Endo

Question 1

Truncal obesity, wasting of extremities, abdominal striae, and acne: Likely diagnosis?

Answer 1

Cushing’s Syndrome

Question 2

Polydipsia and polyuria with normal glucose: Likely deficiency?

Answer 2

ADH

Question 3

Weakness, fever, dry cough, APAP does not help fever, tachycardia, tachypnea, diphoresis, disorientation, scattered ronchi, negative CXR: Likely explanation?

Answer 3

Thyroid Storm

Question 4

Severe fatigue, weight loss, arthralgia, FmHx prostate Ca, polyuria without dysuria, nausea, salt cravings, poor appetite, hypotension, acanthosis nigricans: what lab test?

Answer 4

ACTH stimulation test

Question 5

What hormones are secreted by posterior pituitary? (2)

Answer 5

ADH

Oxytocin

Question 6

Thyroid hormones increase the concentration of specific receptors in heart tissue. What medication can you give to counteract this sympathomimetic bidness?

Answer 6

metoprolol

Question 7

Dude took 40 mg prednisone for 5 weeks for UC. UC feels better, but now he is weak, tired, dehydrated, hypotensive, confused, doesn’t remember last prednisone dose: presumptive diagnosis?

Answer 7

Acute adrenal insufficiency

Question 8

TSH 7.4, diffusely enlarged thyroid gland without nodules: Start what drug?

Answer 8

levothyroxine

Question 9

Sulfonureas (like glipizide) lower blood sugar by:

Answer 9

increasing insulin release from pancreatic beta cells

Question 10

Hispanic, obese, diabetic, weakness, fever, nausea, vomiting, recently started insulin, tachycardia, tachypnea, drowsy, mild epigastric tenderness, pH 7.12, pCO2 17 mmHg, HCO3 5.6 mEq/L, UA with 4+ glucose and 3+ ketones, blood glucose 420 mg/dL, Na 139 mEq/L, Cl 112 mEq/L, K 5.4 mEq/L: Diagnosis?

Answer 10

Diabetic ketoacidosis

Question 11

Diabetic, hypertensive, hypothyroid, hyperlipid. On meds for all. Current labs: A1c 7.0, TSH 12, total cholesterol 268. First thing:

Answer 11

increase levothyroxine and retest thyroid and cholesterol in 4 weeks

Question 12

Recent weight gain, poor wound healing, hyperglycemia, leukocytosis, hypokalemia: Lab test?

Answer 12

cortisol

Question 13

Depression, lethargy, weight gain, TSH 6.5, Free T4 0.3, positive antithyroid peroxidase antibodies: diagnosis?

Answer 13

Hashimoto’s Thyroiditis

Question 14

Most common cause of Cushing’s Syndrome?

Answer 14

glucocorticoid therapy

Question 15

Fun fact about thyroid function tests?

Answer 15

T3 (triiodothyronine) is derived from peripheral deiodination of T4 (hooray!)

Question 16

High TSH, normal free T4 and T4, positive antithyroid antibodies: What do we do now?

Answer 16

Levothyroxine (though Kathy seems ok with monitoring and rechecking in 3 months)

Question 17

What’s a biguanide do?

Answer 17

Inhibits hepatic gluconeogenesis

Question 18

Following thyroidectomy, hoarseness of the voice may occur (but won’t, because Nate is a fucking rockstar), this is caused by damage to the:

Answer 18

Recurrent Laryngeal Nerve

Question 19

Sx of hyperparathyroidism due to parathyroid adenoma:

Answer 19

most patients are asymptomatic

Question 20

Which symptom distinguishes sub-acute thyroiditis from Hashimoto’s thyroiditis?

Answer 20

pain with palpation of the thyroid gland

Question 21

How do you make a hormone?

