ is a diabetes risk factor
    250
  22. __ ovary syndrome is a diabetes risk factor
    polycystic
  23. FPG > or = 126 mg/dl
    diabetes
  24. FPG <126 mg/dl but > or = 110mg/dl
    pre-diabetes
  25. FPG < 110 mg/dl
    normal
  26. complications of diabetes
    stroke, retinopathy, end stage renal disease, heart disease, foot/leg amputation
  27. screen for end stage renal disease with
    microalbumin
  28. Measures Glucose Levels over 2-3 Month Period
    HbA1c
  29. Cannont be used to diagnose diabetes
    HbA1c
  30. don't order an HbA1c after a
    cardiac bypass
  31. HbA1c will not be accurate in patients with
    sickle cell disease, hemolytic anemia, certain drugs, recent trasnfusion
  32. suggested glucose range for diabetics before meals __mg/dL
    80-120
  33. suggested glucose range for diabetics after meals __mg/dL
    100-180
  34. suggested glucose range for diabetics at bedtime __mg/dL
    100-140
  35. suggested A1c for people with diabetes __%
    7
  36. the only current drug used to treat type I diabetes
    insulin
  37. 2 problems of type II diabetes
    lack of correct glucose secretion, insulin resistance
  38. best treatment for type II diabetes
    lifestyle modification
  39. ADA target A1c <__%
    7
  40. target bp for diabetics
    130/80
  41. target LDL for diabetics < or = __mg/dL
    100
  42. target HDL for diabetics > __ mg/dL
    35-45
  43. regular insulin is
    clear
  44. NPH insulin is
    cloudy
  45. in diabetes get rid of the __ first
    low sugars
  46. we don't use __ insulin treatment anymore
    sliding scale
  47. if you use a sliding scale insulin treatment you will let the patient get __
    sweet (hyperglycemic)
  48. diabetic ketoacidosis occurs in type __ predominantly
    I
  49. diabetic ketoacidosis can occur in poorly controlled type __ diabetes
    II
  50. diabetic ketoacidosis breathing
    Kussmaul breathing
  51. reasons for DKA
    infection, cardiac event, skipped medication
  52. what can happen if you overreplace fluid in a child with DKA
    cerebral edema
  53. in euglycemia DKA
    treat the acid not the sugar
  54. when shutting off the insulin pump first give a __
    bolus of long acting insulin
  55. enteral hypoglycemia treatment
    15 gm of carbohydrates
  56. 15 grams of carbohydrates =
    3 glucotabs, 1/2 cup OJ, 5 lifesavers, 1/2 cup regular soda
  57. parenteral hypoglycemia treatment
    D50 IV, glucagon 1 mg IM
  58. complications of diabetes
    atherosclerotic vascular disease, renal disease, neuropathy, retinopathy
  59. FBS of 126 mg/dL is roughly equivalent to an A1c of __%
    7
  60. FBS of 126 mg/dL is roughly equivalent to a 2 hour GTT of __ mg/dL
    200
  61. created when proinsulin splits into insulin and C-peptide
    connecting peptide
  62. c-peptide is decreased in __ diabetes
    type I
  63. c-peptide is increased or normal in __ diabetes
    type II
  64. Fasting blood glucose: no caloric intake for at least __ hours
    8
  65. Timed blood draw after oral load of a specific amount of glucose
    Oral glucose tolerance testing (OGTT or GTT)
  66. medications that increase glucose
    diuretics, estrogens, beta blockers, corticosteroids
  67. medications that decrease glucose
    acetaminophen, alcohol, propanolol, anabolic steroids
  68. 3 hour GTT Interpretation-normal fasting < __ mg/dL
    95
  69. 3 hour GTT Interpretation-normal 1 hour < __ mg/dL
    180
  70. 3 hour GTT Interpretation-normal 2 hour < __ mg/dL
    155
  71. 3 hour GTT Interpretation-normal 3 hour < __ mg/dL
    140
  72. abnormal 3 hour GTT Interpretation is defined as
    2 or more values above reference range
  73. In normal people, 3-6% of hemoglobin is glycosylated in the form __
    A1c
  74. gives information about long term glycemic control(previous 8-12 weeks)
    HbA1c
  75. patients with episodic or chronic hemolysis who have larger proportion of young RBCs might have spuriously low levels of
    HbA1c
  76. glycated albumin or glycated serum protein
    fructosamine
  77. Reflects hyperglycemic period within the last few weeks
    fructosamine
  78. Gives information of short term glycemic control
    fructosamine
  79. Useful for patients with chronic hemolytic anemias that cause shortened RBC life span
    fructosamine
  80. urine microalbumin
    nephropathy
  81. most common complication of DM
    neuropathy
  82. these are painless due to peripheral neuropathy
    diabetic foot ulcer
  83. 1 out of __ Americans born in the United states in 2000 are at risk for DM
    3
  84. Caused by destruction of insulin producing cells
    Type I DM
  85. Diabetes develops during pregnancy and resolves after pregnancy
    gestational diabetes
  86. Mechanisms that regulate the hypothalamus
    Upper cortical inputs (CNS), Autonomic nervous system, Environmental cues (light and temperature), and Peripheral endocrine feedback
