Endocrine Flashcards
What test is best to order in a man with suspected hypogonadism?
Total testosterone (free testosterone is expensive to order)
What test is useful for diagnosing primary hyperaldosteronism?
A morning aldosterone/renin ratio. A ratio >20 with an aldosterone level of >15 ng/dL is highly suggestive.
What is the hallmark electrolyte abnormality seen in refeeding syndrome?
Hypophosphatemia
In critically ill patients (e.g. sepsis) who have hyperglycemia, even if no history of DM, what is the target blood glucose?
The American Association of Clinical Endocrinologists and the American Diabetes Association recommend insulin infusion with a target glucose level of 140–180 mg/dL in critically ill patients. Tighter control is not associated with better outcomes. Regulated through insulin infusions
What facial gland is often enlarged in DM?
Parotid gland (non-painful)
Does tight glycemic control help prevent cardiovascular disease in type 1 diabetes, type 2 diabetes, or both?
Intensive management of hyperglycemia has a beneficial effect on cardiovascular disease in patients with type 1 diabetes mellitus but, unfortunately, not in patients with type 2 diabetes mellitus.
What is the biochemical pattern of primary hyperparathyroidism?
Parathyroid hormone is elevated and serum chloride tends to be high normal or mildly elevated. Alkaline phosphatase may be elevated in more severe cases, while serum phosphate levels tend to be low.
What Grave’s disease treatment may make exophthalmos worse?
Radioactive iodine therapy
How is hyperaldosteronism diagnosed?
With a morning serum aldosterone to renin ratio. A ratio <20 rules it out, while a ratio >20 plus an aldosterone level >15 ng/dL suggests hyperaldosteronism. A salt suppression test must be done for confirmation.
What is the initial treatment for SIADH (patient may present with euvolemic hyponatremia)?
Water restriction. If they cannot tolerate that, demeclocycline (Declomycin) may be tried. In patients with rapid onset and neurologic symptoms such as seizures, hypertonic saline could be given.
What are the screening guidelines for DM?
Testing for diabetes mellitus should be considered in all asymptomatic adults who have a BMI ≥25 kg/m2 and have one or more additional risk factors such as physical inactivity, a first degree relative with diabetes, a high-risk ethnicity, hypertension, hyperlipidemia, or polycystic ovary syndrome. In asymptomatic patients with no risk factors, screening should begin at age 45.
What is the most significant factor for prediction of severe hypoglycemic episodes in a patient with type 2 DM?
In patients with type 2 diabetes mellitus, the single most important predictor of severe hypoglycemia is a previous history of severe hypoglycemia that required external assistance. It is thought that hypoglycemia reduces the body’s protective responses (glucagon and epinephrine) to subsequent episodes of hypoglycemia.
What sized “cold” thyroid nodule requires further work-up with FNA following US?
> 1 cm. Smaller nodules should be followed.
