3-uWorld

Question 1

Difference between hypercalcemia of malignancy and Hypercalcemia from primary hyperparathyroidism is

Answer 1

Hypercalcemia of malignancy:
Very severe hypercalcemia over 13

Primary hyperparathyroid:
Mild hypercalcemia under 11 with often absent or mild symptoms

Question 2

CT scan found adrenal mass Around 2.5 cm,What is the Next step?

Answer 2

Can do work up with testing hormone hypersecretion,

Afterwards FNA

Question 3

What is the adrenal mass size to define adrenal incidentaloma

Answer 3

> 1 cm

Question 4

What Hounsfield unit on adrenal incidentaloma indicates likely adrenal metastasis?

Answer 4

> 20 HU

Question 5

****whom do you consider a high risk/ elevated risk of complications in a patient with hypercalcemia (who has not had complications yet) from primary hyperparathyroidism?

Answer 5

Calcium >1 above normal

Urine calcium secretion >400 mg/day

Question 6

One of the complications of primary hyperparathyroidism

Answer 6

Nephrolithiasis

Osteoporosis With fracture

All the complications of hypercalcemia

Question 7

In a young patient with primary hyperparathyroidism, What indicates resection?

Answer 7

Symptomatic with complications of osteoporosis/hypercalcium

Elevated risk of complications in an asymptomatic person

Question 8

FRAX assessment is used for___

Answer 8

Deciding if therapy needed for patient with osteopenia

Question 9

Osteopenia T-score

Answer 9

-1.1 to -2.4

Question 10

Secondary hyperparathyroidism(Renal Failure)**

phosphorus would be___
Calcium would be___
PTH would be___
Vitamin D would be ___

Answer 10

Phosphorus: HIGH or normal
Calcium: Low or Normal
PTH: High
Vitamin D: Normal 25 hydroxy, 1,25-low

Question 11

Overtreatment of hypothyroidism can result in ___ and ___

Answer 11

Cardiac arrhythmia, bone loss

Question 12

Primary hyperparathyroidism*******

phosphorus would be___
Calcium would be___
PTH would be___
Vitamin D would be ___

Answer 12

Phosphorus: Low
Calcium: High
PTH: High
Vitamin D: Normal

Question 13

Vitamin D deficiency***

phosphorus would be___
Calcium would be___
PTH would be___
Vitamin D would be ___

Answer 13

Phosphorus: Low
Calcium: Low/Normal
PTH: High if vit d <20 *****
Vitamin D: Low

Question 14

Osteoporosis in renal failure with___medication

Answer 14

Anabolic denosumab, bisphosphonates are contraindicated in stage IV CKD

Question 15

How much with vitamin D and calcium to given osteoporosis

Answer 15

Abdomen D8 100 IU
Calcium 1200 mg

Question 16

Consequence of prolonged bisphosphonate use

Answer 16

Atypical bone fracture

Question 17

SERM medication Like Raloxifene for osteoporosis, helps against____Fractures only

Answer 17

Vertebral only

Question 18

Prolia i.e. denosumab, is good for these kinds of fractures___

Answer 18

Vertebral, hip, nonvertebral

Question 19

Starting patient on bisphosphonate, make sure patient does not have___

Answer 19

esophageal issues
CKD with GFR under 35
Upcoming dental appointment

Question 20

Second line option for severe osteoporosis refractory to bisphosphonate

Answer 20

Teriparatide(PTH analog)

Question 21

Hypothyroidism can cause peripheral edema, usually___type

Answer 21

Nonpitting type

Question 22

CAD is a risk in___thyroid issue

Answer 22

Hypothyroidism

Question 23

When taking FNA of an adrenal mass,___must be ruled out

Answer 23

Pheochromocytoma

Question 24

Patient has an adrenal mass 4.5 cm, all the hormone excess levels were negative, what is the next step?

Answer 24

FNA and considering surgical resection

(If it was under 4 cm may just do conservative monitoring)