IM：內分泌

36 flashcards · Other · by Wanying Koh

1. panhypopituitarism order of hormones affected

   越重要越慢受影響 GH --> FSH --> LH --> TSH --> ACTH

2. panhypopituitarism tx 初期給予什麼S-T藥物 那個藥物不能單獨給

   short term glucocorticoid (save adrenal fnt first --> 致命) 不能單獨給 thyroid hormone --> increases metabolism, causes adrenal crisis

3. 去 GI clinic 服用藥物後導致泌乳，乳房腫脹 Dx

   hyperprolactinemia due to metoclopramide (dopamine-R antagonists 止吐藥 其他：精神科藥物 haloperidol)

4. seizures related to hyperprolactinemia

   大發作 ： GTC seizures complex, partial convulsive status epilepticus (NOT absence, petit mal seizures)

5. acromegaly diagnosis

   glucose suppression test (OGTT with 75 g glucose --> confirm dx: post-1hr GH levels not <1ug/dL normal: glucose cause GH levels to fall)

6. 口渴多尿, 無月經, low FSH, LH dx.?

   ADH, oxytocin hypothalamus tumor

7. RAIU scan hot nodules indicative of ? tx?

   non-malignant, uptake more of 131-I toxic adenoma toxic multinodular goiter tx: 131-I 放射碘

8. RF of osteoporosis

   hyperthyroidism NOT: OCS use, obesity, breastfeeding

9. AB targets what in Graves disease Hashimoto disease

   Graves: TSH-R AB Hashimoto: Anti-Tg AB, Anti-TPO AB (thyroid peroxidase)

10. subacute thyroiditis vs. acute thyroiditis: cause tx

    cause: viral infection // bacterial infection tx: NSAIDs, steroids // ABx

11. most common reason for Cushing syndrome

    steroids use

12. Cushing syndrome diagnosis

13. 1' aldosteronism K levels pH of blood

    hypoK metabolic alkalosis

14. most accurate dx for pheochromocytoma

    plasma metanephrine

15. pheochromocytoma tx

    a blocker --> b blocker --> op

16. suspect extra-adrenal pheochromocytoma diagnostic tool

    131-I-MIBG scan

17. which diseases associated with osteoporosis hyperthyroidism type I DM hypoparathyroidism Cushing's syndrome hyperaldosteronism early menopause

    hyperthyroidism type I DM Cushing's syndrome early menopause

18. check levels of vit D in body 測量 1,25(OH)2-D or 25-(OH)D?

    25-(OH)D （前者會受到PTH & kidney 影響）

19. Klinefelter vs. Kallman syndrome FSH & LH levels (high or low?) testosterone levels (high or low?)

    high // low both low

20. meds causing hirutism

    androgen minoxidil phenytoin (NOT methimazole)

21. MEN I gene vs. MEN II gene? tumor suppressor or proto-oncogene?

    MEN I: MENIN - tumor suppressor MEN II: RET - proto-oncogene

22. Type-2 DM mechanisms

    insulin resistance insulin 缺失 glucagon secretion inc. (glycogen --> glucose) free FA inc. (inc. lipolysis) renal glucose reabsorption inc.

23. Type-2 DM occurs at which point

    when glucose levels in blood inc. (一開始會有 insulin resistance, and compensatory insulin levels increase --> 都還不是 DM)

24. GDM dx, done during which weeks

    at weeks 25-28 符合 one criteria 即可： fasting > 92 1h OGTT > 180 2h OGTT > 153

25. T2DM dx

    fasting > 126 (x2) random > 200 + polyuria/polydipsia/weight loss HbA1C >= 6.5% (x2) 2h OGTT > 200 (x2) or 合併 兩個

26. OADs 促進insulin secretion

    sulfonylurea (gli-) glinide (-glinide) DD4-inhibitors (-gliptin) GLP-1 (exenatide)

27. HHS tx

    isotonic saline (0.9% NaCl) insulin (rapid/short acting: aspart, lispro, RI) 補充 K (insulin causes K cellular entry --> hypoK)

28. Kussmaul sign seen in HSS or DKA

    DKA

29. HSS vs. DKA pH age group

    pH: more alkaline // acidic <7.3 age group: 老人 // children

30. OADs which causes Vit B12 deficiency

    biguanides e.g. metformin AE: Vit B12 deficiency + lactate acidosis

31. DM nephropathy course

    10 years from DM: incipient nephropathy -- microglobulinuria 15 years from DM: overt nephropathy -- gross proteinuria, GFR dec, serum Cr inc

32. hormones that inc . dec in elderly

    increase: insulin, PTH, NE decrease: thyroid hormone, 解離態testosterone

33. xanthoma RF found in which areas

    high glucose, high LDL cholesterol, high TG, low thyroid hormone, PBC, cancer subcutaneous area, tendon sheath, limbs extensor surface

34. thyroid nodule common imaging methods

    echo + cytology, FNA biopsy RAIU scan CT/MRI - for nodules located at specific areas NOT pet scan (正子攝影) - usually for meta

35. basal insulin bolus insulin

    basal - 長效型 - determir, glargine 降飯前血糖 bolus - 速效/短效 - aspart, lispro, glulisine // RI - 降飯後血糖

36. 次發性高血壓 + hypoK dx

    hyperaldosteronism check aldosterone, plasma renin