Endocrine Disorders

Question 1

What is the usual cause of T1DM?

Answer 1

Viral illness and immune response causing autoantibodies

Question 2

Which cells are destroyed in T1DM?

Answer 2

Beta cells

Question 3

What are the 3 criteria for prediabetes?

Answer 3

1. Fasting glucose 100-125
2. Postprandial glucose 140-199
3. A1c: 5.7-6.4

Question 4

T/F: does triglycerides >250 put you at increased risk for T2DM?

Answer 4

Yes

Question 5

When should you screen for diabetes according to ADA?

Answer 5

a) Any overweight adult with 1+ risk factor
b) All adults 45+
c) Children with 2+ risk factors

Question 6

Loss of peripheral hair can indicate what?

Answer 6

Atherosclerosis

Question 7

What’s the ADA diabetes diagnosis criteria?

Answer 7

1. Fasting 126+
2. Random 200+
3. A1C 6.5+

Question 8

What is the ADA goal for DM control in terms of A1C?

Answer 8

7.0%

Question 9

What’s the ADA goal for DM control in terms of BP?

Answer 9

<140/90

Question 10

What’s the ADA goal for DM control in terms of fasting BS?

Answer 10

80-130

Question 11

What’s the ADA goal for DM control in terms of random BS?

Answer 11

<180

Question 12

If A1c is >7.5% to start, how many meds should you consider starting off the bat?

Answer 12

2

Question 13

If A1c is >9.0% to start, what should you consider adding off the bat?

Answer 13

Insulin

Question 14

What’s the most potent therapy for reversing DM?

Answer 14

Lifestyle modification

Question 15

What class of drugs is metformin?

Answer 15

Biguanide

Question 16

Does metformin reduce gluconeogenesis in liver?

Answer 16

Yes

Question 17

Do not use metformin if estimated GFR < ____?

Answer 17

<30

Question 18

What category of drug are glipizide and glyburide?

Answer 18

Sulfonylureas

Question 19

GDM confers increased risk to which 2 things during pregnancy?

Answer 19

1. Stillborn

2. Large baby

Question 20

GDM confers increased risk to which 2 things during pregnancy?

Answer 20

1. Stillborn

2. Large baby

Question 21

What’s the T score for osteoporosis?

Answer 21

Amount of bone compared to a young adult of the same gender

Question 22

What are the T scores for the following?:
Normal:
Osteopenia:
Osteoporosis

Answer 22

Normal: >-1
Osteopenia: -1 to -2.5
Osteoporosis: -2.5 or less

Question 23

What’s the z score for osteoporosis?

Answer 23

Amount of bone compared to same age and gender

Question 24

How is the dx of osteoporosis made?

Answer 24

1. One or more fragility fractures

2. T score of -2.5 or less on DEXA

Question 25

When should you treat osteoporosis pharmacologically?

Answer 25

T score -2.5 to -1.0 at high risk for a fracture

Question 26

At what age should DEXA be performed?

Answer 26

65+, or less if have an increased risk

Question 27

What class of drugs are alendronate, risendronate, etc?

Answer 27

Bisphosphonates

Question 28

Normally, low Ca stimulates production of PTH, causing the following effects in: - renal excretion of Ca - renal production of vit D - gut absorption of Ca

Answer 28

- Decreased renal excretion of Ca - Increased production of Vit D by kidney - Increased gut absorption of Ca

Question 29

What's the main cause of primary hyperparathyroidism?

Answer 29

Adenoma

Question 30

Do more females or males get hyperparathyroidism?

Answer 30

Females

Question 31

About 98% of Ca is in the ________?

Answer 31

Bones

Question 32

What conditions can cause secondary hyperparathyroidism?

Answer 32

Chronic renal dz, dialysis, vit D deficiency (can be from Crohn's or celiac)

Question 33

What type of diuretics can cause elevated Ca?

Answer 33

Thiazide

Question 34

Describe the chain of thyroid hormone production?

Answer 34

Hypothalamus: TRH released Anterior pituitary: TSH released -stimulates production of thyroid hormones -Thyroid gland: mono and di to tetra-iodotyrosine to tri-iodotyrosine

Question 35

Where are T1 and T2 converted to T4?

Answer 35

Outside thyroid

Question 36

Where is T4 converted to T3?

Answer 36

Outside thyroid

Question 37

What do T3 and T4 (thyroxine) do?

Answer 37

Perform thyroid bodily functions and suppress TRH and TSH

Question 38

Is T3 or T4 more active?

Answer 38

T3

Question 39

In circulation, is T3 or T4 more prevalent?

Answer 39

T4

Question 40

``` What could the following all cause:? Low albumin PTH resistance Low vit D Dietary Ca deficiency Low Mg Elev phosphorus Pancreatitis Renal failure ```

Answer 40

Low Ca

Question 41

T/F: the thyroid is the only place in the body that uses iodine?

Answer 41

T

Question 42

What's a struma ovarii?

Answer 42

Teratoma that contains mostly thyroid tissue and will pick up iodine on scans

Question 43

What does an elev TSH mean?

Answer 43

Hypothyroid

Question 44

What does an elev T3/T4 mean?

Answer 44

Hyperthyroid

Question 45

Is Graves hyper or hypothyroid?

Answer 45

Hyper

Question 46

What's the treatment of hyperthyroid?

Answer 46

PTU

Question 47

Can a goiter be euthyroid?

Answer 47

Yes

Question 48

Which is the most common (>70%) type of thyroid cancer which has low mortality but high recurrence?

Answer 48

Papillary

Question 49

Which thyroid cancer is approx 15%, usually age 40-60 years old, often has distant mets and does not pick up iodine well on scans?

Answer 49

Follicular

Question 50

Which thyroid cancer is calcitonin-secreting (C cells; parafollicular), and can be part of MEN syndrome?

Answer 50

Medullary

Question 51

Which thyroid cancer is rare, seen more in elderly males, mets to the lung quickly, and has a high death rate?

Answer 51

Anaplastic

Question 52

What are the 2 treatments for thyroid cancer?

Answer 52

1. Surgical | 2. RAI

Question 53

If a patient has high TRH, what does the type of hyperthyroidism have to be?

Answer 53

Hypothalamic tumor