More Hormones, More Problems
Endocrine Emergencies
Lab Interpretation
Pharmacology
Thyroid Trouble
One, Two Step
100

A patient presents with galactorrhea, amenorrhea, and infertility

What is increased prolactin?

100

A patient presents with abdominal pain, Kussmaul respirations, glucose 450, bicarbonate 12, and positive ketones

What is DKA?

100
High TSH, Low T4, elevated thyroglobulin and thyroid peroxidase antibodies.

What is Hashimoto's thyroiditis?

100

An emergency dose of this medication should be carried to mitigate an adrenal crisis?

What is IM hydrocortisone?

100

This cancer has the poorest prognosis

What is Anaplastic thyroid cancer?

100

Cushing's disease(Diagnosis)

What is 2 of 3 cortisol tests, ACTH level, Pituitary MRI?

200

A patient develops enlarged hands, prognathism, cardiomyopathy, and insulin resistance.

What is increased growth hormone?

200

A 32-year-old patient presents with fever, severe tachycardia, agitation, diarrhea, and delirium after stopping methimazole.

What is thyroid storm?

200

Low morning cortisol, Elevated ACTH, +21- hydroxylase antibodies.

What is Addison's disease?

200

This diabetes medication class promotes glycosuria and carries a risk of euglycemic DKA

What are SGLT2 inhibitors

200

Radioactive Iodine therapy is a definitive treatment for this condition?

What is Grave's disease?

200

Thyroid Storm(Treatment)

Propranolol, PTU, Iodine, steroids

300

A patient presents with fatigue, bradycardia, constipation, and weight gain.

What is high TSH and low T4?

300

A patient with a hx of Polymyalgia Rheumatica presents with vomiting, abdominal pain, hypotension, hyponatremia, hyperkalemia, and hypoglycemia.

What is Adrenal crisis?

300

Low ACTH, TSH, T4, Cortisol, FSH, LH

What is anterior hypopituitarism?

300

This drug class decreases triglycerides and increases HDL by increasing extrahepatic LPL activity

What are Fibrates?

300

This condition typically lacks ophthalmopathy and demonstrates patchy radioactive iodine uptake.

What is multi-nodular goiter?

300

DKA with Hypokalemia(treatment)

IV saline, Potassium repletion, Insulin

400

Secondary hypogonadism

What is low LH, FSH and testosterone?

400

A patient presents with confusion, constipation, polyuria, dehydration, and muscle weakness. Calcium is 16.2 mg/dL.

What is a parathyroid crisis?

400

Hypokalemia, metabolic alkalosis, and suppressed renin

What is Conn syndrome?

400

This diuretic, anti-hypertensive medication can cause gynecomastia.

What is spironolactone?

400

A patient from the rural northwest region develops fatigue, weight gain, and diffuse thyroid enlargement

What is Iodine Deficiency?

400

Conn Syndrome(Diagnosis)

Aldosterone/renin ratio, confirmatory test, Adrenal CT, IR adrenal vein sampling

500

A patient presents with tetany, perioral numbness, Chvostek sign, and prolonged QT interval following thyroid surgery

What is decreased parathyroid hormone?

500

A patient presents with altered mental status and hypotension. Vital signs reveal temperature 89°F, heart rate 42, and blood pressure 78/40. The patient has delayed reflex relaxation and dry skin.

What is myxedema coma?

500

A patient with chronic kidney disease develops hypocalcemia and elevated PTH

What is secondary hyperparathyroidism?

500

This medication is preferred to manage hyperthyroidism in pregnant patients.

What is PTU?

500

A patient presents with low radioactive iodine uptake, painful thyroid enlargement, elevated ESR, and transient hyperthyroidism.

What is De Quervain's thyroiditis?

500

Medullary thyroid cancer(Diagnosis)

TSH level, US, FNA, Calcitonin

600

A post-surgical patient develops polydipsia & polyuria with an increased serum sodium level.

What is Decreased ADH

600

A patient with a history of dyslipidemia who was recently treated with erythromycin for pertussis presents with muscle aches and dark urine. Crea level is 2.2 and CPK is 2600.

What is statin-induced Rhabdomyolysis?

600

Elevated morning serum cortisol and 24-hour urine cortisol, High ACTH

What is corticotropin-dependent Cushing's syndrome?

600

This medication decreases growth hormone by acting like somatostatin.

What is Octreotide

600

This condition can lead to facial erythema, JVD and cyanosis.

What is a thyroid nodule causing SVC syndrome?

600

Diabetes Chronic complications management for a 42yo patient.

Maintain A1C less than 7; Maintain BP <140/90, yearly eye exam, foot exam, creatinine, urine albumin, K, lipid panel; Statin therapy; ACE or ARB if Hypertensive