Endocrine

Question 1

Diabetes meilitus

Answer 1

AGIs

Question 2

Iodine deficiency

Answer 2

Leads to thyroid problems, goiter, cretinism and retardation

Eastern Europe, central Africa, Andes and Himalayas

Question 3

Insulins

Answer 3

Short acting lispro (humalog)

Question 4

Addison’s Disease

Answer 4

Deficient in cortisol, androgens and aldosterone

S/s hypotension and low cortisol

First line tx is PO hydrocortisone

Question 5

Cushings disease

Answer 5

Hypersecretion by pituitary gland

S/s HTN and high cortisol, central obesity, moon face and buffalo hump, striae

Diagnose c dexamethasone suppression test

Question 6

Thyroid crisis

Answer 6

Tx c Tapazole and propylthiouracil (PTU) to decrease production of thyroid hormones and propranolol to decrease HR

Question 7

DM 1
vs
DM 2

Answer 7

Antibodies against islet cells in the pancreas which contain beta cells

Occurs when individuals develop insulin resistance

Question 8

Thyroid lab values

Answer 8

Hyperthyroidism = low TSH and high free T3 and T4

Hypothyroidism = high TSH and low free T3 and T4

Question 9

Type 1 Diabetes

Answer 9

HLA-DRA 3 and 4 antigens are found in type 1

Question 10

Hyperthyroidism

Answer 10

Increased metabolism leads to increased appetite, heat intolerance, weight loss, anxiety and elevated HR

Question 11

Hypothyroidism

Answer 11

S/s lid lag (ptosis), cold intolerance, constipation, weight gain, muscle fatigue and edema of hands

Starting dose of levothyroxine (synthroid) is 25mg daily

Question 12

Somogyi effect
vs
Dawn phenomenon

Answer 12

Posthypoglycemic hyperglycemia d/t drop in BG overnight 3am followed by rebound high in the morning 9am

BG that rises throughout the night

Question 13

DKA

Answer 13

Results in body’s inability to use glucose for energy

s/s fruity breath, Kussmaul respiration a, high BG, metabolic acidosis, elevated BUN/Cr, fatty acids are broken down into keystones which are toxic to the body, lethargy, coma, death

Question 14

Metabolic syndrome

Answer 14

Group of risk factors that increase ones risk for heart disease, stroke and DM

Abdominal girth, triglycerides >150, obesity, HTN

Question 15

Hashimoto’s thyroiditis

Graves

Toxic adenoma

High dose amiodarone

Answer 15

Autoimmune hypothyroidism (most common cause)

Autoimmune hyperthyroidism (most common cause)

Can cause thyroid to excrete too much thyroid hormone leading to hyperthyroidism

Cause thyrotoxicosis and hyperthyroidism

Question 16

Hyperosmolar hyperglycemic nonketosis (HHNK)

Answer 16

BG >600 with normal pH

Question 17

Screening

Diagnosis of DM

A1c Goals

Answer 17

Screening:
OB @1st prenatal for DM and 28w for GDM
>45yo q3y unless risk factors
Any age if obese, inactivity, ethnicity, HDL <35, TG >250, HTN, relative c DM, Hx GDM or >9lbs baby, A1c >5.7, CAD

Diagnosis:
FPG (>8h) = >126
75g OGTT (2h) = >200 *OB or PCOS
A1c >6.5
Random PG >200

Treatment Goals:
A1c Goal <6.5 to <8.0
*consider CVD, hypoglycemic hx, life expectancy when setting goal

Preprandial <130

Peak postprandial >180

Question 18

Starting/Intensifying Insulin

Answer 18

Basal: A1c <8 = 0.1-0.2 U/kg
A1c >8 = 0.2-0.3 U/kg

Titrate up q2d until reach goal