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MKSAP > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Preggo hyperthyroid

A

PTU, not methimazole

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2
Q

MEN 2A
MEN 2B
MEN 1

A

MTC, hyperpara, pheo
MTC, pheo, ganglioneuromas
MTC, hyperpara, GI tumors

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3
Q

preggo prolactinoma

A

only dangerous with expansion or hypogonadism

so formal visual field testing q trimester

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4
Q

bedtime normal glucose with morning hyperglycemia

A

obtain 3 AM glucose

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5
Q

Diagnose Cushing’s

Cushing vs ectopic ACTH

A

2 of these: 1 mg dexa suppression/ 24 hour urinary cortisol/ salivary cortisol. FYI, get screening DEXA

8mg dexa suppression test

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6
Q

switching from insulin to orals in type ii DM

A

have to ensure beta cell function and no autoimmunity

test for antibodies and fasting c peptide and glucose

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7
Q

pituitary apoplexy and vision loss

A

steroids and urgent transsphenoidal decompression

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8
Q

thyroid nodule >1 cm

A

FNA

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9
Q

surveillance post thyroidectomy

A

TSH

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10
Q

Hypercalcemia

A

severe: AMS or AKI or >18->hemodialysis, then calcitonin or IV bisphosphonate

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11
Q

PCOS vs late onset CAH

A

Elevated LH

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12
Q

Bisphosphonate drug holiday

If progressive BMD
stable BMD

A

only if stable BMD+ therapy for 3-5 years+ minimal risk factors for fractures

teriparatide
Change less than 4%

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13
Q

hyperaldosteronism due to bilateral adrenal hyperplasia

A

spirinolactone/ amiloride

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14
Q

hyperprolactinemia in setting of hypothyroidism

A

hypothyroidism causes hyperprolactinemia

treat hypothyroidism first

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15
Q

congenital bilateral absence of vas deferens causes
associated with
klinefelter

A

obstructive azospermia
cystic fibrosis
primary hypogonadism, 47XXY

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16
Q

Early morning cortisol <3

Stim test indicated only when

A

Adrenal insufficiency. period. treat

AM cortisol is 4-12 (normal is response >20)

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17
Q

PCOS infertility

A

clomiphene, then IVF

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18
Q

Microprolactinoma in asymptomatic postmenopausal woman

A

surveillance: retest in 6-12 months

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19
Q

DM neuropathy treatment

A

No TCA if cardiac disease, duloxetine instead

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20
Q 
Postprandial hypoglycemia (w/in 5 hours of meal)
symptomatic fasting hypoglycemia
A

mixed meal testing

72 hour fast, hypoglycemic testing

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21
Q

Asherman syndrome

diagnosis

A

amenorrhea+ cyclic pelvic pain post uterine instrumentation

transvag U/S, hysterosalpingogram

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22
Q

progestin withdrawal test

A

differentiates b/w estrogen sufficient (bleeding) and deficient (no bleeding) states

23
Q

at goal preprandial glucose with hgbA1c not at goal

A

check postprandial

24
Q

Hyperaldosteronism screening

A

plasma aldosterone-renin ratio

25
Q

substernal goiter with compressive features

A

thyroidectomy

26
Q

pheo imaging

A

alpha blockade before contrast, beta blockade after if needed

27
Q

secondary hypothyroidism treatment dose

A

based on free T4, not TSH

28
Q

2 discrepant DM screening tests

A

repeat abnormal test

29
Q

> 80 yo, normal TSH

A

up to 8

30
Q

Primary hyperpara+ vitamin d def

If symptomatic primary hyperpara and kidney involvement

A

treat def as it can elevate pth

cinacalcet

31
Q

Osteoporosis

A

Major osteoporotic fracture risk 20% or 3% at hip

32
Q

Osteoporosis

A

Major osteoporotic fracture risk 20% or 3% at hip

33
Q

Inpatient insulin

A

weight based basal and preprandial, not SSI

34
Q

incidentaloma

A

check metanephrines and cortisol

if hypertensive, also check aldosterone

35
Q

Significantly elevated DHEAS

A

adrenal androgen producing tumor

36
Q

hypoparathyroidism vitamins

if urinary calcium is elevated
if urinary and serum (>8.5) calcium elevated

A

25 hydroxy+PTH->1,25 hydroxy->calcium. give calcium and 1,25 hydroxy
decrease calcium
decrease calcium and vitamin d

37
Q

erratic preprandial only glucose levels

A

timing of insulin

38
Q

preggo TSH

A

should be below 2.5

39
Q

Before treating newly diagnosed osteoporosis

A

look for secondary causes:

CBC, CMP, TSH, Vitamin D, urine calcium

40
Q

hypocalcemia electrolyte cause

A

hypomagnesemia (impairs PTH activity), replete mag first

41
Q

pseudohypercalcemia

A

elevated calcium in setting of elevated protein. check ionized calcium

42
Q

pseudohypercalcemia

A

elevated calcium in setting of elevated protein. check ionized calcium

43
Q

before starting testosterone

A

assess for desire for fertility-testosterone can cause infertility. Give HCG instead

44
Q

tissue transglutaminase antibody

A

celiac

45
Q

thyroid stimulating immunoglobulins

A

graves disease

46
Q

hyperparathyroidism surgery

A

impaired kidney function/ <50yr/ Ca >1 ULN/ osteoporosis

secondary hyperpara that is refractory to meds

47
Q

Toxic nodule

Cold nodule

A

scan before treatment

FNA

48
Q

Invasive macroprolactinoma treatment

A

still cabergoline

only surgery if visual field defects on exam

49
Q

sulfonylurea+ dehydration

A

hypoglycemia ->AMS

50
Q

thyrotoxicosis labs

A

t3 in addition

51
Q

high calcium, low PTH (non PTH mediated hypercalcemia)

A

cancer or granulomas

52
Q

Cushing not just cortisol but also

A

excessive androgens

53
Q

euthyroid sick syndrome

A

low everythang

MKSAP (6 decks)

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