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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
Q

What can happen if a hypothyroid patient with coexistent primary or secondary adrenal deficiency gets levothyroxine replacement alone?

A

It may precipitate an acute adrenal crisis

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26
Q

Why does aldosterone deficiency not occur in hypopituitarism?

A

The principal physiologic regulator of aldosterone secretion is the renin-angiotensin system; and not ACTH from the hypothalamic-pituitary axis.

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27
Q

How do non-functioning pituitary tumors cause symptoms

A

By mass effect

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28
Q

Is a prolactin level over 200 ng/ml indicative of a prolactin-secreting tumor in late pregnancy?

A

No - not really.

Prolactin goes up during pregnancy.

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29
Q

Elevated prolactin can cause decreased bone mineral density.

True or false?

A

True

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30
Q

Decreased bone mineral density secondary to elevated prolactin is always reversible.

True or false?

A

False

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31
Q

What is the best screening test for acromegaly?

A

Serum IGF-1 level

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32
Q

What two diagnoses should be considered in a hyperthyroid patient with elevated TSH levels?

A
  • TSH-oma

- Thyroid hormone resistance

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33
Q

Cushing’s syndrome testing should be repeated for confirmation - true or false?

A

True

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34
Q

What is the most common cause of Cushing’s syndrome?

A

Small ACTH-secreting tumor in pituitary

35
Q

Are growth abnormalities in children more commonly due to hormonal problems or normal growth variants/chronic medical conditions?

A

Normal growth variants/chronic medical conditions

36
Q

Spontaneous or easily provoked hypokalemia in a hypertensive patient.

Diagnosis?

A

Primary hyperaldosteronism

37
Q

What are most cases of primary hyperaldosteronism due to?

A

Bilateral adrenal hyperplasia

38
Q

What is the initial screening test for primary hyperaldosteronism?

A

Plasma aldosterone/plasma renin activity (PA/PRA) ratio of greater than 20

39
Q

In patients with adrenal tumors: what do high levels of urinary 17 ketosteroids, homovanillic acid, or plasma dopamine suggest?

A

That the tumor is malignant

40
Q

Which intravenous fluids are recommended in adrenal crisis?

A

Normal saline with 5% dextrose

41
Q

What is the inheritance pattern of congenital adrenal hyperplasia?

A

Autosomal recessive

42
Q

What is the most frequent cause of congenital adrenal hyperplasia?

A

21-hydroxylase deficiency

43
Q

Female with ambiguous genitalia at birth, neonatal salt-wasting, premature puberty and short stature as an adult.

Diagnosis?

A

Congenital adrenal hyperplasia

44
Q

Patient with weight loss, depression and heart disease (angina pectoris, atrial fibrillation, congestive heart failure).

Diagnosis?

A

Thyrotoxicosis

45
Q

What is done to prevent worsening of Grave’s ophthalmopathy after radioactive iodine treatment?

A

Course of oral corticosteroids

46
Q

What is the goal TSH for treatment of primary hypothyroidism?

A

0.5 - 2 mU/L

47
Q

Mechanism of type 1 amiodarone-induced thyroid disease?

A

Hyperthyroidism secondary to iodine load

48
Q

Mechanism of type 2 amiodarone-induced thyroid disease?

A

Destructive thyroiditis

49
Q

Women with type 1 diabetes mellitus have a _____ greater risk of developing postpartum thyroid disorders than do non-diabetic TPO antibody positive women.

A

Three-fold

50
Q

What is the accuracy of FNA in diagnosing malignancy?

A

90 - 95%

51
Q

Are toxic thyroid adenomas usually cancerous?

A

No

52
Q

What is the best tumor marker for differentiated thyroid cancer?

A

Thyroglobulin

53
Q

Are stress glucocorticoids a part of treatment of thyroid storm?

A

Yes

54
Q

What percentage of non-diabetic women get post-partum thyroiditis?

A

~5%

55
Q

What percentage of women with type 1 diabetes mellitus get post-partum thyroiditis?

A

~25%

56
Q

Approximately how much does the requirement for levothyroxine increase during pregnancy (especially first trimester)?

A

Requirements increase by 25 - 50 mcg per day

57
Q

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)?

A

20%

58
Q

Does central precocious puberty occur more frequently in girls or boys?

A

Girls

59
Q

Do girls or boys have a higher incidence of underlying CNS pathology causing central precocious puberty?

A

Boys

60
Q

Testes less than ____ are considered low volume.

A

20 ml

61
Q

What is the most common manifestation of long-standing hypogonadism?

A

Decreased testicular volume

62
Q

In what percentage of men can the specific cause of impotence be diagnosed?

A

85%

63
Q

What are three classes of anti-hypertensives that are least likely to cause impotence?

A
  • ACE inhibitors
  • Angiotensin receptor blockers
  • Calcium channel blockers
64
Q

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?

A

Androgen producing ovarian or adrenal tumor

65
Q

What the four most common causes for hirsutism?

A
  • PCOS
  • CAH
  • Idiopathic/familial hirsutism
  • Medications
66
Q

What are the two most common causes of virilization?

A
  • Androgen secreting ovarian or adrenal tumors

- CAH

67
Q

Which mutation causes MEN 1?

A

Inactivating mutation of the Menin tumor suppressor gene on chromosome 11

68
Q

What is MEN1?

A
  • Hyperplasia and/or tumors of the pituitary gland
  • Pancreatic islets
  • Parathyroid glands
69
Q

What is MEN2A?

A
  • Pheochromocytomas
  • Medullary thyroid carcinoma
  • Hyperparathyroidism
70
Q

What is MEN2B?

A
  • Pheochromocytomas
  • Medullary thyroid carcinoma
  • Mucosal neuromas
71
Q

Which mutation causes MEN 2 syndromes?

A

Mutations in the Ret tumor suppressor gene

72
Q

Is genetic testing for MEN 2 syndromes clinically available?

A

Yes

73
Q

What is autoimmune polyendocrine syndrome type 1 (APS-1)?

A
  • Hypoparathyroidism
  • Adrenal insufficiency
  • Mucocutaneous candidiasis
74
Q

What is autoimmune polyendocrine syndrome type 2 (APS-2)?

A
  • Hypothyroidism/hyperthyroidism
  • Adrenal insufficiency
  • Diabetes mellitus type 1
75
Q

Insulinomas most often cause fasting hypoglycemia with neuroglycopenic symptoms.

True or false?

A

True

76
Q

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.

A

Liver

Hepatic

77
Q

Name a type of fungi that is more common in diabetic ketoacidosis?

A

Mucormycosis

78
Q

What is the most common cause of acanthosis nigricans?

A

Diabetes mellitus

79
Q

What happens to bone and muscle mass with age?

A

Decreases

80
Q

What happens to fat mass with age?

A

Increases

81
Q

What happens to the production of growth hormone with age?

A

Declines in production of growth hormone

82
Q

What happens to production of sex hormones with age?

A

Declines in production of sex hormones

83
Q

What happens to cortisol secretion with age?

A

Increases with age

Endocrinology Fellowship (30 decks)

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