Day 3 - Endo1 Quiz

Question 1

Exophthalmos, most likely cause

Answer 1

Graves’ disease

Question 2

Diabetic gastroparesis dx & tx

Answer 2

Gastric emptying study; Metoclopramide (most common), Cisapride, Erthyromycin, Domperidone

Question 3

Hyperthyroid disease radioactive iodine most likely to result in hypothyroidism: (1) Graves’ disease (2) Toxic multinodular goiter (3) Toxic adenoma

Answer 3

Graves’ disease (taken up by functional thyroid tissue in entire gland, not just hyperfunctional adenomatous tissue)

Question 4

Tx of most common cause of hyperthyroidism

Answer 4

Graves’ disease - radioactive iodine preferred over surgery (if pregnancy, surgery), other indications for surgery - coexisting thyroid nodule, very large goiter

Question 5

Causes of hypoglycemia in non-diabetic pt

Answer 5

Insulinoma, exogenous insulin or sulfonylureas, alcohol-induced fasting, adrenal insufficiency

Question 6

DKA p/w

Answer 6

Kussmaul breathing, weight loss, vomiting w/o diarrhea, polydipsia, polyuria

Question 7

Non-thyroid lab findings may cause suspicion for thyroid disease

Answer 7

Hyperlipidemia, Unexplained hyponatremia, Elevated serum CPK

Question 8

Hyperthyroidism pt w/ elevated anti-TPO antibodies at increased risk of which cancer

Answer 8

Thyroid lymphoma; Hashimoto’s thyroiditis

Question 9

Cause of hyperthyroidism in pt p/w (1) extremely tender thyroid (2) pretibial myxedema (3) pride? and recent weight loss in athletic professional? (4) palpation of single thyroid nodule (5) multiple thyroid nodules (6) recent imaging study using contrast & Jod-Basedow phenomenon, eye changes including edema, proptosis (7) History of thyroid surgery

Answer 9

(1) de Quervain’s thyroiditis (2) Graves’ disease (3) exogenous thyroid abuse (4) Toxic adenoma (5) Toxic multinodular goiter (6) Graves’ disease (7) Excess thyroid hormone replacement

Question 10

Next step: new nodule in pt w/ hyperthyroidism

Answer 10

TSH, Free T4; If hyperthyroidism, radionuclide scan

Question 11

3 newer diabetic drugs

Answer 11

Exenatide, sitagliptin, Prametide

Question 12

w/u etiology of dka

Answer 12

R/o infx (blood/urine cultx, cxr, U/A), Toxicology (amphetamines), Amylase/Lipase (pancreatitis), EKG (if age > 30, q 8 hrs along with serial troponins)

Question 13

Thyroid abnormalities expect during pregnancy

Answer 13

TBG elevated, Total T4 elevated, Free T4 normal

Question 14

Most common complications of thyroid surgery

Answer 14

Damage to recurrent laryngeal nerve (hoarseness) & parathyroids (hypocalcemia)

Question 15

Tx proliferative diabetic retinopathy; Tx peripheral neuropathy

Answer 15

Laser photo coagulation; Gabapentin, pregabalin, duloxetine; Also important for both, control glucose level