Endo

Question 1

DM and hyperglycemia clinical pres may include
8

Answer 1

1. polyuria
2. polydipsia
3. polyphagia
4. weight loss
5. fatigue
6. weakness
7. blurry vision
8. superficial infections

Question 2

DKA and HHS clinical pres may include classic s/sx of hyperglycemia plus
4

Answer 2

1. NV
2. abd pain
3. SOB
4. AMS

Question 3

DM/DKA/HHA - ask about
2

Answer 3

1. last known A1c
2. medication compliance

Question 4

DM physical exam findings may include
3

Answer 4

1. poor wound healing
2. peripheral neuropathy
3. charcot foot

Question 5

DKA and HHS PE findings may include - VS
3

Answer 5

tachycardia
tachypnea
hyptension - severe dehydration

Question 6

DKA and HHS PE findings may include - respiratory
3

Answer 6

1. kussmaul breathing
2. respiratory distress
3. acetone/fruity breath

Question 7

DKA and HHS PE findings may include - abd
1

Answer 7

1. tenderness or may resemble surgical abx

Question 8

DKA and HHS PE findings may include - neuro
5

Answer 8

1. lethargy
2. confusion
3. obtundation
4. coma
5. focal neuro deficits

Question 9

DM/DKA/HHS - img/testing
4

Answer 9

1. POC glucose
2. urinalysis - glucose, ketones
3. pregnancy test
4. consider EKG

Question 10

DM or hyperglycemia - no evidence to treat if

Answer 10

asymptomatic

Question 11

DM tx
4

Answer 11

1. lifestyle changes
2. BP and glucose logs
3. if new dx w/ s/sx consider ER referral
4. refer to PCP for comprehensive w/u

Question 12

DKA/HHS - tx

Answer 12

1. sent to ER
2. keep NPO

Question 13

hypoglycemia

Answer 13

<70

Question 14

hypoglycemia clinical pres
6

Answer 14

1. nausea
2. dizziness
3. confusion
4. fatigue/weakness
5. anxiety
6. visual changes

Question 15

hypoglycemia - ask about history of
10

Answer 15

1. DM
2. BBs
3. ETOH
4. malignancy
5. renal insufficiency
6. liver failure
7. FTT
8. poor nutrition
9. gastrectomy
10. gastric bypass surgery

Question 16

hypoglycemia - PE findings can include
6

Answer 16

1. tremulous
2. nervous
3. combative
4. confused
5. unresponsive
6. comatose

Question 17

hypoglycemia - PE findings for CV (1), neuro (3), GI (1), skin (2)

Answer 17

cv - often tachycardia - caution w/ BB
neuro - difficulty speaking, focal deficits, seizure
GI - vomiting
skin - diaphoretic, warm

Question 18

hypoglycemia - img/testing
2

Answer 18

1. POC glucose
2. EKG

Question 19

hypoglycemia - overall tx
2

Answer 19

1. correct hypoglycemia (juice/food) and recheck blood sugar
2. consider d/c with PCP if appropriate

Question 20

hypoglycemia - consider discharge w/ PCP f/u if
3

Answer 20

1. symptoms resolved
2. no long acting hypoglycemic
3. able to tolerate PO

Question 21

hypoglycemia - caution patients that they may lack what

Answer 21

awareness of hypoglycemia

Question 22

hyperthyroidism

Answer 22

overactive thyroid hormone production

Question 23

hyperthyroidism can include
6

Answer 23

1. Graves disease
2. multinodular goiter
3. toxic adenoma
4. postpartum thyroiditis
5. drug induced thyrotoxicosis
6. subacute thyroiditis

Question 24

hyperthyroidism - ask about
3

Answer 24

1. hyperthyroid med changes
2. med hx - type 1 DM, other autoimmune conditions
3. recent surgery, infection, trauma

Question 25

hyperthyroidism - clinical pres might include 13

Answer 25

1. anxiety 2. nervousness 3. diaphoresis 4. tachycardia 5. palpitations 6. dyspnea 7. diarrhea 8. heat intolerance 9. fatigue 10. weight loss 11. edema 12. blurred vision, eye swelling/pain 13. menstrual irregularity

Question 25

increased risk of hyperthyroidism w/ what meds 4

Answer 25

1. amiodarone 2. lithium 3. iodide 4. alemtuzumab

Question 26

hyperthyroidism - VS PE findings 2

Answer 26

tachycardia febrile

Question 27

hyperthyroidism - HEENT PE findings 4

Answer 27

1. exophthalmos 2. lid lag 3. proptosis (graves) 4. periorbital edema (graves)

Question 28

hyperthyroidism - neck PE findings 4

Answer 28

1. palpable/diffuse goiter 2. +/- bruit 3. palpable nodules (toxic) 4. tender thyroid (subacute)

Question 29

hyperthyroidism - extremities and skin findings on PE 6

Answer 29

1. muscle wasting 2. proximal muscle weakness 3. hand tremor 4. pretibial myxedema (graves) 5. digital clubbing (graves) 6. diaphoresis

Question 30

hyperthyroidism - img/testing

Answer 30

1. EKG 2. glucose 3. pregnancy

Question 31

hyperthyroidism - tx 4

Answer 31

1. avoid strenuous activity 2. limit caffeine intake 3. quit smoking 4. avoid biotin and iodine supplements

Question 32

hyperthyroidism - f/u

Answer 32

refer to PCP for w/u

Question 33

hyperthyroidism - when to refer to ER 2

Answer 33

1. suspected thyroid storm - fever, SVT, a fib, hypotension, HF, ACS syndromes, abd pain, hyperkinesis, liver failure, agitation, psychosis, coma 2. fever + sore throat on methimazole (agranulocytosis)