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fm boards endo 2010
fm boards 2010
| Question | Answer |
|---|---|
| what blood sugar is needed to make diagnosis of diabetes, fasting vs random | >126 >200 |
| complications of diabetes are in 3 categories | macrovascular-cad and stroke, microvascular-retinopathy and nephropathy and neuropathy |
| despite good control of diabetes you often still have this complication | Macrovascular |
| life threatening complications of elevated blood sugar | DKA and hyperosmolar coma(non ketotic hyperglycemia ) |
| iv fluid treatment for DKA | initially normal saline then 1/2 ns. then when bs is less than 250 add in glucose |
| difference between DKA and hyperosmolar coma | no acidosis and ph 7.3 (normal 7.35-7.45) |
| mortality rate associated with hyperosmolar coma | 50% |
| how do you treat low blood sugar in a comatose patient | IM glucagon or iv 50% glucose |
| hypo vs hyperthyroidism | hashimotos vs Graves |
| treatment for hyperthyroid | PTU, methimazole, radioactive Iodine, and surgery |
| 3 types of hypothyroidism | primary, secondary and tertiary |
| primay hypothyroidism is caused by | defect in the gland |
| defect in the gland due to 3 causes | hashimotos, iodine deficiency and drugs |
| what drugs can cause hypothyroidism | amiodarone, lithium, interleuken-2 and alpha interferon(Alia) |
| primary hypothyroidism can also be caused by | thyroidectomy, post radioactive iodine therapy, and neck irradiation |
| secondary and tertiary hypothyroidism is caused by | pituitary failure hypothalmus failure |
| 2 main causes of hypercalcemia | hyperparathyroidism and cancer |
| treatment for hypercalcemia includes 7 options | iv fluids, calcitonin, corticosteroids, iv bisphosphonates, oral phosphate, and dialysis. sometimes surgery |
| hypocalcemia is caused by 7 causes | hypoparathyroidism, pseudohyperparathyroidism, chronic renal failure, vitamin d deficiency, magnesium deficiency, chemotherapy, medications |
| 4 medications that can cause hypocalcemia | diuretics, estrogen, laxatives, magnesium |
| when calcium is low what lab should you check and why | albumin. because half of your calcium is bound to albumin |
| what type of calcium is most important | free calcium or ionized because it is not bound to proteins |
| sx's of low calcium | neuromuscular irritability and tetany |
| 2 test for low calcium | Chvostek's sign and Trousseau's sign |
| describe the Chvostek's sign | tap over the facial nerve and the facial muscles will spasm |
| Trousseau's sign | blow up bp cuff past a patient systolic bp and wrist and fingers will spasm |
| ekg findings of low calcium | prolonged QT |
| treatment for low calcium mild vs severe | oral vs iv calcium |
| types of adrenal insufficiency | primary and secondary |
| primary adrenal insufficiency is a.k.a. | Addison's disease |
| define Addison's | when the adrenal cortex fails to make enough cortisone |
| causes of primary adrenal insufficiency are 5 | autoimmune, hemorrhage, infection, tumor, medication |
| the discontinuation of what medication can cause adrenal insufficiency | corticosteroids |
| secondary adrenal insufficiency is caused by | lack of ACTH produced by the pituitary |
| symptoms of adrenal insufficiency | weakness, weight loss, abd pain, nasuea, vomiting, hyperpigmentatio |
| Addisonian crisis symptoms | severe vomiting, diarrhea, low bp, elevate K, coma and death |
| diagnosis of addison's with what test | cortisol level and ACTH stimulation test. if ACTH is elevated primary disease is present |
| treatment of addison's disease is with | cortisol |
| what is Paget's disease | increased rate of bone remolding in older people |
| cause of Paget's | unknown |
| lab test in Paget's | elevated alk phosp |
| treatment of Paget's symptomatic vs asymptomatic | symp-oral bisphosphonates non symp-no treatment |
| Cushing disease is caused by | too much cortisol |
| too much cortisol can be caused by | excessive steroid therapy, too much ACTH |
| too much ACTH can be caused by | pituitary abnormality or tumor |
| what types of tumors | adrenal and small cell carcinoma of the lung |
| diagnosis of cushings syndrome should be made by 2 test | am cortisol and dexamethasone suppression test |
| physical findings of cushing's | moon face, buffalo hump, weakness, fatigue, poor healing of skin, irregular menses |
| Syndrome of inappropriate anti-diuretic hormone (SIADH) is defined as | too much ADH-leading to concentrate urine |
| concentrated urine leads to what in the blood 3 | hyponatremia, volume overload within the body-which causes low plasma osmolality |
| symptoms of SIADH | nausea, fatigue and headache, can lead to coma |
| causes of SIADH | tumors like small cell of the lung), CNS trauma or infection and medications |
| treatment for SIADH | fluid restriction and slow correction of sodium, plus loop diuretics, lithium, and demeclocycline |
| define Diabetes Insipidus | not enough ADH |
| what happens to urine and osmolality when ADH goes down | urine gets diluted, plasma osmolality goes up |
| sx's of DI-3 | polyuria, polydipsia and dehydration |
| types of DI | central, nephrogenic, dipsogenic(too much water), gestational |
| central is caused by | pituitary of hypothalmic |
| nephrogenic is caused by | kidney not responding to the ADH |
| dipsogenic is caused by | ingestion of too much water |
| gestational | complication of pregnancy |
| diagnosis of DI is confirmed by | water deprivation test or vasopressin test |
| treatment of DI-2 | find underlying cause and vasopressin(DDAVP) |
| causes of hypopituitarism | idiopathic, trauma, tumors , CNS infection and iatrogenic(post radiation) |
| infarction of the pituitary is called | Sheehan's syndrome |
| 6 anterior pituitary hormones | anterior-TSH, PROLACTIN(milk production after baby), FSH, LH, ACTH, GROWTH HORMONE |
| 2 posterio pituitary hormones | ADH and oxytocin(for uterine contraction and milk let down) |
Created by:
ambstudystack
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