Endocrine

Question 1

First line therapy hypothyroid

Answer 1

Thyroxine T4 replacement : levothyroxine

Question 2

Endocrine drug associated with increased risk of osteonecrosis of jaw

Answer 2

Bisphosphates

Question 3

Drug for diabetic neuropathy

Answer 3

Gabapentin

Question 4

MAO of DPP4 inhibitors

Answer 4

“Lipton”
Inhibit breakdown of GLP-1 by inhibiting action of DPP4 (an enzyme that breaks down GLP-1) this leads to increased insulin secretion, decreased glucagon secretion( glucagon is hormone that raises blood sugar levels) also improves glucose tolerance

Question 5

Which medications are used to treat diabetes that also decrease the cardiovascular risk in a patient

Answer 5

GLP drugs

Question 6

Which anti diabetic drug class has a compelling indication for patients with heart failure, cardiovascular disease and mild to moderate diabetic kidney disease

Answer 6

SGLT2: reduce A1C, weight loss, CVD benefits, HF benefits, renal benefits

Question 7

Common side effects SLG 2 inhibitors

Answer 7

Frequent UTi/yeast infections, decreased bone density, risk of amputations, dehydration, DKA

Question 8

Counseling points on how to best take thyroid medications> what would you tell a pt if starting thyroid medication and just diagnosed with hyper/hypothyroid

Answer 8

Take same time every day in morning without food
Take on empty stomach
Increased metabolism when pregnant may need higher dose

Question 9

Hyperthyroid medications which is likely to result in permanent hypothyroidism

Answer 9

Radioactive iodine therapy (RAI) can result in permanent hypothyroidism by destroying thyroid tissue leading to progressive loss of function

Question 10

if have diabetic patient who has an elevated morning fasting glucose level which medication most likely needs to be adjusted

Answer 10

basal insulin long acting

Question 11

Which dm medications have side effects of weight loss:

Answer 11

GLP and SGLT2

Question 12

Which type 2 dm medication is contraindicated in patients with lactic acidosis

Answer 12

Biguanides

Question 13

MOA of biguanides

Answer 13

Increases peripheral glucose uptake and utilization
Improves insulin sensitivity
Decreases hepatic glucose production
Decreases intestinal absorption of glucose

Question 14

Which anti-diabetic medication you would avoid in patients with congestive heart failure

Answer 14

Thaiolidinediones (TZDs/glitazones) pioglitazone, rosiglitazone
Avoid Class III, IV HF

Question 15

Indication of use and contraindications of use of biphosphonates

Answer 15

Indication: prevent and treat osteoporosis (zoledronic acid: prevent and treat pt who can’t tolerate oral therapy)
Contraindicatons: hypocalcemia, severe GERD,
Alendronate: esophageal stricture or impaired esophageal motility
Risedronate: inability to stand/sit upright 30 min
Ibandronate: inability to sit/stand upright 60 min

Question 16

Secondary positive effect of raloxifine or avista

Answer 16

1rst: selective estrogen receptor modulator> estrogen actions on bone> good
2nd: estrogens actions on breasts> decrease risk of breast cancer