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AGACNP Exam > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What is found in 80% of pts with DMI?

A

Antibodies against GAD-65

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2
Q

Ketone development is seen in which type of DM?

A

Type I

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3
Q

A serum fasting (at least 8 hours) blood glucose of what or above on more than one occasion is diagnostic for DM?

A

126

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4
Q

An A1C of what or above is diagnostic for DM?

A

6.5%

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5
Q

What is the optimal insulin regimen?

A

A basal insulin plus a mealtime bolus of rapid or short acting insulin

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6
Q

What occurs with the Somogyi effect?

A

The pt will be hypoglycemic at 3am but have rebound hyperglycemia at 7am

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7
Q

How do you treat the Somogyi effect?

A

Reduce or omit bedtime dose of insulin

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8
Q

What occurs with the Dawn phenomenon?

A

Blood glucose becomes progressively elevated throughout the night, with resulting elevated BS at 7am

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9
Q

How do you prevent Dawn phenomenon?

A

Add or increase bedtime dose of insulin

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10
Q

What are the three components of Syndrome X?

A

Obesity, HTN and abnormal lipid profiles

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11
Q

Waist circumference is equal to or above what in metabolic syndrome?

A

Above 40 inches in men and above 35 inches in women

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12
Q

BP is above or equal to what in metabolic syndrome?

A

Above 135/85

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13
Q

Triglycerides are equal to or above what in metabolic syndrome?

A

150

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14
Q

Fasting BG is equal to or above what in metabolic syndrome?

A

100

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15
Q

HDL is below what in metabolic syndrome?

A

Below 40 in men and below 50 in women

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16
Q

Will you see ketones in the blood or urine in DMII?

A

No

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17
Q

What is the starter drug of choice in DMII?

A

Metformin

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18
Q

What is the major potential complication of metformin?

A

Lactic acidosis

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19
Q

What is the second line therapy class of drugs for DMII?

A

GLP-1 agonist

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20
Q

What are two potential complications of GLP-1 agonists?

A

Thyroid CA and pancreatitis

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21
Q

What is the dosing for insulin for DKA?

A

0.1 units/kg as a bolus followed by 0.1 units/kg/hr drip

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22
Q

What is the most common presentation of hyperthyroidism?

A

Grave’s disease

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23
Q

In a hyperthyroid pt, what happens to TSH and T3?

A

TSH is low and T3 is high

24
Q

What med is given for symptomatic management in hyperthyroid?

A

Propranalol

25
Q

What is the most common cause of hypothyroidism?

A

Hashimoto’s

26
Q

What thyroid labs are seen in hypothyroidism?

A

Elevated TSH and low T4

27
Q

What symptom may occur when starting synthroid?

A

Hair loss

28
Q

What should you avoid in thyroid crisis?

A

Aspirin

29
Q

What is Cushing’s?

A

ACTH hypersecretion

30
Q

What happens to BP in Cushing’s?

A

Will be elevated

31
Q

What happens to the distribution of fat in Cushing’s?

A

Moves from the extremities to a more central distribution

32
Q

What are three major electrolyte disturbances in Cushing’s?

A

Hyperglycemia, hypernatremia, hypokalemia

33
Q

What is Addison’s disease a deficiency of?

A

Cortisol, androgens and aldosterone

34
Q

How is Addison’s managed?

A

With glucocoticoid and mineralocorticoid replacement

35
Q

What three lab abnormalities are seen in Addison’s?

A

Hypoglycemia, hyponatremia, hyperkalemia

36
Q

What is a cosyntropin stimulation test used to rule out?

A

Addison’s disease

37
Q

What does SIADH cause?

A

Inappropriate water retention

38
Q

Neuro changes in SIADH are 2/2 what?

A

Hyponatremia

39
Q

What will pt with SIADH’s fluid status be?

A

Euvolemic

40
Q

What is serum os in SIADH?

A

<280

41
Q

What is urine os in SIADH?

A

> 100

42
Q

What is urine sodium in SIADH?

A

> 20 mEq/L

43
Q

How to manage SIADH if serum Na+ > 120?

A

Restrict total fluids to 1L/ 24 hours

44
Q

How to manage SIADH if serum Na+ 110-120 w/o neuro changes?

A

Restrict total fluids to 500mL/ 24 hours

45
Q

How to manage SIADH if serum Na+ <110 or neuro sx are present?

A

Replace with isotonic or hypertonic saline and Lasix

46
Q

What is diabetes insipidus?

A

Inadequate output of or kidney response to ADH

47
Q

Difference between SIADH and DI?

A

SIADH=too much ADH; DI=not enough ADH

48
Q

What are the main sx of DI?

A

Water craving and polyuria

49
Q

What happens to sodium in DI?

A

Will see hypernatremia

50
Q

What is a normal BUN?

A

10-20

51
Q

What is a normal Cr?

A

0.5-1.5

52
Q

What is normal urine specific gravity?

A

1.010-1.03

53
Q

What is used to treat acute DI?

A

DDAVP

54
Q

For a pt being discharged with DI, what is the maintenance dose of DDAVP?

A

10 ug q 12-24 hours IN

55
Q

What four things are on a urine assay test for pheochromocytoma?

A

Urine catecholamines, metanephrines, VMA and creatinine

56
Q

How do you confirm diagnosis of a pheochromocytoma?

A

CT scan

57
Q

What should you watch for after removal of a pheochromocytoma?

A

Hypotension

AGACNP Exam (14 decks)

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