Endocrine

Question 1

Gold standard for diagnosing DM2

Answer 1

Oral glucose tolerance test

vs. screening tests like HbA1c or fasting glucose

Question 2

MEN1

Answer 2

1) Primary parathyroidism
2) Pituitary tumors (prolactinomas)
3) Pancreatic tumors (gastrinomas)

Question 3

MEN2a

Answer 3

1) Medullary thyroid (calcitonin)
2) Pheochromocytoma
3) Parathyroid hyperplasia

Question 4

MEN2b

Answer 4

1) Medullary thyroid (calcitonin)
2) Pheochromocytoma
3) Mucosal neuromas

Question 5

Papillary thyroid cancer

Answer 5

1 most common

Lymph node involvement and local tissue spread
Psammoma body present

Question 6

Follicular thyroid cancer

Answer 6

#2 most common (after papillary)
Hematogenous spread (no lymphadenopathy)
Hurthle cells present but not specific (could be benign)

Question 7

Serum osmolality

Answer 7

2x sodium + glucose/18

Question 8

Serum corrected sodium in hyperglycemia

Answer 8

Measured sodium + 2 for each 100 glucose over 100

Question 9

Graves’ disease ophthalmopathy

Answer 9

Caused by thyrotropin receptor antibodies on fibroblasts and adipocytes

Can be worsened with radioactive iodine ablation

Question 10

Dawn phenomenon

Answer 10

elevated morning fasting glucose due to increased GH and cortisol

Question 11

Potassium management in DKA

Answer 11

Add K if under 5.2

Hold insulin if under 3.3

Question 12

DKA management

Answer 12

High low NS -> switch to D5NS when glucose under 200
IV insulin -> switch to SQ when PO, glucose <200, gap <12, HCO3>15
Bicarb for pH <6.9

Question 13

Diabetic retinopathy complication

Answer 13

vitreous hemorrhage

Question 14

Patient with TB with low BP?

Answer 14

TB primary adrenal insufficiency

Results in normal anion gap metabolic acidosis