Endocrine Disorders

Question 1

ADA screening recommendations for dm

Answer 1

annual if bmi >25 and one/more risk factors for dm
every 3 yrs otherwise

Question 2

prediabetes values

Answer 2

hga1c- 5.7-6.4%
FPG- 100-125
OGTT- 140-199

Question 3

types ii dm values

Answer 3

hga1c- >6.5%
fpg- >126
ogtt- >200
random glucose with symptoms- >200

Question 4

hga1c suggested goals

Answer 4

most adults- <7%
healthy older adults- <7.5%

Question 5

physical exam monitoring for dm type ii

Answer 5

foot exam every 3 months
eye exam annually

Question 6

recommendations for frequency of a1c testing in type ii dm

Answer 6

every 3 months if not at goal
otherwise every 6 months

Question 7

biguanide example

Answer 7

metformin

Question 8

sulfonylurea 2nd examples

Answer 8

glimepiride
glipzide
glyburide

Question 9

meglitinides med example

Answer 9

repglinide
nateglinide

Question 10

dpp-4 inhibit med examples

Answer 10

alogliptin
linagliptin
saxagliptin
sitagliptin

Question 11

glp-1 med examples

Answer 11

exenatide
liraglutide
dulaglutide
semaglutide

Question 12

tzd med examples

Answer 12

pioglitazone
rosiglitazone

Question 13

sglt2 med examples

Answer 13

canaglifozin
dapaglifozin
empaglifozin
ertuglifolozin

Question 14

sulfonylurea MOA and SE

Answer 14

potentiates insulin secretion
hypoglycemia, weight gain

Question 15

dpp-4 moa and se

Answer 15

slows inactivation of incretin
“gliptins”, don’t use initially

Question 16

glp-1 moa and se

Answer 16

increases synthesis of insulin in response to BG rise
no hypoglycemia, weight loss

Question 17

tzd moa and se

Answer 17

improves insulin sensitivity
NOT for HF, increased risk of fracture

Question 18

SGLT-2 inhibitor MOA and SE

Answer 18

prevents reabsorption of renal glucose
UTI, yeast infection

Question 19

pt with hx of heart failure- dm med rec?

Answer 19

sglt2

Question 20

initiation of basal insulin

Answer 20

start at 0.1-0.2 u/kg or 10 units
adjust by 2-4 units once-twice weekly to reach FBG goal

Question 21

most sensitive measure of thyroid disease

Answer 21

tsh
produced by anterior pituitary

Question 22

primary hypothyroidism labs

Answer 22

TSH: high
T4: low
T3: normal

Question 23

subclinical hypothyroidism labs:

Answer 23

TSH: high
T4: normal
T3: normal

Question 24

primary hyperthyroidism labs

Answer 24

TSH: low
T4: high
T3: normal/elevated

Question 25

most common cause of hypothyroidism

Answer 25

hashimoto’s thyroiditis

Question 26

subclinical hypothyroidism tx

Answer 26

treat if TSH>10

Question 27

levothyroxine replacement dose if young

Answer 27

1.6 mcg/kg/day

Question 28

levothyroxine replacement dose if middle age

Answer 28

50 mcg

Question 29

older adult levothryoxine replacement

Answer 29

25mcg

Question 30

recheck TSH how long after replacement starts

Answer 30

4-6 weeks

Question 31

metformin contra if

Answer 31

decreased GFR
elevated ALT, AST

Question 32

fasting blood glucose goal diabetes

Answer 32

80-130

Question 33

older adult fasting blood glucose goal

Answer 33

90-130

Question 34

postprandial glucose goal

Answer 34

<180