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Endocrinology Fellowship > Endocrine Secrets - Top 100 Secrets > Flashcards

Endocrine Secrets - Top 100 Secrets Flashcards

1
Q

Protein kinase C activation contributes to microvascular complications in diabetes.

True or false?

A

True

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2
Q

Polyol accumulation contributes to microvascular complications in diabetes.

True or false?

A

True

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3
Q

Accrual of intracellular glucosamine contributes to microvascular complications in diabetes.

True or false?

A

True

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4
Q

Oxidative stress contributes to microvascular complications in diabetes.

True or false?

A

True

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5
Q

What is the risk of developing type 2 diabetes mellitus within 5 - 10 years if a woman is diagnosed with gestational diabetes?

A

50%

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6
Q

When is it most important to control HbA1c in the context of pregnancy?

A

Prior to pregnancy and in the first 10 weeks of pregnancy.

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7
Q

What level of triglycerides increases the risk of pancreatitis?

A

Over 1000 mg/dL

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8
Q

What level of triglycerides increases the risk of coronary artery disease?

A

Over 150 mg/dL

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9
Q

Obesity is associated with arthritis.

True or false?

A

True

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10
Q

Siburamine is FDA approved for…?

A

Weight loss

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11
Q

FRAX score with 10 year risk of hip fracture of ______ warrants treatment of osteoporosis.

A

3% or more.

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12
Q

FRAX score with 10 year risk of major osteoporotic fracture of ______ warrants treatment of osteoporosis.

A

20% or more

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13
Q

What are the two mechanisms of osteoporosis in patients treated with glucocorticoids?

A
  • Suppressed bone formation

- Enhanced bone resorption

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14
Q

Is treatment recommended in pre-menopausal women or men with 5 mg or more of prednisone (or equivalent) for 3 or more months who have a BMD T-score of less than or equal to - 1.0?

A

Yes

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15
Q

What are the three causes of osteomalacia and rickets?

A
  • Abnormal vitamin D supply, metabolism of action
  • Abnormal phosphate supply or metabolism
  • A small group of disorders in which there is normal vitamin D and mineral metabolism.
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16
Q

Abnormal bone architecture resulting from an imbalance between osteoclastic bone resorption and osteoblastic bone formation.

Name the disease.

A

Paget’s disease

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17
Q

What is the most effective treatment of Paget’s disease of bone?

A

Bisphosphonates

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18
Q

What two diagnoses account for over 90% of the cases of hypercalcemia?

A
  • Primary hyperparathyroidism

- Hypercalcemia of malignancy

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19
Q

Which two mineral metabolism conditions is cinacalcet FDA approved for?

A
  • Secondary hyperparathyroidism

- Parathyroid carcinoma

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20
Q

Does cinacalcet reduce PTH and calcium levels in primary hyperparathyroidism?

A

Yes

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21
Q

What does PTHrp do to renal calcium excretion?

A

Inhibits it/decreases it

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22
Q

What is the treatment of choice for hypocalcemia in patients with hypoparathyroidism or renal failure?

A

Calcitriol (1,25-dihydroxyvitamin D)

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23
Q

Salt intake should be limited to _______ or less to prevent kidney stones.

A

2300 mg

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24
Q

Protein intake should be limited to _______ or less to prevent kidney stones.

