ENDO2015 Flashcards
When treating menopause - do studies show estrogen alone is more dangerous in older women than combined estrogen + progesterone therapy (for cardiovascular end-point)?
No conclusive evidence.
When treating menopause - do studies show that estrogen + progesterone is safer in younger women (from cardiovascular end point)?
Yes
When converting patient from U-100 to U-500 what should you do to the total daily dose if the HbA1c is high-ish (8 - 10%)?
Keep the same dose.
When converting U-100 to U-500 in a patient with a normal/controlled HbA1c what should you do to the total daily dose?
Decrease it by 10 - 20%
How many shots of U-500 should be given if total daily dose is under 300 units?
Two (BID)
How many shots of U-500 should be given if total daily dose is 300 - 600 units?
Three (TID)
How many shots of U-500 should be given if total daily dose is over 600 units?
Four (QID)
Do patients with ESRD have a risk reduction for cardiovascular disease when a statin is started?
No
No benefit at all of cardiovascular benefit
Do patients after kidney transplant benefit (from cardiovascular risk point of view) from statins?
Yes
Is there an increase in harm from using statins in ESRD patients?
No
Is the cardiovascular risk reduction in early stage CKD patients or renal transplant patients less than or equal to risk reduction in non-renal patients?
Risk reduction is the same.
Why is PSA monitored when patients are put on testosterone therapy?
Because of the theoretical risk that an occult prostate cancer will be exacerbated.
(Levels fluctuate with therapy)
What is the average fluctuation of PSA values in people not on testosterone therapy?
1.4 ng/dL
So a rise more than 1.4 ng/dL warrants a urology referral
Which PSA levels are followed per endocrine guidelines?
Total or total/free PSA levels
Total PSA values
Which antibodies should be tested for to see if a patient have primary ovarian insufficiency?
Adrenal antibodies (ovarian antibodies are not specific)
Is degree of thyroid auto-immunity correlated with ovarian auto-immunity?
No
Does pituitary resistance to thyroid hormone usually develop during childhood or adulthood?
Childhood
Steroid treatment after radioactive iodine treatment for Grave’s disease with ophthalmopathy.
Dose and duration?
Prednisolone 15 - 40 mg for 6 weeks to 2 months
Who produces more growth hormone: pre-menopausal women, post-menopausal women or men?
Pre-menopausal women
Are growth hormone requirements higher in patients taking transdermal or oral estrogen?
Oral estrogen
What does growth hormone do to cortisol levels?
Decreases it.
What does growth hormone do to free T4 levels?
Decreases them
What does estrogen do to IGF-1 levels?
Decreases it.
Adrenal mass with Hounsfield units of less than -30 (pure fat).
Diagnosis?
Myelolipoma
What are the Hounsfield units of an adrenal cyst?
10 - 20 units
Is MIBG taken up by normal adrenals?
Yes - especially the left adrenal gland
What happens to bone density after bariatric surgery?
It decreases
Should you start a bisphosphonate in the setting of a low calcium intake?
No
Are oral bisphosphonates a good idea after bariatric surgery?
No - they can pre-dispose to ulcers.
Is the ratio of LH/FSH high or low in hypothalamic amenorrhea?
Low
The LH is usually low-normal to low; and is usually not higher than the FSH
Do you do FNA biopsy of nodule you suspect to be parathyroid carcinoma?
No
Contra-indicated because of cutaneous spread
Does adjuvant chemotherapy work in parathyroid carcinoma?
No
Is it a good idea to treat someone on aromatase inhibitors for breast cancer with tamoxifen?
No studies have been done so there is no evidence to prove that it is.
What happens to thyroglobulin antibodies after radioactive iodine treatment?
Usually goes up.
At what dose of grapefruit juice do statin doses need to be reduced?
750 mL/day or more
high dose grapefruit juice - one glass would contain 250 - 300 mL of grapefruit juice
Which three statins need to have doses reductions with high dose grapefruit/grapefruit juice?
- Atorvastatin
- Simvastatin
- Lovastatin
Approximately how many mL is a grapefruit?
~ 800 mL
What kidney stones are you likely to get after Roux-en-Y surgery?
Calcium oxalate stones
What abnormality can be seen on pituitary MRI in diabetes insipidus?
Thickened pituitary stalk
What is the most common endocrinology abnormality in pituitary metastasis?
Diabetes insipidus
Can subclinical hyperthyroidism cause atrial fibrillation?
Yes
Does warfarin cause decreased BMD?
No
