Endocrine

Question 1

triad of insulinomas?
3 lab values?
test to confirm diagnosis?

Answer 1

symptoms of hypoglycemia, measured hypoglycemia, symptoms relived by giving glucose
hypoglycemia, elevated insulin and c peptide
insulin still elevated after 72 hour fast

Question 2

3 classic lab values associated with hypoparathyroidism?

Answer 2

low calcium, high phosphate and low pth

Question 3

two step process to diagnose thyroid nodules?

Answer 3

US THEN radio uptake

Question 4

TSH stimulates TSH and what other hormone?

Answer 4

prolactin

Question 5

If GISTs are c kit mutation what is the chemo drug of choice and why?

Answer 5

imatinib because it is a tyrosine kinase muation

Question 6

If I see a patient with chronic kidney disease and a case with a fracture what I am thinking?

Answer 6

because of the kidney disease, high PTH goes and breaks up the bone.

Question 7

What med to use to treat graves in pregnancy?

Answer 7

PTU

Question 8

big differentiator between hypothyroidism and depression?

Answer 8

depression you tend to lose weight and hypo you gain

Question 9

what is the 3 step process in the diagnosis of primary hyper aldosterone?

Answer 9

first measure the plasma aldosterone to plasma renin activity, if it is greater than 20 do a sodium loading test. if the sodium does not lower the aldosterone to lower than 10, they have primary and do a CT to see if it is adenoma or hyperplasia.

Question 10

how do we manage lobular carcinoma of the breast?

Answer 10

excisional biopsy to rule out DCIS

Question 11

10% rule for pheo?

Answer 11

10% recur, familial, bilateral, extra adrenal, malignant, and in children

Question 12

most common thyroid cancer and what will be in the vinette?

Answer 12

papillary

radiation exposure

Question 13

before surgical resetion of parathyroid adenoma, what do we use to localize it?

Answer 13

sestambi scan

Question 14

How to treat primary adrenal insufficiency?

secondary and tertiary?

Answer 14

gluco and fludro or hydro

just gluco

Question 15

3 symptoms of high calcium crisis to remember?

how to treat?

Answer 15

NV, fatigue and confusion

saline to flush it out, loops, maybe calcitonin after

Question 16

which htn drug is good for older pts with osteoporosis and why?

Answer 16

thiazides because they hold on to calcium

Question 17

diagnostic choice for gastric cancer?

two countries to always remember about gastric cancer?

Answer 17

endoscopy

japan and korea

Question 18

mom presents for 6 week post partum appointment and has all signs of hyperthyroidism? how do we go about managing it and why is it happening?

Answer 18

postpartum thyroiditis. It is a spontaneous autoimmune disease. beta blockers

Question 19

If I have a patient where I am suspecting thyroid cancer and the calcitonin is elevated, what type of cancer am I thinking and why?

Answer 19

medullary thyroid cancer because this type of cancer originates from the parafollicular cells which produce calcitonin

Question 20

what is the initial and confirming test for acromegaly?

Answer 20

first check Insulin like growth factor level

if that is up, confirm with GH suppression test

Question 21

first line treatment for acromegaly?

When to use ocreatide

Answer 21

transphenoidal resection

not good surgery candidates or have symptoms after resection

Question 22

which thyroiditis usually comes on after a viral or flu like illness?
what will iodine uptake show and why?
how to treat?

Answer 22

de quervain thyroiditis
decreased uptake because the excess hormone released is just stored hormone
NSAIDS

Question 23

besides SCC of lung causing PTRP hormone what other cancer does this?

Answer 23

breast

Question 24

What is the phenomenon in the morning causing hyperglycemia and why?

Answer 24

dawn phenom because early morning growth hormone secretion anti insulin