  87. CRH stands for
    Corticotropin Releasing Hormone
  88. GHRH stands for
    Growth Hormone Releasing Hormone
  89. GnRH stands for
    Gonadotropin Releasing Hormone
  90. TRH stands for
    Thyrotropin Releasing Hormone
  91. SS stands for
    Somatostatin
  92. Name the Anterior Pituitary Hormones
    FSH, LH, TSH, Prolactin, GH, ACTH
  93. What does FSH do?
    Estrogen in women and Spermatogenesis in men
  94. What does Luteinizing Hormone do?
    Regulates ovulation in women and stimulates testosterone in men
  95. What does TSH do?
    Increases thyroid hormone production
  96. What does Prolactin do?
    Induces lactation
  97. What does Growth Hormone do?
    Controls acral growth
  98. What does Adrenocorticotropic hormone do?
    Stimulates cortisol production
  99. Name the posterior pituitary hormones
    Vasopressin/ADH and Oxytocin
  100. What does ADH do?
    Prevents free water loss
  101. What does oxytocin do?
    Induces labor
  102. When the Pituitary is not making TSH to stimulate the thyroid and thus no T4 is made, this is called...
    Secondary Hypothyroidism (No TSH)
  103. When the pituitary gland fails to secrete ACTH, the adrenal gland is not stimulated and as a result no cortisol is produced. This is called...
    Secondary Adrenal Insuficiency (no ACTH)
  104. The absence of FSH/LH causes
    Hypogonadotropic Hypogonadism (the problem is with the pituitary and not the gland). Consequently, estrogen and testosterone are low.
  105. No GH causes
    Growth Hormone Deficiency
  106. No ADH/AVP causes
    Diabetes Insipidus
  107. Primary Hypothyroidism
    Thyroid fails to make T4; TSH is high, Free T4 is low. Recommended screening for Primary is to check the TSH
  108. Secondary Hypothyroidism
    Pituitary gland fails to make TSH; TSH is inappropriately LOW, Free T4 is LOW, other Pituitary Hormone Deficiencies, Cannot follow TSH to adjust thyroid hormone replacement. Do not replace thyroid hormone before replacing cortisol!!!
  109. Symptoms of Hypothyroidism
    Cold intolerance, fatigue, heavy menstrual bleeding, weight gain, myxedema coma
  110. Diagnosis of Secondary Hypothyroidism
    Symptoms of hypothyroidism, Low TSH, Low T4, Other symptoms to suggest Pan-hypopituitarism
  111. Adrenal Insufficiency (AI) is ______ deficiency
    Cortisol
  112. Primary Adrenal Insufficiency is known as
    Addison's Disease. The adrenal gland does not respond to ACTH and does not make adrenal hormones. ACTH is HIGH
  113. Secondary Adrenal Insufficiency
    Pituitary does not make ACTH; adrenal is not stimulated to make cortisol (may be a big tumor present)
  114. Tertiary Adrenal Insufficiency
    Suppression of CRH and ACTH by exogenous cortisol use (like prednisone, Hypothalamus/Pituitary axis is asleep and can take up to 6 months to awaken)
  115. Addison's Disease symptoms
    Are based on hypocortisolism and hypoaldosteronism. Fatigue, Hypotension, Hyponatremia, Hyperkalemia (b/c you don't have aldosterone), Hyperpigmentation (from ACTH), death
  116. Thyroid, USP
    Armour Thyroid/Hypothyroid Agent
  117. Liothyronine
    Cytomel/Hypothroid Agent
  118. Liotrix
    Thyrolar/Hypothroid Agent
  119. Levothyroxine
    Synthroid, Unithroid, Levoxyl/Hyperthryoid Agent
  120. Propylthiouracil
    PTU/Hyperthyroid Agent
  121. Insulin Lispro
    Humalog/Rapid acting insulin
  122. Insulin Aspart
    NovoLog/Rapid acting insulin
  123. Insulin Glulisine
    Apidra/Rapid acting insulin
  124. Insulin Glargine
    Lantus/Long acting insulin
  125. Insulin Detemir
