Endo 2

Question 1

Dawn phenomenon

Answer 1

high FBG concentrations due to diurnal secretion patterns of hormones, particularly GH at 12-2am

Question 2

how to determine if insulin dosing needs to be adjusted - dawn phenomenon

Answer 2

examine glucose patterns at least 3-4 hours after the last meal or snack and insulin bolus, as well as at 3 am

Question 3

diabetic retinopathy - type 1, screen when

Answer 3

after age 10 years

Question 4

diabetic retinopathy - type 2 screen when

Answer 4

refer to ophthalmologist shortly after dx; then eye exam needed every 6-12 months

Question 5

insulin that lasts from meal to meal

Answer 5

regular insulin

Question 6

insulin that lasts from breakfast to dinner

Answer 6

NPH

Question 7

graves disease is to

Answer 7

hyperthyroidism

Question 8

classic finding for hyperthyroidism

Answer 8

very low TSH w/ elevations in both serum free T4 and T3 levels

Question 9

pretibial myxedema

Answer 9

thickening of the skin usually located in the shins and gives an orange peel appearance

Question 10

pretibial myxedema is to

Answer 10

hyperthyroid/Grave’s disease

Question 11

what antibody is positive in grave’s disease

Answer 11

thyrotropin receptor antibodies TRAb

Question 12

thyroid peroxidase antibody TPO is positive in what

Answer 12

graves disease and hashimoto’s disease

Question 13

preferred tx for mod to severe hyperthyroidism

Answer 13

PTU

Question 14

med options for hyperthyroid
2

Answer 14

methimazole
PTU

Question 15

PTU can cause what issue

Answer 15

liver failure

Question 16

for hyperthyroidism, what med is preferred tx during the first trimester

Answer 16

PTU

Question 17

hyperthyroidism adjunctive tx - given to alleviate the symptoms of hyperstimulation

Answer 17

BB

Question 18

normal TSH range

Answer 18

0.5-5

Question 19

high TSH and low free T4

Answer 19

hypothyroid

Question 20

hashimoto’s is to

Answer 20

hypothyroid

Question 21

gold standard test to confirm hashimoto’s thyroiditis

Answer 21

TPOs

Question 22

classic triad of symptoms for pheochromocytoma

Answer 22

episodic HA
sweating
tachycardia

Question 23

initial test for pheochromocytoma

Answer 23

24 hour urine fractionated metanephrines and catecholamines

Question 24

elevated TSH and decreased serum T4 or T3

Answer 24

hypothyroid

Question 25

overt thyrotoxicosis is defined as the syndrome of

Answer 25

hyperthyroidism associated with suppressed TSH and elevated serum levels of T4 or T3

Question 26

diabetic retinopathy findings
6

Answer 26

cotton wool spots
intraretinal hemorrhages
hard exudates
microanuerysms
occluded vessels
dilated or tortuous vessels

Question 27

ocular effects more specific to HTN
3

Answer 27

AV nicking
retinal arterial narrrowing
papilledema

Question 28

myxedema coma

Answer 28

severe hypothyroidism leading to slowing of function in multiple organs

Question 29

hallmark presentation for myxedema coma (severe hypothyroidism)

Answer 29

decreased mental status
hypothermia
hypotension
bradycardia
hyponatremia
hypoglycemia
hypoventilation

Question 30

primary hypothyroidism lab values

Answer 30

high serum TSH concentration
low serum free T4 concentration

Question 31

subclinical hypothyroidism labs

Answer 31

high TSH concentration
normal free T4 concentration

Question 32

which hormones stimulates testosterone release from the testes

Answer 32

luteinizing hormone LH

Question 33

which lab value can differentiate primary from secondary adrenal insufficiency

Answer 33

adrenocorticotropic hormone ACTH

Question 34

primary adrenal insufficiency - clinical manifestations often include
6

Answer 34

fatigue
weight loss
nausea
vomiting
muscle and joint pain
hyperpigmentation

Question 35

lab values for primary adrenal insuffiency

Answer 35

hyponatremia
hyperkalemia
anemia
low serum cortisol levels
high ACTH concentration

Question 36

both serum cortisol and plasma ACTH concentrations are low - think

Answer 36

secondary (pituitary disease) or tertiary (hypothalamic disease) adrenal insufficiency

Question 37

adrenal crisis presents as
4

Answer 37

tachycardia
hypotension
cool extremities
dehydration

Question 38

Cushing’s syndrome features
8

Answer 38

striae
decreased libido
central obesity/weight gain
menstrual changes
round face
hirsutism
HTN
lethargy

Question 39

initial testing for cushing’s syndrome can include

Answer 39

late night salivary cortisol (two measurements)
24 hour urinary free cortisol excretion (two measurements)
overnight 1 mg dexamethasone suppression test

Question 40

which DM med can cause weight gain

Answer 40

sulfonylurea like glipizide

Question 41

how does dawn phenomenon happen

Answer 41

there is diurnal secretion patterns of hormones at night with GH being released at midnight to 2 am which inhibits the action of insulin, causing an increase in BG In the morning