Endocrine

Question 1

What is normal TSH?

Answer 1

0.4-4

Question 2

What is normal T4?

Answer 2

4.5-11.2

Question 3

High TSH and low T4 indicates what?

Answer 3

Hypothyroid

Question 4

How is hypothyroid treated?

Answer 4

Levothyroxine

Question 5

What are two most common causes of hypothyroid?

Answer 5

Low iodine intake and Hashimoto’s

Question 6

What drug is given for symptom relief of hyperthyroid?

Answer 6

Beta blockers

Question 7

Radioactive iodine is given for hyper or hypothyroid?

Answer 7

Hyperthyroid

Question 8

Myxedema coma is severe what?

Answer 8

Hypothyroidism

Question 9

Myxedema coma will have what on CBC?

Answer 9

Normal WBC with increased bands

Question 10

Levothyroxine is what?

Answer 10

T4

Question 11

With what drug and dose is myxedema coma treated?

Answer 11

500-800 mcg Levothyroxine IV

Question 12

Low TSH and high T4 indicate what?

Answer 12

Hyperthyroid

Question 13

Thyroid crisis is a complication of what?

Answer 13

Hyperthyroid

Question 14

What does CBC look like in thyroid crisis?

Answer 14

May be mildly elevated

Question 15

What kind of fluid to give for thyroid crisis?

Answer 15

Dextrose

Question 16

Should a pt with thyroid crisis be cooled?

Answer 16

Yes

Question 17

What is the first med given for thyroid crisis?

Answer 17

Propranolol

Question 18

Glucocorticoids can be given for what thyroid complication?

Answer 18

Thyroid crisis

Question 19

What is Cushing’s syndrome?

Answer 19

A set of symptoms that result from excess exposure to cortisol

Question 20

What is Cushing’s disease?

Answer 20

Excess cortisol production from adrenal tumor

Question 21

Is Cushing’s syndrome more often exogenous or endogenous?

Answer 21

Exogenous

Question 22

Cushing’s causes what labs abnormalities?

Answer 22

Hypernatremia and hypokalemia

Question 23

What should you do if you suspect Cushing’s?

Answer 23

Consult endocrine

Question 24

Is Cushing’s an emergency?

Answer 24

No

Question 25

How do you work up Cushing's?

Answer 25

24 hour urine collection and low dose dexamethasone ACTH suppression test

Question 26

How to treat exogenously caused Cushing's?

Answer 26

Stop giving steroids

Question 27

How to treat endogenously caused Cushing's?

Answer 27

Locate and resect tumor

Question 28

Pasireotide treats what?

Answer 28

Endogenous Cushing's

Question 29

What is adrenal insufficiency?

Answer 29

Low cortisol output

Question 30

What is Addison's?

Answer 30

Failure of the adrenal gland

Question 31

What is secondary adrenal insufficiency?

Answer 31

Failure to produce ACTH

Question 32

What labs are seen in Addison's?

Answer 32

Hyponatremia and hyperkalemia

Question 33

How to diagnose acute adrenal insufficiency?

Answer 33

Send random cortisol level

Question 34

Random cortisol level above what excludes acute adrenal insufficiency?

Answer 34

18

Question 35

ACTH stress test failing to reach what level at any time of day indicates adrenal insufficiency?

Answer 35

18

Question 36

ACTH stress test failing to rise by what in the morning indicates adrenal insufficiency?

Answer 36

9

Question 37

Primary AI is treated how?

Answer 37

Glucocorticoids and mineralocorticoid

Question 38

Secondary AI is treated how?

Answer 38

Only glucocorticoids

Question 39

What is a pheochromocytoma?

Answer 39

A catecholamine secreting tumor

Question 40

What is typical age of onset of pheochromocytoma?

Answer 40

20-50

Question 41

You should have 3 of what 4 symptoms to suspect pheochromocytoma?

Answer 41

Headache, diaphoresis, hypertension, palpitations

Question 42

What imaging is used to diagnose pheochromocytoma d?

Answer 42

CT abdomen or MRI

Question 43

What labs are used to diagnose pheochromocytoma?

Answer 43

Plasma free metanephrines / urine fractionated metanephrines

Question 44

When do you use imaging to diagnose pheochromocytoma?

Answer 44

If labs come back positive

Question 45

If you see a tumor on CT/MRI when attempting to find a pheochromocytoma what is the next step?

Answer 45

MIBG

Question 46

What two meds to use to treat pheochromocytoma?

Answer 46

Phenoxybenzamine and metoprolol

Question 47

Besides meds, how else do you treat pheochromocytoma?

Answer 47

Surgical resection

Question 48

What is diabetes insipidus defined as?

Answer 48

Polyuria with greater than 3L urine output

Question 49

What occurs in central DI?

Answer 49

Inability to make ADH

Question 50

What occurs in nephrogenic DI?

Answer 50

Inability of the kidneys to react to ADH

Question 51

What occurs in psychogenic DI?

Answer 51

Increased water intake 2/2 psychiatric issues

Question 52

How to treat central DI?

Answer 52

Desmopressin IV

Question 53

What is the apparent fluid status of SIADH on physical exam?

Answer 53

Euvolemic

Question 54

Do patients with SIADH usually have peripheral edema?

Answer 54

No

Question 55

What is serum os in SIADH?

Answer 55

Hypoosomolar

Question 56

What is urine sodium in SIADH?

Answer 56

Normal to high

Question 57

What is urine os in SIADH?

Answer 57

High

Question 58

How do you treat SIADH if they are very symptomatic?

Answer 58

HTS

Question 59

Non-emergent SIADH should have a water restriction of how much?

Answer 59

500mL- 1.5L per day