    Levemir/Long acting insulin
  126. Glyburide
    Diabeta/Sulfonylurea
  127. Glipizide
    Glucotrol/Sulfonylurea
  128. Glimepiride
    Amaryl/Sulfonylurea
  129. Repaglinide
    Prandin/Meglitinide
  130. Nateglinide
    Starlix/Meglitinide
  131. Metformin
    Glucophage/Biguanide
  132. Rosiglitazone
    Avandia/Thiazolidinedione
  133. Pioglitazone
    Actos/Thiazolidinedione
  134. Acarbose
    Precose/Alpha-glucosidase Inhibitor
  135. Miglitol
    Glyset/Aplha-glucosidase Inhibitor
  136. Sitagliptin
    Januvia/Incretin mimetic DPP-4 inhibitor
  137. Exenitide
    Byetta/Incretin mimetic GLP-1 agonist
  138. Pramlintide
    Symlin/Amylin analog
  139. Prednisolone
    Prelone
  140. Methylprednisolone
    Medrol, Depo-Medrol, Solu-Medrol
  141. Betamethasone
    Celestone
  142. outer zone of adrenal cortex
    zona glomerulosa
  143. middle zone of adrenal cortex
    zona fasciculata
  144. inner zone of adrenal cortex
    zona reticularis
  145. innermost portion of the adrenal gland
    adrenal medulla
  146. outer portion of the adrenal gland
    adrenal cortex
  147. major mineralocorticoid
    aldosterone
  148. aldosterone is made in the
    zona glomerulosa
  149. __ stimulates
    renal tubule reabsorbtion of sodium and excretion of potassium
  150. major glucocorticoid
    cortisol
  151. cortisol is made in the
    zona fasciculata
  152. cortisol counters the effects of
    insulin
  153. cortisol has a __ secretory pattern
    diurnal
  154. cortisol secretion is highest in the
    morning
  155. cortisol is anti-__
    inflammatory
  156. __ is elevated in exercise and stress
    cortisol
  157. androgens are made in the
    zona reticularis
  158. Dysfunction at the level of the adrenal gland by a local lesion or disease process
    PRIMARY Adrenal Insufficiency (AI)
  159. AI from the level of the pituitary gland -> inadequate ACTH secretion
    SECONDARY Adrenal Insufficiency
  160. AI from the level of the hypothalamus -> interference w/ CRH secretion
    SECONDARY Adrenal Insufficiency
  161. Involves all 3 zones of the adrenal cortex- ie (usually) a deficiency in glucocorticoid as well as mineralocorticoid and androgen
    Addison's disease
  162. hyperpigmentation due to excess ACTH is only seen in __ AI
    primary
  163. long term exogenous cortisol therapy can lead to __
    secondary AI
  164. AM cortisol > or = __ is a normal result and rules out AI
    18
  165. AM cortisol < or = __ is a positive result and rules in AI
    3
  166. AM cortisol in the range of 3-18 needs __
    dynamic testing
  167. if you have ruled in AI by either a low AM cortisol or subnormal ACTH response check the __
    plasma ACTH level
  168. HIGH (endogenous) ACTH: Levels > 100 would be consistent with __ AI
    primary
  169. A normal ACTH level (between 5 - 45 pg/ml) effectively rules out __ AI
    primary
  170. In adrenal crisis __
    do not wait for pending lab results before beginning empiric treatment in crisis
  171. In adrenal crisis __
    treat with IV dexamethasone 4mg, or IV hydrocortisone 100mg
  172. In adrenal crisis __ is preferred because it won’t interfere w/ further diagnostic testing and is long acting
    dexamethasone
  173. If AI is truly primary there is not only a cortisol deficit but __ deficit as well
    an aldosterone
  174. In primary AI, to fix the aldosterone deficit treat with __
    fludrocortisone
  175. With AI prior to surgery __ hydrocortisone dose
    increase

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