Endocrine

Question 1

What are the most common side effects associated with starting metformin?

Answer 1

• Diarrhea
• Nausea
• Metalic Taste
• Anorexia

Question 2

A 24-year-old man with type 1 diabetes presents to the clinic, brought by a friend, and is feeling clammy, sweaty, and dizzy. He looks confused but is speaking full sentences. A rapid random blood glucose is completed and is 48 mg/dL. Which of the following is the best intervention at this time?

A. Administer intranasal glucagon
B. Begin normal saline intravenously
C. Inject subcutaneous insulin
D. Provide an oral fast-acting carbohydrate load

Answer 2

Provide an oral fast-acting carbohydrate load

Question 3

What is the dopamine agonist of choice used to treat acromegaly that persists after surgical resection?

What is the single best test to diagnose acromegly?

Answer 3

Cabergoline

Aerum IGF-1; An unequivocal rise in IGF-1 confirms the diagnosis

Question 4

A 45-year-old man presents with increasing glove and shoe sizes. A physical exam reveals macrognathia, doughy hands, and macroglossia. Laboratory studies demonstrate an equivocal serum level of insulin-like growth factor 1. Which of the following is the next step in diagnosis?

A) MRI of the brain
B) Oral glucose suppression test
C) Random serum growth hormone measurement
D) Serum insulin-like growth factor 1 binding protein 3 measuremen

Answer 4

Oral glucose suppression test

Once a positive IGF-1 is received, this confirms diagnosis of acromegly. Next step is to order a glucose suppression test. Serum growth hormone is measured before and two hours after the ingestion of 75 g glucose.