A

1 g/kg ideal body weight

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25
What can happen if a hypothyroid patient with coexistent primary or secondary adrenal deficiency gets levothyroxine replacement alone?
It may precipitate an acute adrenal crisis
26
Why does aldosterone deficiency not occur in hypopituitarism?
The principal physiologic regulator of aldosterone secretion is the renin-angiotensin system; and not ACTH from the hypothalamic-pituitary axis.
27
How do non-functioning pituitary tumors cause symptoms
By mass effect
28
Is a prolactin level over 200 ng/ml indicative of a prolactin-secreting tumor in late pregnancy?
No - not really. | Prolactin goes up during pregnancy.
29
Elevated prolactin can cause decreased bone mineral density. True or false?
True
30
Decreased bone mineral density secondary to elevated prolactin is always reversible. True or false?
False
31
What is the best screening test for acromegaly?
Serum IGF-1 level
32
What two diagnoses should be considered in a hyperthyroid patient with elevated TSH levels?
- TSH-oma | - Thyroid hormone resistance
33
Cushing's syndrome testing should be repeated for confirmation - true or false?
True
34
What is the most common cause of Cushing's syndrome?
Small ACTH-secreting tumor in pituitary
35
Are growth abnormalities in children more commonly due to hormonal problems or normal growth variants/chronic medical conditions?
Normal growth variants/chronic medical conditions
36
Spontaneous or easily provoked hypokalemia in a hypertensive patient. Diagnosis?
Primary hyperaldosteronism
37
What are most cases of primary hyperaldosteronism due to?
Bilateral adrenal hyperplasia
38
What is the initial screening test for primary hyperaldosteronism?
Plasma aldosterone/plasma renin activity (PA/PRA) ratio of greater than 20
39
In patients with adrenal tumors: what do high levels of urinary 17 ketosteroids, homovanillic acid, or plasma dopamine suggest?
That the tumor is malignant
40
Which intravenous fluids are recommended in adrenal crisis?
Normal saline with 5% dextrose
41
What is the inheritance pattern of congenital adrenal hyperplasia?
Autosomal recessive
42
What is the most frequent cause of congenital adrenal hyperplasia?
21-hydroxylase deficiency
43
Female with ambiguous genitalia at birth, neonatal salt-wasting, premature puberty and short stature as an adult. Diagnosis?
Congenital adrenal hyperplasia
44
Patient with weight loss, depression and heart disease (angina pectoris, atrial fibrillation, congestive heart failure). Diagnosis?
Thyrotoxicosis
45
What is done to prevent worsening of Grave's ophthalmopathy after radioactive iodine treatment?
Course of oral corticosteroids
46
What is the goal TSH for treatment of primary hypothyroidism?
0.5 - 2 mU/L
47
Mechanism of type 1 amiodarone-induced thyroid disease?
Hyperthyroidism secondary to iodine load
48
Mechanism of type 2 amiodarone-induced thyroid disease?
Destructive thyroiditis
49
Women with type 1 diabetes mellitus have a _____ greater risk of developing postpartum thyroid disorders than do non-diabetic TPO antibody positive women.
Three-fold
50
What is the accuracy of FNA in diagnosing malignancy?
90 - 95%
51
Are toxic thyroid adenomas usually cancerous?
No
52
What is the best tumor marker for differentiated thyroid cancer?
Thyroglobulin
53
Are stress glucocorticoids a part of treatment of thyroid storm?
Yes
54
What percentage of non-diabetic women get post-partum thyroiditis?
~5%
55
What percentage of women with type 1 diabetes mellitus get post-partum thyroiditis?
~25%
56
Approximately how much does the requirement for levothyroxine increase during pregnancy (especially first trimester)?
Requirements increase by 25 - 50 mcg per day
57
What percentage of patients with acute psychiatric presentations (schizophrenia and major affective disorders) have mild elevations in their serum T4 levels (and sometimes T3 levels)?
20%
58
Does central precocious puberty occur more frequently in girls or boys?
Girls
59
Do girls or boys have a higher incidence of underlying CNS pathology causing central precocious puberty?
Boys
60
Testes less than ____ are considered low volume.
20 ml
61
What is the most common manifestation of long-standing hypogonadism?
Decreased testicular volume
62
In what percentage of men can the specific cause of impotence be diagnosed?
85%
63
What are three classes of anti-hypertensives that are least likely to cause impotence?
- ACE inhibitors - Angiotensin receptor blockers - Calcium channel blockers
64
What is the most likely diagnoses if a serum testosterone is greater than 200 ng/dl or a DHEAS more than 1000 ng/ml in a hirsute patient?
Androgen producing ovarian or adrenal tumor
65
What the four most common causes for hirsutism?
- PCOS - CAH - Idiopathic/familial hirsutism - Medications
66
What are the two most common causes of virilization?
- Androgen secreting ovarian or adrenal tumors | - CAH
67
Which mutation causes MEN 1?
Inactivating mutation of the Menin tumor suppressor gene on chromosome 11
68
What is MEN1?
- Hyperplasia and/or tumors of the pituitary gland - Pancreatic islets - Parathyroid glands
69
What is MEN2A?
- Pheochromocytomas - Medullary thyroid carcinoma - Hyperparathyroidism
70
What is MEN2B?
- Pheochromocytomas - Medullary thyroid carcinoma - Mucosal neuromas
71
Which mutation causes MEN 2 syndromes?
Mutations in the Ret tumor suppressor gene
72
Is genetic testing for MEN 2 syndromes clinically available?
Yes
73
What is autoimmune polyendocrine syndrome type 1 (APS-1)?
- Hypoparathyroidism - Adrenal insufficiency - Mucocutaneous candidiasis
74
What is autoimmune polyendocrine syndrome type 2 (APS-2)?
- Hypothyroidism/hyperthyroidism - Adrenal insufficiency - Diabetes mellitus type 1
75
Insulinomas most often cause fasting hypoglycemia with neuroglycopenic symptoms. True or false?
True
76
Most patients with carcinoid syndrome have extensive _____ metastasis that either impair the metabolic clearance of mediators secreted by the primary tumor or that secrete the mediators directly into the ______ vein.
Liver | Hepatic
77
Name a type of fungi that is more common in diabetic ketoacidosis?
Mucormycosis
78
What is the most common cause of acanthosis nigricans?
Diabetes mellitus
79
What happens to bone and muscle mass with age?
Decreases
80
What happens to fat mass with age?
Increases
81
What happens to the production of growth hormone with age?
Declines in production of growth hormone
82
What happens to production of sex hormones with age?
Declines in production of sex hormones
83
What happens to cortisol secretion with age?
Increases with age

Endocrinology Fellowship (31 decks)

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