Adult Endocrinology

Question 1

what are clinical presenting sx of DM

Answer 1

Polyuria
Polydypsia
Nocturia 
Blurred Vision 
Weight Loss
Infections/Slow healing

Question 2

What is the diagnostic fasting glucose for a diabetic

Answer 2

> 126

Question 3

What is the two hour plasma glucose levels following a 75g OGTT

Answer 3

> 200mg

Question 4

What could be a cause of mental status changes in someone with DM

Answer 4

High or low blood sugar

Question 5

Which hyperglycemic events are more likely in type 1 DM? Type 2?

Answer 5

Type 1 DKA

Type 2 is HHS

Question 6

What main things lead to DKA

Answer 6

Inadequate Insulin administration
Infection
Infarction
Surgery 
certain drugs (cocaine)

Question 7

what are initial symptoms of DKA

Answer 7

Anorexia
Nausea
Vomiting
Polyuria
Thirst

Question 8

what symptoms indicated progression of DKA

Answer 8

Abdominal pain
Altered mental status
Coma

Question 9

What type of acidosis would DKA illicit

Answer 9

High Anion gap

also metabolic but I didnt know how to ask High anion without giving it away. if you knew that rate 5 and be on your way

Question 10

what would you monitor in the ICU for DKA

Answer 10

Acid-base status
Renal Function
Potassium and other electrolytes

Question 11

what is the general 1-2-3 rule of fluid replacement

Answer 11

2-3 L NS over 1-3 hrs
1/2 saline at 150mL/hr
When glucose gets to 250 mg switch to D5 1/2 NS

Question 12

What is the initial insulin regiment for DKA correction

Answer 12

10-20 units IV
then 5-10 units/hr continuous IV
increase if no response

Question 13

What is important to evaluate about your patient with DKA

Answer 13

underlying cause! or else they will relapse

Question 14

What electrolyte needs to be replaced in DKA

Answer 14

Potassium

keep an eye on cardiac function throughout

Question 15

What are absent in NKHS (HHS) to differentiate it from DKA

Answer 15

absent N/V. abdominal pain, and kussmaul respirations

Question 16

What is the major cause of mortality in T2DM

Answer 16

Cardiovascular disease

Question 17

What does an HbA1C tell you clinically (not what it is)

Answer 17

the 3-4 month average level of blood sugar.

Good for checking compliance

Question 18

What is a good way to evaluate nephropathy

Answer 18

Spot/random urine sample

-look for protein

Question 19

is 24 hr urine collection used often

Answer 19

no it can be cumbersome

but i think this is outpatient

Question 20

What should DM pts do daily

Answer 20

Foot inspection

Question 21

What should be the levels of TSH and Free T4 in primary hypothyroidism

Answer 21

TSH up

T4 down

Question 22

What should be the levels of TSH and Free T4 in primary hyperthyroidism

Answer 22

TSH down

T4 Up

Question 23

What is the temperature trend of thyroid nodules and how likely they are to malignant

Answer 23

Colder more malignant

Question 24

What should suspect if Calcium and phosphate are opposite

Answer 24

PTH issue

Question 25

What should you suspect if the calcium and phosphate do the same thing

Answer 25

Vit D issue

Question 26

what are the classifications of hypercalcemia

Answer 26

1. parathyroid-related
2. Malignancy-related
3. Vit-D
4. Associated high bone turnover
5. Renal Failure

Question 27

what is the EKG finding of hypercalcemia

Answer 27

shortened QT interval