Endocrine

Question 1

DM Type 2

Answer 1

Insulin resistance leading to ineffective transport of glucose out of blood vessels

Question 2

Risk Factors for DM Type 2

Answer 2

Age>45, BMI>25, sedentary lifestyle, gestation diabetes, hypertension, HbA1c>5.7, fasting glucose>100

Question 3

Clinical presentation of DM Type 2

Answer 3

Polyuria, polydypsia, polyphagia, increased hunger, weight gain, dehydration, impaired healing, recurrent UTIs, acanthosis nigricans, retinopathy

Question 4

ADA Diagnosis criteria

Answer 4

HbA1c>6.5, fasting glucose>126, 2-hr glucose>200 on oral glucose tolerance, random glucose >200

Question 5

Diabetic foot exams

Answer 5

look for callus, breaks in skin, pulses, sensation, dryness

Question 6

What is the ominous octet of type 2 diabetes?

Answer 6

NT dysfunction, increased lipolysis, increased glucose reabsorption, decreased glucose uptake, decrease incretin effect, increased hepatic glucose production, increased glucagon secretion, impaired insulin secretion

Question 7

Describe DKA

Answer 7

look sick, mental changes, nausea, vomiting, abdominal pain, signs of dehydration, Kussmaul resp., fruity breath

Question 8

What are some associated conditions with type 1 diabetes?

Answer 8

autoimmune thyroiditis, celiac disease, addison’s disease

Question 9

What is metabolic syndrome?

Answer 9

group of metabolic abnormalities that confer increased risk of CVD and diabetes mellitus

Question 10

How do we diagnose Metabolic syndrome?

Answer 10

abdominal obesity, triglycerides>150, HDL<40 in men and <50 in women, BP>130/85, Fasting glucose>100

Question 11

What is a primary disease?

Answer 11

inhibits action of downstream glands, gland itself

Question 12

What is a secondary disease?

Answer 12

pituitary gland problem

Question 13

What is a tertiary disease?

Answer 13

dysfunction of hypothalamus and its ability to release hypothalamus

Question 14

What are some causes of endocrine dysfunction?

Answer 14

hormone excess, hormone deficiency, resistance

Question 15

How do we measure hormone levels?

Answer 15

immunoassays, plasma and urinary samples, correct interpretation in clinical context

Question 16

What is dynamic endocrine testing?

Answer 16

suppression or stimulation test

Question 17

What are the two maintain types of treatment for endocrine diseases?

Answer 17

replacing the deficient hormone, suppressing excess hormone production

Question 18

What are the key functions of the thyroid?

Answer 18

metabolism, secrete T3, T4, and TSH

Question 19

What are some common clinical manifestations of hyperthyroidism

Answer 19

weight loss, anxiety, diaphoresis, heat intolerance

Question 20

What are some potential causes for hyperthyroidism?

Answer 20

Graves’, goiter, toxic adenoma, amiodarone-induced thyroiditis

Question 21

What are some common clinical manifestations of hypothyroidism?

Answer 21

fatigue, weight gain, anorexia, dry, coarse skin, cold intolerance, weakness, impaired memory

Question 22

What are some potential causes for hypothyroidism?

Answer 22

Hashimoto’s thyroiditis, iodine deficiency, subacute thyroiditis, sever illness, amiodarone and other drugs

Question 23

What is a classic presentation of Graves’?

Answer 23

proptosis and exophthalmos

Question 24

What is the function of PT glands?

Answer 24

Calcium regulation in the body

Question 25

What are some symptoms of hypocalcemia?

Answer 25

spastic reflexes, chvostek's sign, Trousseau's sign

Question 26

What are some symptoms of hypercalcemia?

Answer 26

bone disease, nephrolithiasis, increased calcitriol, renal tubular acidosis, hypertension, bradycardia, decreased QT interval

Question 27

What is primary hyperparathyroidism?

Answer 27

prolonged PTH excess, presents as anorexia, nausea, constipation, polydipsia, and polyuria

Question 28

What is hypoparathyroidism?

Answer 28

most common cause of hypocalcemia, decreased PTH levels

Question 29

What is Cushing's syndrome?

Answer 29

overproduction of ACTH by pituitary or ingestion of exogenous corticosteroids

Question 30

What are some common presentations of cushing's?

Answer 30

HTN, central obesity, depression, hirsutism, moon facies, buffalo hump, easy bruising, striae

Question 31

How do you examine the thyroid?

Answer 31

have patient flex neck, place index fingers just below cricoid, have patient swallow, displace trachea to right and left to feel size and texture

Question 32

What might the thyroid feel like if the patient had Graves disease?

Answer 32

soft

Question 33

What might the thyroid feel like if the patient had a malignancy or hashimoto's?

Answer 33

firm

Question 34

What might the thyroid feel like if the patient had thyroiditis?

Answer 34

tender

Question 35

What are the steps of a diabetic foot exam?

Answer 35

1. examine for lesions (claw toes, ulcers, amputations, toenails) 2. monofilament testing 3. vibratory testing using 128 Hz 4. superficial pain 5. bilateral DTRs of ankle 6. bilateral pulses