IM Plat- Endocrinology

Question 1

Give the 3 approved drugs for the management of pre-diabetic patients.

Answer 1

Acarbose, Metformin and Thiazolidinediones

Question 2

Give the criteria for the diagnosis of DM.

Answer 2

Either of the following:

1. HbA1c >/= 6.5%
2. FPG >/= 126 mg/dL (7.0 mmol/L)
3. 2/hr plasma glucose after an OGTT >/= 200 mg/dL (11.0 mmol/L)
4. RPG >/= 200 mg/dL (11.0 mmol/L) + classic sxs of hyperglycemia

Question 3

What is the hallmark of proliferative diabetic retinopathy?

Answer 3

Neovascularization (in response to retinal hypoxia)

Question 4

The second messenger system for insulin.

Answer 4

Tyrosine kinase

Question 5

Which group of OHAs has the propensity for causing edema as a side effect?

Answer 5

Thiazolidinediones (Rosiglitazone, Pioglitazone)

Question 6

What is the serum potassium goal in patients with DKA and HHS?

Answer 6

4-5 mEq/L

Question 7

These are manifestations of hypoglycemia as a direct result of CNS glucose deprivation and includes behavioral changes, confusion, fatigue, seizure and syncope.

Answer 7

Neuroglycopenic symptoms

Question 8

Which CAH hormone deficiency causes virilizing symptoms?
A. 21-beta hydroxylase 
B. 3-beta-hydroxysteroid dehydrogenase
C. 11-beta-hydroxylase
D. 17-alpha hydroxylase

Answer 8

A. 21-beta hydroxylase

Question 9

Which CAH hormone deficiency causes non-virilizing symptoms?
A. 21-beta hydroxylase 
B. 3-beta-hydroxysteroid dehydrogenase
C. 11-beta-hydroxylase
D. 17-alpha hydroxylase

Answer 9

D. 17-alpha hydroxylase

Question 10

Give the normal ejaculate volume, sperm count, motility and morphology.

Answer 10

Volume: 2-6 mL
Count: >20 million/mL
Motility: 50%
Morphology: >15% normal

Question 11

These are manifestations of hypoglycemia that results from perception of physiologic changes caused by CNS-mediated sympathoadrenal (both adrenergic and cholinergic) discharge and includes palpitations, tremors, anxiety, sweating, hunger and paresthesia.

Answer 11

Neurogenic/Autonomic

Question 12

What hormone of pregnancy promotes the growth of the fetus and is used as an index of fetal well-being?

Answer 12

Human chorionic somatomammotropin or human placental lactogen

Question 13

Delayed puberty is defined as the absence of secondary sexual characteristics at age ___ in boys and ___ in girls.

Answer 13

13 in girls; 14 in boys

Question 14

What is the most common functioning pituitary adenoma?

Answer 14

Prolactinoma

Question 15

This pharmacologic drug antagonizes endogenous GH action by blocking peripheral GH binding to its receptor.

Answer 15

Pegvisomant

Question 16

Which subunit is unique to TSH?

Answer 16

Beta subunit (alpha is similar to LH, FSH and hCG)

Question 17

What is the most common cardiovascular manifestation of hyperthyroidism?

Answer 17

Sinus tachycardia

Question 18

What is the most common symptom of hypothyroidism?

Answer 18

Tiredness/weakness

Question 19

What is the most common sign of hypothyroidism?

Answer 19

Dry, coarse skin and cool, peripheral extremities

Question 20

What is the most common symptom of hyperthyroidism?

Answer 20

Hyperactivity/irritability

Question 21

What is the recommended daily calcium intake in post-menopausal women to prevent bone loss?

Answer 21

750-800 mg/day

Question 22

What is the most common cause of ACTH-independent cortisol excess?

Answer 22

Cortisol-producing adrenal adenoma

Question 23

What is the recommended daily Vitamin D3 intake in post-menopausal women to prevent bone loss?

Answer 23

10-20 mcg/day

Question 24

Condition where the normal thyroid tissues are replaced by fibrous tissue.

Answer 24

Reidel thyroiditis

Question 25

What is the best test to differentiate pituitary, adrenal and ectopic Cushing syndromes?

Answer 25

High-dose dexamethasone suppression test

Question 26

What is the earliest manifestation of pituitary failure during childhood? adulthood?

Answer 26

Growth retardation in childhood; hypogonadism in adults

Question 27

What is the most common cardiovascular manifestation of hyperthyroidism?

Answer 27

Sinus tachycardia

Question 28

What is the treatment of choice for hyperfunctioning solitary thyroid nodules?

Answer 28

RAI ablation

Question 29

Osteoporosis is defined by the WHO as a decrease in bone mineral density by ___ SD.

Answer 29

= -2.5

Question 30

What is the most common cause of ACTH-independent cortisol excess?

Answer 30

Cortisol-producing adrenal adenoma

Question 31

What is the best test to differentiate pituitary, adrenal and ectopic Cushing syndromes?

Answer 31

High-dose dexamethasone suppression test

Question 32

What is the clinical hallmark of mineralocorticoid excess?

Answer 32

Hypokalemic hypertension

Question 33

What is the most common primary thyroid cancer in adults and children?

Answer 33

Papillary thyroid cancer

Question 34

What is the most sensitive initial test for pheochromocytoma?

Answer 34

Plasma metanephrine

Question 35

What is the most common cause of primary adrenal insufficiency?

Answer 35

Autoimmune adrenalitis

Question 36

How does one distinguish a primary from a secondary adrenal insufficiency?

Answer 36

Presence of hyperpigmentation in primary AI

Question 37

Triads: Pheochromocytoma

Answer 37

Palpitations, headache, diaphoresis

Question 38

What is the surgical procedure of choice for pheochromocytoma?

Answer 38

Atraumatic endoscopic surgery

Question 39

What serum marker can be used as an alternative indicator of glycemic control when the HbA1c is inaccurate such as in hemolytic anemia?

Answer 39

Albumin

Question 40

What is the treatment of choice for severe hypercalcemia complicated by renal failure?

Answer 40

Hemodialysis

Question 41

What are the preferred sites for bone mineral density scan in patients 60 yo?

Answer 41

60 yo: Hip

Question 42

This group of incretin-related drugs prolong endogenous GLP-1 action.

Answer 42

DPP4 inhibitors (Sitagliptin, Saxagliptin)