Endocrine

Question 1

The SIGMA trial stated what?

Answer 1

In asthma, patients that used budesonide-formoterol as needed was non-inferior to BID budesonide with severe asthma exacerbations but was inferior to controlling symptoms. Not to mention, the budesonide-formoterol had 1/4 fewer steroid exposure episodes

Question 2

The FRAME trial showed what?

Answer 2

Romosozumab was associated with a lower risk of vertebral fracture that placebo at 12 months and with transition to denosumab at 24 months. Clinical fracture risk is decrease at 1 year with Romosozumab.

Question 3

What is the mechanism of action of Romosozumab?

Answer 3

Targets and inhibits the protein sclerostin, preventing the inhibition of bone formation. This allows the WNT messenger to bind to LDL receptor related proteins.

Question 4

What is the mechanism of action of denosumab?

Answer 4

Prevents RankL from activating its receptor RANK on the surface of osteoclasts and their precursors, this prevents the activation of osteoclasts and decreases bone breakdown

Question 5

What is the preferred drug of choice for Myasthenia Gravis?

Answer 5

Pyridostigmine

Question 6

If there is an insulinoma concern, what is the first to order?

Answer 6

72 hour fast, watch blood sugar

Question 7

Symptomatic Management of an insulinoma, what is a good medication to give, new?

Answer 7

Diazoxide

Side Effects are Hirsutism and Fluid retention

Question 8

Large amount of Diarrhea, hypokalemia, hypercalcemia, hyperglycemia, non-anion gap metabolic acidosis, and a low calculated stool osmotic gap, what is this sounding like?

Answer 8

VIPoma

Question 9

Graves disease and pregnancy, what should be done?

1st Trimester?

2nd and 3rd trimester?

Answer 9

1st Trimester: PTU

2nd and 3rd trimester: Methimazole

Question 10

When a patient has a high risk thyroid cancer/thyroid removed, what should be done regarding the replacement hormone?

Answer 10

Start levothyroxine to suppress TSH be less than 0.1 uU/L

Question 11

Why would a thyroglobulin level be measured?

Answer 11

Ensure that thyroid tissue is no longer functioning and gone, do not check until after 25 days, half life is a long time

Question 12

Thyroid storm occurs, what thionamide should be started?

Answer 12

PTU or Methimazole

Question 13

What is the mechanism of action via Methimazole?

Answer 13

inhibits synthesis of thyroxine and triiodothyroine by blocking the oxidation of iodine in the thyroid gland

Question 14

Patient has severe autoimmune conditions, rash, Raynaud’s Disease and such. What is this? What is the autoantibody disease name?

Answer 14

Mixed Connective Tissue Disease

Anti-U1 Ribonucleoprotein