Answer 21

Don’t pay her

Question 22

Posterior pituitary secretes: (2)

Answer 22

ADH

Oxytocin

Question 23

Anterior pituitary secretes: (6)

Answer 23

ACTH
TSH
GH
PRL
FSH
LH

Question 24

Thyroid gland secretes: (2)

Answer 24

Thyroxine

Calcitonin

Question 25

Thymus secretes: (1)

Answer 25

Thymosins

Question 26

Adrenal medulla secretes: (2)

Answer 26

Epinephrine | Norepinephrine

Question 27

Adrenal cortex secretes: (3)

Answer 27

Glucocorticoids (cortisol) Mineralcorticoids (aldosterone) Testosterone

Question 28

Pancreatic islet cells secrete: (2)

Answer 28

Insulin | Glucagon

Question 29

Pineal gland secretes: (1)

Answer 29

Melatonin

Question 30

Parathyroid glands secrete: (1)

Answer 30

Parathyroid hormone

Question 31

Testicles secrete: (1)

Answer 31

Androgens, especially testosterone

Question 32

Ovaries secrete: (2)

Answer 32

Estrogens | Progesterone

Question 33

GNRH _______'s FSH + LH

Answer 33

promote

Question 34

Dopamine _______'s prolactin

Answer 34

inhibits

Question 35

Hyperparathyroid symptoms

Answer 35

osteoporosis, maybe tetany with advanced disease Stones, groans, psychic overtones, thrones?

Question 36

Hyperparathyroid labs

Answer 36

decreased Mg, PO4

Question 37

Primary hyperparathyroidism

Answer 37

80% adenomas, high PTH

Question 38

Secondary hyperparathyroidism

Answer 38

Low calcium / vitamin D

Question 39

Tertiary hyperparathyroidism

Answer 39

autonomous parathyroid function with increased Ca and increased PTH from chronic secondary hyperpara.

Question 40

Common way to find parathyroid imbalance

Answer 40

abnormal calcium

Question 41

Eval of parathyroid imbalance

Answer 41

``` Chem PTH Ionized Calcium Corrected calcium 24 hour urine calcium alk phos? bone mineral density imaging of parathyroid ```

Question 42

30 mg prednisone for 3 weeks or more will do what to your adrenal

Answer 42

make it go night night

Question 43

Diagnosing adrenal insufficiency

Answer 43

ACTH in AM Cortisol in AM cosyntropin

Question 44

Treatment of Diabeetus 1

Answer 44

Insulin / pump

Question 45

Treatment first line for diabeetus 2

Answer 45

Lifestyle: Diet, exercise, weight loss

Question 46

Positive thing about metformin

Answer 46

minimal hypoglycemia risk

Question 47

Sulfonureas problems

Answer 47

hypoglycemia risk weight gain give it with food

Question 48

Kathy doesn't seem to like glitazones

Answer 48

just an observation

Question 49

happy fasting sugar

Answer 49

80-120

Question 50

happy post meal sugar

Answer 50

no higher than 180

Question 51

What happens with nocturnal hypoglycemia

Answer 51

maybe wake up sweaty, shaky and foggy | maybe don't wake up

Question 52

How frequently should you tickle a diabetic's feet, Keivon?

Answer 52

yearly

Question 53

What things should be checked yearly on a diabetic?

Answer 53

feet eyes kidneys (microalbumin, creatinine) lipids

Question 54

What should be checked twice a year on diabetics?

Answer 54

A1c

Question 55

Top 5 thyroid cancers by frequency?

Answer 55

``` Papillary >70% Follicular 15% Medullary Anaplastic: The scary one Thyroid lymphoma ```

Question 56

Signs of Grave's dz

Answer 56

``` exophthalmos heat intolerance tachycardia unintentional weight loss hyperreflexia fatigue ```

Question 57

Fractions of free and bound testosterone

Answer 57

60% bound to SHBG 38% weakly bound to albumin 2% free

Question 58

3 methods for diagnosing Diabeetus 2

Answer 58

Oral glucose tolerance test A1c Random glucose >200 mg/dL with symptoms

Question 59

Benefits of glitazones

Answer 59

enhanced insulin sensitivity

Question 60

risks of glitazones

Answer 60

weight gain, fluid retention

Question 61

Leading cause of death in diabetics

Answer 61

MI

Question 62

Symptoms of hyperglycemia

Answer 62

``` polydipsia polyuria blurry vision fatigue poor wound healing frequent infections weight loss nausea and vomiting ```

Question 63

Diabeetus is the #1 cause of these 4 things in adults

Answer 63

Blindness Kidney disease Nerve damage Amputation

Question 64

5 ways to mitigate CV risk in diabeetus

Answer 64

Increase physical activity Reduce saturated fat 6-10% weight loss Statins to keep LDL