Endo

Question 1

Dx of SIADH

Answer 1

-euvolemia
- no diuretics in 24-48 hours
- urine osm high + low serum Na and osm

Question 2

SIADH treatment

Answer 2

• fluid restriction <800 cc/24 hours over severe days to correct hypoosmolality
• treat underlying cause
• For servere hypoNa w/ seizures/obtunded –> 3% saline

Question 3

Oral diabetes medications that have been FDA approved for secondary prevention of CVD

Answer 3

liraglutide (GLP1)
Empagliflozin (SGLT2)

Question 4

monitoring DM in patients with hemoglobinopathies (falsely lower A1c)

Answer 4

Fructosamine

Question 5

Dx in graves

Answer 5

RAIU: diffuse
+Thyrotropin receptor abx

(no uptake in thyroiditis, post partum thyroiditis, subacute thyroioditis)

Question 6

Postpartum thyroiditis

Answer 6

Transient or persistent thyroid dysfunction within 1 year childbirth

-MOA: release of preformed thyroid hormone

• Dx: RAIU is LOW during hyperthyroid phase
• preg/breast feeding are CI to RAIU

Question 7

When is thyroid US indicated?

Answer 7

only if palpable abrnomality of thyroid gland

Question 8

Hashimotos (autoimmune thyroiditis)

Answer 8

+ TPO ab, sx of HYPOthyroidism

Question 9

BMI with most benefit for bariatric surgery

Answer 9

> 40

Question 10

Rotterdam criteria

Answer 10

Need 2/3:
1. hyperandrogenism
2. annovulatory cycles
3. at least one polycystic ovary

Question 11

meds/conditions that alter metabolism of levothyroxine

Answer 11

gastritis
h pylori
chronic PPI

inc by 30%

Question 12

Contraindications for GLP1

Answer 12

medullary thyroid CA or MEN

Question 13

impaired fasting glucose

Answer 13

100-125

Question 14

DM meds that cause weight gain

Answer 14

sulfonylureas, thiazolidinediones, insulins

Question 15

GFR cut off for prescribing metformin

Answer 15

men 1.5
women 1.4

Question 16

A1c to start insulin

Answer 16

> 9

Metformin should be first line regardless

Question 17

Absolute contraindications to testosterone replacement

Answer 17

Hct >54%, PSA >4, breast/prostate CA, nodules on DRE

Hct >50% is relative CI

Question 18

first line tx of RA

Answer 18

methotrexate (DMARD)
- starting within 3 mo leads to sustained remission
- underlying liver disease is a contraindication to MTX

Question 19

First dx test in thyroid concern always? W/u if nodule on exam?

Answer 19

TSH, than US if nodule

If nodule?
Low &raquo_space; RAUI
High&raquo_space; FNA

Question 20

impacts of over treating hypothyroidism

Answer 20

afib
osteoporosis

Question 21

tx of Graves

Answer 21

1= radioactive idoine ablation
2= Methimazole (1st line), PTU (2nd line)

Question 22

when is PTU considered first line

Answer 22

1st tri pregnancy and lactation

Question 23

thyroid nodules epidemiology

Answer 23

95%= benign adenoma
5%= malignant

Of malignant lesions, 60% papillary,12% follicular

Question 24

goal TSH in pregnancy

how to adjust levothyroxin

Answer 24

<3

Inc by 25-50%

Question 25

survival outcomes after weight loss surgery: -all cause mortality -DM

Answer 25

Mortality benefit over non-surgical methods; all cause mortality dec 30-50% at 7-15 years DM remission in large proportion of patients at 2 years

Question 26

lab monitoring for nutritional deficiency after bariatric surgery

Answer 26

q3 mo for one year then annually

Question 27

1st line tx of DM if presenting with weight loss

Answer 27

Insulin! patient is in a catabolic state

Question 28

female athlete triad

Answer 28

low energy relative to needs ex: exercising beyond caloric store irregular periods from hypothalamic shut down, impaired bone mineral density

Question 29

t/f breastfeeding decreases risk f DM

Answer 29

true also HTN, CVD

Question 30

Test after adrenal incidentaloma

Answer 30

dexamethasone suppression test

Question 31

Factors associated with an increased risk of osteoporosis

Answer 31

include smoking, excessive alcohol consumption, low body weight, and a parental history of hip fracture.

Question 32

Elevated ALP, nrmal GTT

Answer 32

Think Pagets >> order xray pelvis, tibia, skull >> if pagets, order radionucleotide bne scan