Endocrine Boards - Sheet1 (2)

Question 1

Elevated PTH and calcium. Low phosphate. Short QT interval. Bones, stones, and moans, psych groans

Answer 1

Primary hyperparathyroid

Question 2

Elevated PTH. Normal/Low calcium. Renal failure and Vit D deficiency

Answer 2

Secondary hyperparathyroid

Question 3

Neck Surgery. Chvostek and Trousseau. Prolonged QT

Answer 3

Hypoparathyroid

Question 4

Eye and Skin manifestation

Answer 4

Graves

Question 5

PTU - first trimester. methimazole - after first trimester

Answer 5

Hyperthyroid Treatment

Question 6

Low TSH and Free T4. Check adrenal function

Answer 6

Central hypothyroid

Question 7

TSH. Ultrasound. Warm Nodules are benign. Cold nodules are cancer

Answer 7

Thyroid nodule

Question 8

Pituitary adenoma. Lung tumor. Adrenal tumor. Low ACTH = adrenal. High ACTH = pituitary or lung.

Answer 8

Cushings

Question 9

Increased ACTH = adrenal. Low ACTH = pituitary. ACTH stimulation test. Hyponatremia & Hyperkalemia. Fludrocortisone

Answer 9

Addisons

Question 10

Androgen and/or estrogen secreting = cancer. CT scan. Surgery

Answer 10

Adrenal cortical carcinoma

Question 11

Increased growth hormone. Pituitary tumor. Large hands/feet. Increased insulin like growth factor.

Answer 11

Acromegaly

Question 12

Low C-peptide. Antibodies. Beta cell destruction.

Answer 12

Type 1 DM

Question 13

Insulin insensitivity. Weight loss. Metformin.

Answer 13

Type 2 DM

Question 14

Hyperglycemia( < 1,000 (but usually about 350). Type 1. Anion gap metabolic acidosis and serum ketones. Infection. Hypokalemia.

Answer 14

Diabetic Ketoacidosis

Question 15

Glucose > 1,000. Type 2

Answer 15

Hyperosmolar hyperglycemia

Question 16

Triglycerides > 1,000 = pancreatitis. Statins first line.

Answer 16

Hyperlipidemia

Question 17

Galactorrhea, oligomenorrhea, amenorrhea. Hook effect. HCG, TSH, MRI. Cabergoline.

Answer 17

Prolactinemia

Question 18

Decreases hepatic glucose production and peripheral glucose utilization, decreases intestinal glucose absorption

Answer 18

Metformin

Question 19

Stimulates pancreatic beta cell insulin release (insulin secretagogue - non glucose dependent)

Answer 19

Sulfonylureas (glyburide and glipizide)

Question 20

Increases insulin sensitivity in peripheral receptor site adipose and muscle has no effect on pancreatic beta cells

Answer 20

Thiazolidinediones (Pioglitazone - Actos and Rosiglitazone - Avandia)

Question 21

Delays intestinal glucose absorption

Answer 21

α-Glucosidase inhibitors (Acarbose precose and Miglitol glyset)

Question 22

Stimulates pancreatic beta cell insulin release

Answer 22

Meglitinides (Repaglinide prandin and Nateglinide)

Question 23

Lowers blood sugar by mimicking incretin - causes insulin secretion, decreased glucagon and delays gastric emptying

Answer 23

GLP-1 Agonists (Exenatide Byetta)

Question 24

Dipetpidylpetase inhibition - inhibits degradation of GLP-1 so more circulating GLP-1

Answer 24

DDP-4 Inhibitors (Sitagliptin Januvia)

Question 25

SGLT-2 inhibition lowers renal glucose threshold which results in increased urinary glucose excretion

Answer 25

SGLT-2 Inhibitor (Canagliflozin)

Question 26

A1C 5.7-6.4, Fasting glucose 100-125, 2-hour oral glucose tolerance test 140-199

Answer 26

Pre-diabetes

Question 27

Name the diagnostic criteria for diabetes

Answer 27

Fasting blood glucose > 126 mg/dl at least 8 hours on two occasions GOLD STANDARD! --Hemoglobin A1C > 6.5 indicates average blood sugar 10-12 weeks prior to measurement -- 2 hour plasma glucose of > 200 on an oral glucose tolerance test -- 3 hour GTT is gold standard in GDM -- Random plasma glucose > 220 in patients with classical symptoms of hyperglycemia

