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Endocrinology Flashcards

(60 cards)

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1
Q

Which HLA subtypes are associated with type 1 diabetes?

A

DQA and DQB

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2
Q

What single random plasma glucose level can you diagnose a person with diabetes?

A

> 200

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3
Q

Which medications have been shown to delay onset to DM2?

A

Metformin
Alpha glucosidase inhibitors (acarbose, voglibose)
Thiazolidinediones (rosiglitazone, pioglitazone)

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4
Q

What value on oral glucose tolerance test is consistent with diabetes?

A

> 200

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5
Q

When do you screen for gestational diabetes?

A 
24-28 weeks
Positive if: 
Fasting >92
1 hour > 180
2 hour > 153
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6
Q

What conditions can falsely lower HbA1C due to more rapid turnover of erythrocytes?

A

Hemodialysis
Hemolytic anemia
Blood transfusions
Hemoglobinopathies

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7
Q

What is average blood glucose for an A1C of 10?

A

240

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8
Q

Which patient populations should sulfonylureas (gluburide) be avoided?

A

Impaired kidney function

Elderly

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9
Q

Which sulfonylureas is potentially associated with increased risk of myocardial infarction?

A

Glyburide

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10
Q

What possible complication can occur if metformin is continued and IV contrast is given?

A

Lactic acidosis

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11
Q

What condition should thiazolidenidines be avoided?

A

Heart failure

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12
Q

What oral hypoglycemic drugs need to be avoided in liver disease?

A

Metformin

Thiazolidenidines

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13
Q

When do you start retinal screening in type 1 diabetics?

A

5 years after diagnosis

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14
Q

When do you screen for diabetic retinopathy in pregnant women with diabetes (either type)?

A

Every trimester

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15
Q

What level of microalbunuria indicates marcoalbunuria?

A

> 300

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16
Q

What is Whipples triad?

A
  1. Hypoglycemic symptoms
  2. Low plasma glucose documented by a lab
  3. Resolution of symptoms with glucose ingestion
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17
Q

What is the most common functional pituitary adenoma?

A

Prolactinoma

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18
Q

What is most common pituitary adenoma?

A

Non functional

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19
Q

Which MEN syndrome has pituitary adenomas?

A

MEN1

3Ps - pituitary, parathyroid, pancreas

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20
Q

What is the drug drug interaction between iron supplements and levothyroxine?

A

Impaired levothyroxine absorption leading to hypothyroid state

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21
Q

What is the thyroglobulin level in exogenous ingestion of thyroid hormone?

A

Low

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22
Q

Which MEN syndrome has marfanoid habitus?

A

MEN2b

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23
Q

What condition of Graves’ disease of present means you should not give radio iodine ablation?

A

Graves ophthalmopathy - can transiently worsen symptoms

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24
Q

What additional studies should all patients with medullary thyroid cancer have?

A

RET proto-oncogene sequencing

Metanephrine/norephrine testing for pheo

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25
How much time after acute illness does euthyroid sick syndrome tend to recover?
8 weeks
26
What level is elevated in euthyroid sick syndrome though it is rarely measured?
Reverse T3
27
What dose increase is usually needed for levothyroxine in pregnant patients?
30-50% increase
28
What is normal cortisol level in healthy individuals in response to cosyntrophin test?
Should be >18
29
What is gold standard to diagnose Cushing syndrome?
24 hour urine cortisol
30
What is normal cortisol level after dexamethasone suppression test?
5 suggestive of cushings
31
What testing do you do to look for ACTH secreting pituitary adenoma if MRI does not localize tumor?
Bilateral Inferior petrosal sinus sampling
32
Which form of Cushing syndrome is called Cushing disease?
ACTH producing pituitary adenoma
33
What size of adrenal incidentaloma require surgical removal regardless if functional?
6 cm
34
What houndsfield units is indicative of a malignant adrenal incidentaloma? Benign?
>20
35
What is the renin:aldosterone ratio suggestive of primary hyperaldosteronism?
>20
36
What is another names for Schmidts syndrome?
Autoimmune polyendocrinopathy syndrome type 2 (APS2)
37
What is normal aldosterone level in response to salt load if no primary hyperaldosteronism?
Should be
38
What adrenal cytotoxic drug aids in treatment of adrenal carcinoma?
Mitotane
39
What defines secondary amenorrhea?
Absence of menstrual cycle for >6 months in previously menstruating female
40
What is Asherman syndrome?
Uterine scarring from previous gynecological procedure causing uterine outflow obstruction
41
What medication can mimic primary Hyperparathyroidism by resetting the set point for activation of calcium sensing receptor (CSR)?
Lithium
42
Which type of lung cancer frequently secretes PTHrP?
SCC
43
What is correction factor for hypocalcemia value with low albumin?
Add 0.8 for every 1 mg/dL below 4.0
44
Does hypo or hyper calcemia prolong QTc interval?
Hypocalcemia
45
What is most common medical condition that is contraindication to bisphosphate therapy?
CKD (CrCl
46
Does laser photocoagulation improve central or peripheral vision?
Improves central but tends to lose peripheral vision
47
What size adrenal mass always requires removal?
> 6 cm
48
What FSH level is consistent with primary ovarian insufficiency?
> 35
49
What FRAX risk of fracture indicates need for starting bisphosphanate?
Major fracture risk >20% or hip fracture risk >3% over next 10 years
50
What is black box warning for use of teriparatife (recombinant PTH)?
Osteosarcoma risk - can be used with history of radiation therapy, Paget disease, Hyperparathyroidism, hypercalcemia
51
What is goal TSH in first trimester of pregnancy?
52
How much increased requirement of levothyroxine is needed during pregnancy?
30-50%
53
What is the most common hormone deficiency following TBI?
Growth hormone
54
What appetite stimulating drug can cause adrenal insufficiency if rapidly discontinued?
Megestrol
55
What disease other than prolactinoma can cause secondary hypogonadism?
Hemachromatosis
56
Does opiate induced Hypogonadism central or primary?
Central Hypogonadism
57
What gene causes familial hypocalciuric hypercalcemia?
CASR gene
58
What random cortisol level in critically ill patient excludes adrenal insufficiency?
> 12
59
What size of adrenal incidentaloma requires adrenalectomy?
>4 cm or houndsfield units > 20 is concerning
60
What gene mutation should be checked with patients with medullary thyroid cancer?
RET proto-oncogene

Internal Medicine (12 decks)

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