Endocrine SM

Question 1

What is the first lab to order for thyroid evaluation?

Answer 1

TSH

Question 2

A high TSH, low T3/T4 is

Answer 2

hypothyroidism

Question 3

A low TSH, high T3/T4 is

Answer 3

hyperthyroidism

Question 4

First line medication for hypothyroidism? What organ will this commonly effect?

Answer 4

levothyroixine/Synthroid

cardiac effects - start low in elderly

Question 5

How often is TSH rechecked?

Answer 5

every 4-6 weeks

Question 6

First line medications for hyperthyroidism

Answer 6

beta blocker

Tapazole, PTU (PTU first trimester, then Tapzole 2nd)

Question 7

What is the purpose of the parathyroid?

Answer 7

calcium and phosphorus levels

Question 8

What happens in hyperparathyroidism? What is a possible concern?

Answer 8

Ca is HIGH
Phosphorus is LOW

malignancy

Question 9

What happens in hypoparathyroidism?

Answer 9

Ca is LOW

Phosphorus is HIGH

Question 10

What is happening in type 1 diabetes? What will this patient develop/how do you find out they are type 1?

Answer 10

antibodies destroying beta cells = insulin dependent

DKA - ketones

Question 11

Somogyi vs Dawn effect

Answer 11

hyperglycemia upon awakening
S: drop in glucose 1-2 am, high in morning (exercise before bed, insulin doses)
D: steady rise in glucose all night long (increase in growth hormone)

Question 12

What A1C determines diabetes?

Answer 12

6.5%

Question 13

What labs should be monitored for Metformin?

Answer 13

renal (eGFR <30 STOP!, <46 decrease dose)
stop if CT with contrast
B12

Question 14

Side effects of Metformin? Max dose? Anemia? Also treats what?

Answer 14

GI distress
2550 mg per day
B12 deficiency
PCOS in females

Question 15

How is type 2 diabetes diagnosed?

Answer 15

A1C
2 random glucose
fasting glucose
OGTT

Question 16

When should insulin be initiated for type 2 diabetes?

Answer 16

> 9% A1C

Question 17

What diabetic medications are likely to cause hypoglycemia?

Answer 17

sulfonylureas (zide, mide, ride)

TZDs

Question 18

What diabetic medications are cardioprotective?

Answer 18

GLP-1 (tides)

SGL2 (gliflozin)

Question 19

What annual screenings are necessary for diabetics?

Answer 19

Podiatrist
Ophthalmology
Microalbumin in urine - kidney

Question 20

What are long acting insulins?

Answer 20

L
Lantus
Levemir

Question 21

What are the expected signs and symptoms of Addison’s disease?

Answer 21

too little cortisol - addrenal insufficiency (needs steroids)
hyperpigmentation - dark/tan
ammenorrhea
crave salt
weak
weight loss
excess urine
all labs are LOW except potassium - hyperkalemia

Question 22

What is the biggest concern of Addison’s disease?

Answer 22

addisonian crisis

need emergency kit of steroids

Question 23

What are expected signs and symptoms of Cushing’s disease?

Answer 23

too much cortisol - too much steroid drugs
moon face
purple striae
abdominal obesity, thin arms and legs
osteoporosis, excess sweating/hairiness/hunger, high BP
labs are HIGH except potassium - hypokalemia

Question 24

How is Lupus diagnosed?

Answer 24

ANA in conjunction with symptoms

Question 25

What are expected findings of lupus?

Answer 25

malar rash - butterfly, spares nasolabial folds

raised red patches, light sensitivity, ulcers in mouth, arthritis/swelling/tenderness, protein in urine

Question 26

What organ is affected the most by lupus?

Answer 26

kidneys

Question 27

Sjogren’s syndrome consists of?

Answer 27

dry eyes and mouth