Endo 1

Question 1

normal nonfasting glucose level

Answer 1

<125

Question 2

common side effects of metformin in the first two weeks of starting med

Answer 2

diarrhea
flatulence

Question 3

A diagnosis of hypothyroid can be made when

Answer 3

after there are two abnormal TSH levels unless the initial value is very elevated and the patient is symptomatic

Question 4

Next step when an elevated TSH is discovered

Answer 4

repeat TSH and get a serum free T4 - after this repeat and with the free T4, you can diagnose hypothyroidism

Question 5

BMI that indicates increased risk of type 2 DM

Answer 5

BMI greater than or equal to 25

Question 6

fatigue and weight gain - why order a CBC

Answer 6

CBC may be helpful in ruling out anemia or infection as the cause of fatigue

Question 7

fatigue and weight gain - why order a A1c

Answer 7

fatigue and weight gain may suggest diabetes

Question 8

hypothyroidism is most prevalent in who

Answer 8

women over 40 years of age

Question 9

impaired fasting glucose value

Answer 9

100-125

Question 10

impaired fasting glucose f/u

Answer 10

none

Question 11

drug class of choice for treatment of elevated LDL is

Answer 11

statin

Question 12

prior to starting a statin

Answer 12

dietary modifications are usually attempted for 3 months prior to starting a statin - unless LDL is very elevated, and they have comorbidities such as DM

Question 13

ADA ASA recommendations

Answer 13

ADA recommends low dose ASA therapy as primary prevention (level C rec) in patients who have type 2 DM that are at an increased risk of CV event - ASA as a secondary prevention who have DM and a history of CV event is a level A rec

Question 14

renal and metformin

Answer 14

monitor values as it is excreted in kidneys

Question 15

NPH (intermediate acting) insulin can be increased by what

Answer 15

2-3 units at a time until BG is normal

Question 16

you increased the patient’s NPH in the AM to help with BG before dinner - how do they recheck their BG

Answer 16

BG checks for 3 days after the insulin change (BG checks before dinner)

Question 17

nephropathy develops in how many DM patients

Answer 17

20-40%

Question 18

screening for albuminuria is most easily accomplished how

Answer 18

by performing a random urine collection

Question 19

albuminuria may be considered when

Answer 19

when 2-3 specimens of urinary albumin-to-creatinine ratio (UACR) collected within 3-6 months are abnormal

Question 20

normal urinary albumin-to-creatinine ratio (UACR) value

Answer 20

< 30 mg/gm Cr

Question 21

fasting glucose values that equal or exceed 126 on different days =

Answer 21

dm type 2 - an A1c is not needed for dx but should be drawn to establish baseline

Question 22

DM A1c

Answer 22

greater than or equal to 6.5

Question 23

pre DM A1c

Answer 23

5.7-6.4

Question 24

what is the earliest detectable glycemic abnormality in patient with type 2 dm

Answer 24

postprandial glucose elevation

Question 25

once glucose levels are elevated and remain elevated, patients usually experience symptoms such as 4

Answer 25

fatigue thirst frequent urination hunger

Question 26

You should have how many elevated TSH levels to dx hypothyroid

Answer 26

two

Question 27

A patient is hypothyroid when TSH levels exceeds what value

Answer 27

5

Question 28

common s/sx of hypothyroidism 7

Answer 28

fatigue weight gain dry skin cold intolerance constipation menstrual irregularities hair and nails break easily

Question 29

hypoglycemia during sleep in a 75 year old can cause

Answer 29

stroke or seizure

Question 30

AM fasting glucose goal for DM

Answer 30

80-130

Question 31

PPD glucose goal DM

Answer 31

<180

Question 32

which lab abnormality commonly accompanies hypothyroidism

Answer 32

dyslipidemia

Question 33

lipids and TSH levels

Answer 33

elevated lipids, specifically dyslipidemia is common when TSH values exceed 10

Question 34

patient presents with dyslipidemia - think about screening for what else

Answer 34

thyroid issues, check TSH

Question 35

dyslipidemia should not be treated until when (TSH)

Answer 35

until the TSH decreases to 10 or less

Question 36

abnormal lab values associated with hypothyroidism 6

Answer 36

1. dyslipidemia 2. hyponatremia 3. hyperprolactinemia 4. hyperhomocysteinemia 5. anemia 6. elevated creatinine phosphokinase

Question 37

hyperthyroid effect on BP

Answer 37

increase of both systolic and diastolic numbers

Question 38

most common form of hyperthyroidism

Answer 38

grave's disease

Question 39

graves disease - TSH, T3, T4

Answer 39

low TSH elevated T3/4

Question 40

long-acting insulin mimics what

Answer 40

the amount of insulin the pancreas produces at a steady rate throughout the day and night

Question 41

adjustment in doses of long-acting insulin are typically based on what glucose values

Answer 41

based on AM fasting glucose values