Endocrine

Question 1

when and why do you stop metformin

Answer 1

48 hours before angiography
imaging w/ contrast
lactic acidosis
Cr > 1.5 males or > 1.4 females

Question 2

ADR of pioglitazone

Answer 2

fluid retention

Question 3

Defn of subclinical hypothyroidism

Answer 3

incr TSH
NL T3 or T4
no sxs

Question 4

incr TSH
NL T3 or T4
no sxs

Answer 4

subclinical hypothyroidism

Question 5

med that decr insulin resistance

Answer 5

thiazolidinediones (ex: pioglitazone (Actos))

Question 6

DM med safe in CKD

Answer 6

glipizide

Question 7

CI to thiazolidinedines (pioglitazone)

Answer 7

heart failure
T1DM
liver dz
premenopausal anovulatory female

Question 8

DM med that decr weight

Answer 8

exenatide (byetta)

Question 9

inpt glucose target

Answer 9

140-180

Question 10

how to differentiate hyperparathyroidism w/ familial hypocalciuric hypercalcemia

Answer 10

24 hour urine CA (incr or NL in elevated PTH, decr in FHH)

Question 11

best test to r/o adrenal insufficiency

Answer 11

AM cortisol, R/O if >13

Question 12

painful thyroid gland, hyperthyroid, incr ESR

Answer 12

subacute thyroiditis

Question 13

tx of subacute throiditis

Answer 13

prednisone

Question 14

when to screen DM

Answer 14

age 45, every 3 yrs OR BMI >25 w/ risk factor

Question 15

can’t use eventide (Byetta) when

Answer 15

Cr Cl

Question 16

rough estimates of blood glucose w/ A1c

Answer 16

6.0 = 120

incr 1 = incr 30

Question 17

Tx of hirsutism

Answer 17

spironolactone

OCPs

Question 18

what meds stimulate pancreatic insulin secretion

Answer 18

sulfonylureas (glipizide)

Question 19

TSH receptor immunoglobulins, dx..

Answer 19

Graves disease

Question 20

TSH receptor blocking antibodies

Answer 20

Hashimoto’s thyroiditis

Question 21

pt 65+ with low TSH (physiologic hyperthyroidism) at risk for

Answer 21

hip fractures

Question 22

newly diagnosed diabetics should be vaccinated for

Answer 22

Hep B

Question 23

what to monitor if giving testosterone supplementation

Answer 23

Hct monitored every 6 months for first 18 months, then annually
D/C if Hct incr 50%

Question 24

diabetic foot ulcer. Evaluate osteomyelitis w/

Answer 24

MRI

Question 25

MOA metformin

Answer 25

inhibits gluconeogenesis in liver

Question 26

indications for parathyroidectomy

Answer 26

patient > 50 yrs old or | patient with symptomatic hyperparathyroidism (fracture)

Question 27

which med is preferred to treat hyperthyroidism and why

Answer 27

methimazole (PTU can cause severe hepatocellular damage)

Question 28

meds most likely to cause hypoglycemia

Answer 28

sulfonylureas (glyburide more than glipizide)

Question 29

dx primary hyperaldosteronism

Answer 29

plasma aldosterone to renin ratio

Question 30

patients w/ T1DM should be screened for

Answer 30

``` hypothyroidism celiac disease nephropathy hypertension retinopathy ```

Question 31

tx adrenal crisis

Answer 31

IV hydrocortisone

Question 32

A1c goal for end stage chronic illnesses

Question 33

elevated prolactin, next step

Answer 33

MRI pituitary

Question 34

management of thyroid nodules

Answer 34

TSH low TSH: radionuclide scan high or normal TSH: FU if 1 cm