Endocrinology

Question 1

Etiology of adrenal insufficiency

Answer 1

autoimmune

Question 2

s/s of adrenal insufficiency

Answer 2

-skin hyperpigmentation
-weight loss
-fatigue
-abdominal pain
-change in body hair
-amenorrhea

Question 3

Diagnosis of adrenal insufficiency

Answer 3

acth stimulation test

Question 4

what imbalances does addison’s disease cause (-Na, -K, -glycemia)

Answer 4

hyponatremia
hyperkalemia
hypoglycemia

Question 5

Treatment of adrenal insufficiency

Answer 5

hydrocortisone

Question 6

What is the MC pathophysiology for Cushing’s Syndrome?

Answer 6

exogenous steroid or hypercortisolism from ACTH-secreting pituitary tumor

Question 7

s/s of Cushing’s disease

Answer 7

-central obesity
-buffalo hump
-purple striae
-hirsutism
-hypertension

Question 8

diagnosis of Cushing’s disease

Answer 8

-Dexamethasone suppression test
-24 hour free cortisol
-Serum ACTH

Question 9

treatment of cushing’s disease

Answer 9

treat underlying condition

Question 10

What is the MCC of hyperthyroidism

Answer 10

Grave’s disease
(autoimmune, against TSH receptors)

Question 11

S/S of hyperthyroidism

Answer 11

-palpitations
-Heat intolerance
-increase HR
-weight loss
-exophthalmos
-goiter

Question 12

Diagnosis of hyperthyroidism

Answer 12

Low TSH, high T3 and T4

Question 13

Tx of hyperthyroidism

Answer 13

-methimazole
-PTU
PTU if Pregnant

Question 14

MCC of hypothyroidism

Answer 14

Hashimoto’s thyroiditis

Question 15

S/S of hypothryoidism

Answer 15

-fatigue
-weight gain
-cold
-hair loss

Question 16

PE of Hypothyroidism

Answer 16

periorbital edema, dry skin, thin eyebrows

Question 17

Dx of hypothryoidism

Answer 17

low T4, high TSH

Question 18

Tx of hypothyroidism

Answer 18

synthroid (Levothyroixine)

Question 19

Hashimoto’s is a risk factor for which lymphoma?

Answer 19

non-Hodgkin lymphoma

Question 20

S/S of diabetes

Answer 20

polyuria, polydipsia, polyphagia

Question 21

ADA diagnostic criteria for DM2

Answer 21

Symptoms plus 1 of the following:
Random plasma glucose of > 200 mg/dL
Fasting plasma glucose of >126 mg/dL on 2 separate occasions
Glycated hemoglobin (A1C) of >6.5%
Plasma glucose of >200 mg/dL two hours after a 75 g glucose load during an oral glucose tolerance test

Question 22

fasting glucose levels

Answer 22

normal: <100
prediabetes: 100-125
diabetes: >126

Question 23

A1C levels

Answer 23

normal: <5.6
prediabetes: 5.7-6.4
diabetes: 6.5 or higher

Question 24

Which diabetic medications cause hypoglycemia?

Answer 24

Meglitinides (Repaglinide, Nateglinide)
Insulin (Regular, Lispro, Aspart, NPH, Glargine)
Sulfonyureas (glyburide, glipizide)

Question 25

vaccines recommended for DM patients

Answer 25

flu pneumonia covid hep b

Question 26

Dawn phenomenon

Answer 26

nocturnal release of counter regulatory hormones increase glucose levels

Question 27

somogyi effect

Answer 27

patient takes **too much insulin** before bed and **becomes hypoglycemic** at night and body compensates with hormones

Question 28

how to tell difference between dawn phenomenon and somogyi effect

Answer 28

both present as **hyperglycemia** in the morning (fasting glucose readings) due to body's natural response to fasting overnight-hormones (epinephrine/cortisol) inc glucose: **dawn** D/t excess amounts of exogenous inslulin with evening dose: dawn

Question 29

Treatment of Dawn Phenomenon

Answer 29

increase evening dose of insulin

Question 30

treatment of somogyi effect

Answer 30

decrease evening dose of insulin

Question 31

MOA of metformin

Answer 31

inhibits hepatic gluconeogenesis

Question 32

s/s of DKA

Answer 32

-acetone smell -**kussmaul respirations** -hypotension and tachycardia -n/v -abdominal pain

Question 33

Tx of DKA

Answer 33

-fluids first -then insulin -check K

Question 34

s/s of HHS (Hyperosmolar hyperglycemic state)

Answer 34

-hypotension -tachycardia -t2DM -Suuuuuuuper high glucose

Question 35

tx of HHS

Answer 35

-fluids first -then insulin