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High Yield Pharmacology
MEN 2B (Multiple Endocrine Neoplasia)
Pathophysiology
RET Gene
Autosomal Dominant
Signs and Symptoms
Medullary Thyroid Carcinoma
Pheochromocytoma
Mucosal Neuromas
Marfanoid Body Habitus
2 mins
MEN 2A (Multiple Endocrine Neoplasia)
Pathophysiology
Autosomal Dominant
RET Gene
Signs and Symptoms
Medullary Thyroid carcinoma
Calcitonin
Parathyroid
Pheochromocytoma
45 secs
MEN 1 (Multiple Endocrine Neoplasia)
Pathophysiology
Autosomal Dominant
Menin Mutation (Tumor Suppression Gene)
Chromosome 11
Signs and Symptoms
Pancreatic Endocrine Tumors
Pituitary Tumors
Parathyroid Adenomas
2 mins
Hashimoto's Thyroiditis
Symptoms
Hypothyroidism with Bouts of Hyperthyroidism
Enlarged, Nontender Thyroid
Mechanism
Autoimmune
Anti-Thyroid Peroxidase (TPO)
Anti-Thyroglobulin
Lab Findings
Hurthle Cells
Lymphoid Follicles
Associations
HLA-DR5 and HLA-DR3
Increased Risk Of Non-Hodgkin Lymphoma
2 mins
Graves' Disease Labs and Treatment
Labs
Decreased TSH
Increased T3
Increased T4
Radioactive Iodine Uptake (RAIU)
Treatment
Beta blocker
Methimazole
Radioiodine Ablation
1 min
Graves' Disease Characteristics
Women 20-40 years old
Pathophysiology
Anti-TSH Receptor Antibodies
Symptoms
Ophthalmopathy
Exophthalmos
Hyperthyroidism
Goiter
Pretibial Myxedema
1 min
Diabetic Ketoacidosis (DKA) Treatment
Initial Management
IV Normal Saline
Regular Insulin Drip
Subsequent Management (correction of electrolytes)
Potassium (K+)
Glucose
Treat Underlying Cause
Monitoring
Venous pH
Serum Bicarbonate (HCO3)
1 min
Diabetic Ketoacidosis (DKA) Signs and Symptoms
Kussmaul respirations
Dehydration
Abdominal Pain
Nausea/vomiting
Psychosis
Fruity breath Odor
1 min
Diabetic Ketoacidosis (DKA) Diagnosis and Labs
Diagnosis
Blood glucose Increased > 250 mg/dL
Anion gap metabolic acidosis
Decreased pH < 7.3
Decreased serum bicarbonate < 18
Plasma ketones
Other Labs
Hyperkalemia
1 min
Cushing's Syndrome Symptoms And Diagnosis
Symptoms/Findings
Osteoporosis
Amenorrhea
Truncal Obesity
Skin Changes
Buffalo Hump
Immune Suppression
Moon Facies
Hypertension
Decreased Insulin Sensitivity
Diagnosis
24-hour urine free Cortisol
Dexamethasone Suppression Test
2 mins
Cushing's Syndrome Characteristics
More Common in Women
Exogenous Etiologies
Glucocorticoids
Endogenous Etiologies
Decreased ACTH
Primary Adrenal Disease
Increased ACTH
Pituitary Adenoma (Cushing's Disease)
Paraneoplastic: Small Cell Carcinoma
CRF-releasing Tumors
2 mins
Addison's Disease
Mechanism
Chronic 1° Adrenal Insufficiency
Atrophy
Destruction
Symptoms
Deficiency In Cortisol And Aldosterone
Skin Hyperpigmentation
Increased POMC
Hypotension
Hyperkalemia
Acidosis
Addisonian Crisis
Diagnosis
ACTH (Cosyntropin) Stimulation Test
Treatment
Exogenous Cortisol
2 mins
21 Hydroxylase Deficiency
Pathophysiology
Decreased Cortisol
Increased 17 Hydroxyprogesterone
Decreased Aldosterone
Signs and Symptoms
Hypotension
Increased Renin
Hyperkalemia
Female Pseudohermaphroditism
2 mins
17 Alpha Hydroxylase Deficiency
Decreased Cortisol
Decreased Sex Hormones
Increased Mineralocorticoids (DOC)
Hypertension
Hypokalemia
XY Externally Phenotypic Female
No Internal Reproductive Structures Due to Mullerian Inhibitory Factor
XX Externally Phenotypic Female
Sexual Infantilism
2 mins
11 Beta-Hydroxylase Deficiency
Pathophysiology
Decreased Cortisol
Decreased Aldosterone
Increased Sex Hormones
Increased 11 Deoxycorticosterone (11 DOC)
Signs and Symptoms
Hypertension
Masculinization
1 min
Alpha 1 Receptor
Characteristics
Gq Subunit
Increase Vascular Smooth Muscle Contraction
Increase Pupillary Dilator Muscle Contraction
Increase Intestinal and Bladder Sphincter Muscle Contraction
1 min
Alpha 2 Receptor
Characteristics
Gi Subunit
Decrease Sympathetic Outflow
Decrease Insulin Release
Decrease Lipolysis
Increase Platelet Aggregation
Decrease Aqueous Humor Production
2 mins
Beta-1 Receptor
Characteristics
Gs Protein Class
Increased Heart Rate
Increased Contractility
Increase Renin Release
Increased Lipolysis
44 secs
Beta-2 Receptor
Characteristics
Gs protein class
Increased Heart Rate
Increased Contractility
Increased Lipolysis
Increased Insulin
Increased Aqueous Humor Production
Ciliary Muscle Relaxation
Vasodilation
Bronchodilation
Decrease Uterine Tone
2 mins
P450 Inducer
Griseofulvin
Phenytoin
Carbamazepine
Rifampin
Barbiturates
Chronic Alcohol Use
St. John's Wort
51 secs
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