Adult Endo 2

Question 1

What are some of the long term complications of DM?

Which is the major cause of mortality?

Answer 1

Cardiovascular Disease (major Cause)
CAD

Question 2

1) What HbA1C value indicates good control?

2) What happens if HbA1C is too low?

Answer 2

1) 6.5 or less

2) Hypoglycemia and syncope

Question 3

1) What is a form of autonomic neuropathy?
2) What happens in it?
3) Why is this important?

Answer 3

1) Diabetic Gastropathy
2) Variable stomach emptying
3) Insulin requirements are variable

Question 4

1) How can nephropathy for proteinuria be screened?
2) What is normal Urine Protein level?
3) As Kidney Function Declines, what happens to Insulin Requirement?

Answer 4

1) Random Urine Sample
2) <300 mg/24 hour
3) Also declines

(As Kidney fails, Increased amount of insulin in body, and thus less insulin is needed)

Question 5

1) What is the earliest measurable sign of proteinuria and diabetic nephropathy?
2) What is the amount?

Answer 5

1) Microalbumin

2) 30 mg-300 mg

Question 6

1) When is a 24hr urine collection used in diabetic nephropathy?
2) What is being used for?

Answer 6

1) Only in advanced Kidney Disease (NOT routinely)

2) Protein and Creatine Clearance

Question 7

What should be ordered quarterly on diabetic patients?

Answer 7

1) SGM log (Self Glucose Monitoring)
2) HbA1C
3) Foot inspection

SHF

Question 8

What should be done annually for diabetic monitoring?

Answer 8

1) Monofilament Testing
2) Urine Protein Screening
3) Dilated Eye Exam

MUD

Question 9

What are some general foot care recommendations?

Answer 9

1) Daily Inspection
2) Moisturize (Avoid under/between toes)
3) Prescription Shoes
4) No Barefoot

DMP N

Question 10

What is the most important Lifestyle Modification in diabetes

Answer 10

Physical Activity

Question 11

What behavior is the single most additive risk for vascular disease?

Answer 11

Smoking

Question 12

What are the characteristic of T1DM?

• Hormones
• Volume?
• Mental?
• Cause?

Answer 12

1) Absolute Insulin Deficiency
1) Absolute Glucagon Excess
2) Volume Depletion
3) Mental Status Changes
4) Autoimmune

Question 13

What are the characteristic of T2DM?

1) Hormones?
2) Volume?
3) Mental?

Answer 13

1) Relative Insulin Deficiency and Glucagon Excess
2) Volume Depletion
3) Mental Status Changes

Question 14

What are the signs and sx of Hyperthyroidism

1) Cardio Issues?
2) Fat?
3) GI?
4) Other?

Answer 14

1) Tachycardia and Bruits
2) Weight loss and Gynecomastia
3) Diarrhea
4) Tremor

Question 15

TSH, Free T4 Levels

1) Primary Hypothyroid
2) Primary Hyperthyroidism
3) TSH Producing Tumor
4) Central Hypothyroidism

Answer 15

1) Increased TSH, Decreased FT4
2) Decreased TSH, Increased FT4
3) Increased TSH, Increased FT4
4) Decreased TSH, Decreased FT4

Question 16

Euthyroid Sick

1) What do they look like?
2) What is the issue with labs?
3) What should be cautioned in this?

Answer 16

1) Critically Ill patient
2) Does not fit with primary, secondary, or tertiary dysfunction
3) Interpreting thyroid testing and treatment

Question 17

Thyroid Surgery

1) What nerve can be damaged?
2) What other endocrine structure can be damaged?

Answer 17

1) Recurrent Laryngeal Nerve

2) Parathyroids

Question 18

How does PTH increase intestinal absorption of calcium?

Answer 18

Stimulates Renal 1,25(OH)2D

Question 19

1) If Ca and PO4 are moving in opposite directions, what is the issue?
2) If Ca and Po4 are moving in the same direction, what is the issue?

Answer 19

1) PTH Imbalance

2) Vitamin D issue

Question 20

What are five causes of hypercalcemia?

Answer 20

1) Parathyroid
2) Malignancy
3) Vitamin D
4) High Bone Turnover
5) Renal Failure

PMV HR

Question 21

What is the treatment for hypercalcemia of malignancy if patient has altered mental status or EKG changes (qt shortening)

Answer 21

Aggressive Volume expansion with isotonic Saline

Question 22

How do you test for Osteoporosis and Excessive Bone Turn-over?

Answer 22

DEXA scan