Endocrine

Question 1

Initial test in Hyperthyroidism

Answer 1

TSH

Question 2

when to repeat thyroid function test after stating treatment

Answer 2

4-6 weeks

Question 3

most serious complication of graves ophthalmopathy

Answer 3

Optic nerve compression

Question 4

antithyroid DOC for thyroid storm

Answer 4

PTU

Question 5

best treatment for hypothyroidism

Answer 5

Levothyroxine

Question 6

MCC of hypothyroidism worldwide

Answer 6

Iodine deficiency
mountain regions , Alps, Andes

Question 7

MCC of hypothyroidism in iodine sufficient areas

Answer 7

Hashimoto thyroiditis (AI) and iatrogenic (tx for hyperthyroidism), post RAI

Question 8

thyroid nodule with low TSH, what is the test?

Answer 8

thyroid scan–> is indicated if the TSH is suppressed to demonstrate HYPERFUNCTIONING state
Toxic adenoma –> mgnt: RAI

Question 9

Thyroid nodule with high TSH, what is the test?

Answer 9

Ultrasound guided FNAB - may be not hyperfunctioning state

Question 10

what drug inhibits cortisol synthesis at the level of 11b-hydoxylase, ONLY adrenal inhibiting medication administered to pregnant women with cushing syndrome

Answer 10

Metyrapone

Question 11

it inhibits the early steps of steroidogenesis

Answer 11

Ketoconazole

Question 12

MCC of mineralocorticoid excess

Answer 12

Primary Hyperaldosteronism

Question 13

MCC of cushingoid features

Answer 13

Iatrogenic Hypercortisolism

Question 14

MCC of Cushing’s syndrome OVER ALL

Answer 14

MEdical use of glucocorticoid for immunosuppression for the treatment of inflammatory disease

Question 15

primary cause of DEATH in Cushing

Answer 15

Cardiovascular Disease

Question 16

Parameters to diagnose DM`

Answer 16

HbA1c - >/6.5 %
FPG - >/126/mgdL (7mmol/L)
2 hr, 75g OGTT - >/200mgdl (11mmol/L)
RBS - >/200mgdl (11mmol/L)l

Question 17

what need to be assessed in DM ANNUALLY

Answer 17

Neuropathy
Nephropathy
Lipids

Question 18

what need to be assessed in DM, 2x/yr

Answer 18

BiAnnual eyes and feet exam

Question 19

How many times to assessed HbA1C in a yr?

Answer 19

2-4x a yr

Question 20

when to consider DUAL combination therapy in DM?
Consider combination Injectable therapy when A1c, RBS ?

Answer 20

DUAL - >/9%
Injectable - Hba1c 10%, RBS >/300mg/dL

Question 21

Anti DM promotes WEIGHT GAIN

Answer 21

Sulfonylureas
TZD
Insulin

Question 22

Anti DM promotes WEIGHT LOSS

Answer 22

Metformin
SGLT2 inhibitor
GLP1 receptor agonist

Question 23

Anti DM that is WEIGHT NEUTRAL

Answer 23

DPP4 inhibitor

Question 24

Drugs with MOA of increase insulin secretion

Answer 24

Sulfonylureas: Glimepiride, Glipizide

Question 25

DM Drugs with MOA of INSULIN SENSITIZERS

Answer 25

metformin - reduces hepatic glucose production TZD: Pioglitazone - react on PPAR-gamma

Question 26

DM Dugs that inhibit intestinal absorption of sugar, it blocks the enzymes that breakdown complex carbs

Answer 26

Alpha- glucosidase inhibitor: Acarbose, Vogilbose, MIglitol

Question 27

Insulin prep with long half live (24 hrs)

Answer 27

basal insulin analogs: Glargine, Detemir, Degludec

Question 28

Onset of action and duration of Rapid acting insulin

Answer 28

RAI: Lispro, Aspart, Glusiline <15mins, duration: 2-4hrs

Question 29

target LDL in DMT2 with very high risk CV

Answer 29

<55mg/dl

Question 30

target LDL in DMT2 with high risk CV

Answer 30

<70mg/dl

Question 31

target LDL in DMT2 with NO RF

Answer 31

<100mg/dl

Question 32

target LDL in NONDIABETIC

Answer 32

<130mg/dl

Question 33

first defense against HYPOGLYCEMIA

Answer 33

decrease insulin secretion 2nd - Glucagon 3rd - Cortisol

Question 34

Target goal in adults with DM: HbA1c, pre-prandial, post-prandial, BP

Answer 34

HbA1c - <7% Pre-prandial - 4.4-7.2 mmol/L Post - prandial - <10 BP - 140/90 --> if with CKD/CVD: <130/80

Question 35

most effective therapy in diabetic RETINOpathy

Answer 35

PREVENTION

Question 36

MC pattern of dyslipidemia

Answer 36

hypertriglyceridemia low HDL cholesterol level

Question 37

TRIAD of DKA

Answer 37

Hyperglycemia HAGMA Ketosis

Question 38

difference of HHS to DKA

Answer 38

HHS - Insulin deficiency -- hyperosmolarity, osmotic diuresis -- dehydration glucose level >600

Question 39

dominant ketone in ketosis

Answer 39

3 hydroxybutyrate

Question 40

major nonmetabolic complication of DKA therapy

Answer 40

Cerebral edema

Question 41

method of choice to determine the thyroid SIZE aacurately

Answer 41

Ultrasound

Question 42

drug NOT used in thyroid Storm

Answer 42

Amiodarone -- exacerbate by giving excess Iodide

Question 43

High TSH, Normal FT4

Answer 43

Mild subclinical hypothyroidism

Question 44

high TSH, Low FT4

Answer 44

Primary hypothyroidism Autoimmune hypothyroidism

Question 45

low TSH, high FT4

Answer 45

primary thyrotoxicosis: Graves, multinodular goiter, toxic adenoma

Question 46

low TSH, normal FT4

Answer 46

Subclinical hyperthyrodism t3 toxciosis

Question 47

monitoring on treatment of thyroid? stable px? adjustment of tx?

Answer 47

on tx; 3-4mos stable: 6-12 mons adjust: 6-8 weeks

Question 48

size of the nodule to be palpable

Answer 48

>1cm in diameter

Question 49

most accurate diagnostic in Cushing syndrome

Answer 49

24hr urine cortisol

Question 50

best initial diagnostic test in Cushing syndrome:

Answer 50

1mg overnight Dexa suppression test and 24 hr urine cortisol

Question 51

TRIAD of Pheochromocytoma

Answer 51

Profuse sweating headaches Episodic palpitations

Question 52

human monoclonal antibody to RANKL -->inhibits the formation of osteoclast

Answer 52

denosumab