Question 28

At what serum creatinine level should Metformin be stopped

Answer 28

Cr > 1.5

Question 29

Early morning hyperglycemia - Normal glucose until 2-8 am when it rises. Results from decreased insulin sensitivity and nightly surge of counterregulatory hormones during nighttime fasting

Answer 29

Dawn Phenomenon

Question 30

Nocturnal hypoglycemia followed by rebound hyperglycemia due to surge in growth hormone

Answer 30

Somogyi effect

Question 31

Diabetic w/ anorexia, anemia, wt loss, pallor

Answer 31

Chronic renal failure

Question 32

Gastroparesis, impotence, recurrent infections, stocking-glove paresthesia

Answer 32

Diabetic neuropathy (Treat w/ TCA (amitriptyline)

Question 33

Hypoglycemia despite glucose administration. Increased C-peptide

Answer 33

Insulinoma

Question 34

Hypoglycemia in alcoholic

Answer 34

Give Thiamine before glucose to prevent Wernicke's encephalopathy

Question 35

Decreased radioactive iodine uptake, decreased free T4, increased TSH

Answer 35

Hashimoto's thyroiditis

Question 36

Female, weight loss, palpitations, atrial fibrillation

Answer 36

Hyperthyroid (work it up with TSH, T4)

Question 37

Exopthalmos, palpitations, wt. loss. Elevated radioactive idodine uptake

Answer 37

Hyperthyroid, Graves Dx - Tx w/ Radioactive iodine

Question 38

Post thyroidectomy - most likely injury

Answer 38

Recurrent laryngeal nerve = hoarseness

Question 39

Post thyroidectomy - electrolyte watch

Answer 39

Hypocalcemia

Question 40

Infant w/ round face, large protruding tongue, dry skin, umbilical hernia, constipation, enlarged abdomen, poor feeding, delayed developmental milestones

Answer 40

Congenital Hypothyroidism

Question 41

Recurrent HA, HTN not responding to meds, sweating. Attacks of severe HA, HTN, glycosuria. Urinary catecholamines, urinary metanephrines

Answer 41

Pheochromocytoma - Tx pre-op w/ alpha blocker

Question 42

HTN not responsive to meds

Answer 42

Renal artery stenosis (Infrarenal artery)

Question 43

HTN w/ hypernatremia, hypokalemia

Answer 43

Primary Aldosteronism

Question 44

Wt. gain, edema, coarse dry skin, hair, menorrhagia, cold intolerance, hx transphenoidal surgery & radiation

Answer 44

Hypothyroidism

Question 45

Tetany, hypocalcemia, cataracts

Answer 45

Hypoparathyroidism

Question 46

Exogenous corticosteroid use

Answer 46

Cushing syndrome

Question 47

Dexamethasone suppression test

Answer 47

Cushing syndrome

Question 48

Central obesity, abdominal stria, hyperglycemia, moon facies, buffalo hump, easy bruising

Answer 48

Cushing syndrome

Question 49

Acute steroid withdrawal

Answer 49

Addison's disease, crisis

Question 50

Hyperpigmentation, hypoglycemia, orthostatic hypotension, hypotension not responsive to fluids, hypotension following an illness, trauma, or surgery

Answer 50

Addison's disease, crisis (Low aldosterone; get Random or AM cortisol, ACTH stimulation test)

Question 51

Worsening fatigue, wt loss, weakness, recurrent abdominal pain, hair loss, hyperpigmentation. Hyponatremia, hyperkalemia

Answer 51

Addison's disease, crisis (Low aldosterone; get Random or AM cortisol, ACTH stimulation test)

Question 52

Hyponatremia, hyperkalemia

Answer 52

Acute adrenal insufficiency (Addison's crisis)

Question 53

Polyuria, polydipsia. Dilute urine, Hypernatremia

Answer 53

Diabetes insipidus

Question 54

Concentrated urine. Hyponatremia

Answer 54

SIADH

Question 55

45,X - low hairline, low set ears, webbed neck, short stature; shield chest, wide set nipples, infertility, lack of Secondary sex characteristics

Answer 55

Turners (gonadal dysgenesis

Question 56

XXY ♂ - short stature, ↓ intelligence; small firm testes, gynecomastia, abn arm-body length

Answer 56

Klinefelters (hypogonadism)