Endo

Question 1

Infants of diabetic mothers at risk for what (regardless of diabetic control) (6)

Answer 1

1) Macrosomia
2) Hypoglycemia
3) Cardiac defects (TA / TGA / HLHS / truncus)
4) NTDs
5) poor lung maturation
6) neonatal jaundice
Require level II U/S and fetal echo in 2nd trimester

Question 2

Euvolemic hyponatremia / dec UO / serum osmoles / inc urine osmoles?

Answer 2

SIADH

Question 3

SIADH tx?

Answer 3

H2O restriction; 3% NS for Na <120 or seizures

Question 4

Ddx for primary amenorrhea (8)

Answer 4

1) Constitutional delay
2) eating disorders
3) chronic dz
4) severe androgen resistance
5) Rokitansky syndrome (absence of uterus)
6) imperforate hymen
7) GnRH deficiency
8) primary ovarian failure

Question 5

Do most patients with chronic lymphocytic thyroiditis (Hashimoto’s) present with hypo or euthyroidism?

Answer 5

Euthyroid (normal TSH / free T4), despite having physical (goiter) or lab (autoAb) signs.

Question 6

Most sensitive test for chronic lymphocytic thyroiditis (Hashimoto’s)?

Answer 6

Anti-TPO Abs (85%)

Question 7

2/3 of Hashimoto’s pts p/w large, normal or small thyroid?

Answer 7

Atrophic (small to non-palpable glands).

Question 8

Main side effects of methimazole? (2)

Answer 8

1) Drug induced rash

2) Granulocytopenia

Question 9

Main side effect of PTU?

Answer 9

Hepatoxicity -> Making it clearly inferior to methimazole in tx of Grave’s

Question 10

Mechanisms of PTH (3):

Answer 10

1) Inc Ca absorption via activation of vitamin D
2) Inc osteoclast activity
3) Direct PTH effect on distal and TAL

Question 11

Classes of causes of prepubertal vaginal bleeding (7)

Answer 11

1) Anatomic: Urethral prolapse, labial adhesions
2) Infectious: Enteric (Shigella) / resp pathogens
3) Tumor: Sarcoma botryoides, endodermal sinus tumor
4) Derm: Lichen atrophicus, friable warts
5) Foreign body
6) Trauma: Saddle injury / SA
7) Rare: McCune Albright (unusual presentation)