Endo

Question 1

Renal complication of DM that have propensity for hyperkalemia and acidemia. Exacerbated by ACEI, ARBS and Aldo-antagonists

Answer 1

Type IV RTA

Hyporeninemic Hypoaldosteronemic

Question 2

2 factors for diabetic kidney disease

Answer 2

Albuminuria + decreased GFR <60ml/min

Question 3

In DM is associated with increased risk of cardiovascular disease

Answer 3

Albuminuria

Question 4

Pathogenesis related to chronic hyperglycemia

Answer 4

Angiotensin II
GF
ENDOTHELIN
AGEs

Question 5

Spot urinary albumin to CREA ratio

Answer 5

Albuminuria

Question 6

Interventions effective in slowing progression from micro albuminuria to macro albuminuria

Answer 6

1. Improve glycemic control
2. Strict Bp
3. Administration of ACE-I or ARBs

Question 7

BP goal in patients with DM nephropathy with risk of CVD and CKD

Answer 7

<130/80

Question 8

BP goal in patients with DM nephropathy with proteinuria

Answer 8

125/75

Question 9

Protein intake in Diabetic kidney disease

Answer 9

0.8 mg/kg/day

Question 10

Referral for transplant evaluation once GFR is

Answer 10

<20ml/min

Question 11

Major risk factors for diabetic neuropathy

Answer 11

Increased BMI

Smoking

Question 12

Most common form of diabetic neuropathy

Answer 12

Distal symmetric polyneuropathy

DSPN

Question 13

Major risk factors for foot ulceration sand falls

Answer 13

LOPS Loss of protective sensation

DSPN Distal symmetric polyneuropathy

Question 14

Most prominent Gastric complication in CM by parasympathetic dysfunction

Answer 14

Delayed gastric emptying (gastroparesis)
Altered small and large bowel motility
( constipation and diarrhea)

Question 15

DM RELATED GI autonomic neuropathy

Answer 15

Nocturnal diarrhea alternating with constipation

Question 16

If with known CHD with DM

Answer 16

Ace-I or ARBS, statin and Aspirin

Question 17

DM AND POST MI

Answer 17

Beta blocker

Question 18

Dm and CHF

Answer 18

Avoid THIAZOLDINEDIONES (pioglitazone) due to edema 
Use metformin instead if with good renal fx

Question 19

What drug is recommended for primary prevention in DM patients with increased CV risk (>50 years old, at least 1 risk factor -HTN, DYSLIPIDEMIA, smoking, albuminuria and family history)

Answer 19

Aspirin

Question 20

Use of moderate intense statin

Answer 20

Age 40-75 without additional risk,
<40 y/o but with additional risk,
All with DM + Age >75years oks

Question 21

Intensity of statin if DM + atherosclerotic CVD disease

Answer 21

High intensity statin therapy

Question 22

Combo statin + fenofibrate is not recommended except if

Answer 22

1. With recent ACS

2. If LDL remains >70mg/dL in an individual with diabetes and CVD on a statin

Question 23

If LDL remains >70mg/dL in an individual with diabetes and CVD on a statin

Answer 23

Add ezetimibe

Question 24

Bp goal for most patients with DM and with hypertension

Answer 24

<140/90

Question 25

Bp goal of YOUNGER DM px or with increased cardiovascular risk

Answer 25

<130/80

Question 26

Dm foot ulceration is most commonly at the

Answer 26

PLANTAR FOOT SURFACE

Question 27

Most common pathogen in infected ulcer

Answer 27

AEROBIC GRAM POSITIVE COCCI Staph MRSA Group A and B STREP

Question 28

Most specific modality for infected ulcer

Answer 28

MRI

Question 29

Interventions with demonstrated efficacy in diabetic foot wounds

Answer 29

1. Off loading 2. Debridement 3. Wound dressing 4. Appropriate use of antibiotics 5. REVASCULARIZATION 6. Limited amputation

Question 30

Antibiotics Severe infection in infected ulcer

Answer 30

Vancomycin + BLAC INHIBITOR OR VANCOMYCIN + QUINOLONE + metronidazole

Question 31

Rare infection seen exclusively in DM

Answer 31

1. RHINOCEREBRAL MUCORMYCOSIS 2. EMPHYSEMATOUS INFECTIONS OF THE GALL BLADDER 3. “Malignant” or invasive OTITIS MEDIA sec to pseudomonas aeruginosa

Question 32

SERM approved for Osteoporosis

Answer 32

RALOXIFENE

Question 33

SERM USED IN BREAST CA AND FOR OSTEOPOROSIS

Answer 33

Tamoxifen

Question 34

SERM combined with conjugated estrogen

Answer 34

BAZEDOXIFENE

Question 35

Drug for osteoporosis that suppresses osteoclasts activity by direct action on osteoclasts calcitonin receptor

Answer 35

Calcitonin

Question 36

Strongest antiresorptive that Benefit among postmenopausal women with osteoporosis to reduce fracture over 3 years

Answer 36

DENOSUMAB

Question 37

Most common cause of pituitary hormone hyposecretion and hypersecretion syndromes in adults

Answer 37

PITUITARY ADENOMA

Question 38

Feature of type A insulin resistant syndrome

Answer 38

Affects young women Severe hyperinsulinism Features of hyperandrogenism

Question 39

Classic triad of pheochromocytoma

Answer 39

Profuse sweating Headache Palpitation + hypertension = diagnosis

Question 40

Dominant sign of pheochromocytoma

Answer 40

Hypertension

Question 41

Disorders of Male reproduction that have hypogonadotrophic hypogonadism

Answer 41

Kallman’s syndrome Adrenal congenital hypoplasia ACH Gnth receptor mutation

Question 42

Most common location of primary hyperparathyroidism

Answer 42

Inferior parathyroid glands

Question 43

Increase giant multinucleated osteoclasts in scalloped areas of the surface of the bone (HOWSHIP LACUNAE) and a replacement of the normal cellular and marrow elements by fibrous tissue Sec to primary hyperparathyroidism

Answer 43

OSTEITIS FIBROCA CYSTICA

Question 44

Definitive therapy for primary hyperparathyroidism

Answer 44

Surgical excision

Question 45

Bone disease seen in patients with secondary hyperparathyroidism and CKD

Answer 45

Renal osteodystrophy

Question 46

Glucocorticoids May be of benefit to the ff for controlling hypercalcemia

Answer 46

Vitamin D and A intoxication | Hypercalcemia of Granulomatous disease

Question 47

Most common cause of primary adrenal insufficiency

Answer 47

Autoimmune adrenalitis