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Physician Assistant Exam > Endocrinology > Flashcards

Endocrinology Flashcards

2
Q

What two hormones are produced in the posterior pituitary?

A

Oxytocin and antidiuretic hormone (ADH, vasopressin)

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3
Q

What role does c-peptide play in the diagnosis of diabetes?

A

It is a marker of insulin production. Elevated C-peptide points to DM 2. Decreased c-peptide points towards DM 1

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4
Q

How do fibrates work to affect the lipid profile?

A

They inhibit synthesis of VLDL and elevate lipoprotein lipase

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5
Q

How do statins work to affect the lipid profile?

A

They slow the rate limiting step of cholesterol synthesis

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6
Q

How does nicotinic acid work to affect the lipid profile?

A

It inhibits secretion of VLDL

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7
Q

What heparin complication is relevant to endocrinology?

A

Adrenal infarct leading to a cushing’s syndrome

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8
Q

During pregnancy which is the prefered treatment of hyperthyroidism PTU or methimazole?

A

PTU

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9
Q

Propranolol belongs to what class of medication?

A

Beta blockers

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10
Q

Is metformin indicated or contraindicated in renal failure?

A

Contraindicated

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11
Q

List the 5 Insulines in order of peak efficacy?

A

Lispro 1-2 hrs, Regular 2-4 hrs, NPH 5-7 hrs, Lente 4-8 hrs, UltraLente 8-14 hrs

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12
Q

What medication class does metformin (glucophage) fall into?

A

Biguanide

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13
Q

Does niacin increase or decrease HDL?

A

Increase

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14
Q

What life threatening side effect do statins have?

A

Rhabdomyolysis

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15
Q

Which lipid medication may cause flushing?

A

Niacin

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16
Q

What class of medications is the first line for lowering LDL?

A

Statins

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17
Q

What are the 5 criteria for Metabolic syndrome?

A

HDL 135/85, Triglycerides >150, Fasting glucose > 100, Waist > 40 inches in men > 35 inches in women

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18
Q

What is included in Whipple’s triad of hypoglycemia?

A

History of previous hypoglycemia, serum glucose of < 40, immediate recovery upon administration of glucose

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19
Q

How often should a diabetic’s HgbA1C be checked and what should it be?

A

Every three months (remember the life a RBC is 90-120 days) and it should be below 6.5%

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20
Q

Typically what is the first medication started in type 2 DM?

A

Metformin

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21
Q

What is the suffix associated with sulfonylureas?

A

ide, glipizide, Tolbutamide,Tolazamide

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22
Q

What class of medications does pioglitazone (Actos) fall into?

A

Thiazolidinediones also known as glitazones

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23
Q

How do glitazones work?

A

They improve insulin sensitivity

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24
Q

How do sulfonylureas medications work?

A

They stimulate the production of insulin

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25
Q

How does metformin work?

A

Decreases the hepatic glucose production and increases peripheral glucose uptake

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26
Q

As it relates to diabetics, what is the dawn phenomenon?

A

Reduced insulin response between 5 and 8 am

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27
Q

What specific breathing pattern is associated with diabetic ketoacidosis?

A

Kussmaul respirations

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28
Q

Fruity breath should make you think of what diagnosis?

A

Diabetic Ketoacidosis

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29
Q

Patient presents with erectile dysfunction and complains of some numbness in his feet. On second thought he has noticed significant polyuria and polydipsia. What diagnosis should you be thinking of?

A

Diabetic neuropathy

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30
Q

Stocking glove should make you think of what diagnosis?

A

Diabetic neuropathy and B12 deficiency neuropathy

31
Q

List four diagnostic criteria for diabetes?

A

Random glucose > 200, fasting plasma > 126, two hour postprandial glucose > 200, HgA1c > 6.5%

32
Q

HLA-DR gene is a marker for what endocrine disorder?

A

DM type 1

33
Q

What is the most common cause of DM type 1?

A

Autoimmune destruction of the islet cells in the pancreas

34
Q

What percentage of diabetes in the US is type 2?

A

80-90%

35
Q

What is the first first line medical treatment for pheochromocytoma?

A

Beta blockers

36
Q

What is the test to begin with if you suspect pheochromocytoma?

A

24 hour urine for catecholamines

37
Q

What is the treatment for Addison’s disease?

A

Hydrocortisone or prednisone

38
Q

Will ACTH be elevated or decreased in Addison’s disease?

A

Elevated if the problem is at the adrenal glands

39
Q

Hyperpigmentation of the skin along creases should make you think of what diagnosis ?

A

Addison’s disease

40
Q

Cortical adrenal insufficiency is also known as what disease?

A

Addison’s disease

41
Q

List two ectopic tumors that may produce ACTH and give a patient Cushing’s syndrome?

A

Small cell lung cancer, pancreatic islet cells, thymomas

42
Q

Name two tests you might use to rule out Cushing’s syndrome.

A

24 hour free cortisol urine test and dexamethasone suppression test

43
Q

List 4 physical exam findings for Cushing’s syndrome.

A

Moon face, buffalo hump, purple strai, central obesity, supraclavicular fat pads, easy bruising

44
Q

Is Cushing’s syndrome an elevated or decreased ACTH?

A

Elevated

45
Q

Moans, groans, stones and bones describe symptoms of what endocrine problem?

A

Hyperparathyroid

46
Q

What is the most common cause of hyperparathyroidism?

A

Single parathyroid adenoma in 80% of cases.

47
Q

What is Trousseau’s sign?

A

Inflate BP cuff and hold for 3 minutes. Patient with low Ca will get carpel tunnel symptoms.

48
Q

What is Chvostek’s sign?

A

Tap on facial nerve and get a twich with low Ca

49
Q

What is the most common cause of hypoparathyroid?

A

Post thyroidectomy with the complication of parathyroidectomy

50
Q

What is the main function of parathyroid hormone?

A

Increase serum Ca

51
Q

What is the treatment for myxedema?

A

Levothyroxine and slow warming

52
Q

Positive antithyroid peroxidase and antithyroglobulin antibodies should make you think of what diagnosis ?

A

Hashimoto’s

53
Q

What medication might you use prior to thyroidectomy in a patient with hyperthyroidism?

A

Methimazole or propylthiouracil (PTU)

54
Q

In a patient with hyperthyroidism will TSH most likely be elevated or decreased?

A

Decreased

55
Q

Which thyroid cancer is the most aggressive?

A

Anaplastic

56
Q

Name the four thyroid cancers.

A

Papillary, Follicular, Medullary, Anaplastic

57
Q

What is the least aggressive thyroid cancer?

A

Papillary

58
Q

What is the most common thyroid cancer?

A

Papillary makes up about 80% of thyroid cancers

59
Q

How does levothyroxine work?

A

It helps convert T4 to T3

60
Q

What is Hashimoto’s disease?

A

An autoimmune cause of hypothyroid

61
Q

What is the first line medical treatment for a patient who presents with palpitations and nervousness secondary to hyperthyroidism?

A

Beta Blockers

62
Q

What is Graves’ disease?

A

The most common cause of hyperthyroidism. It is an autoimmune disease.

63
Q

A 35 year old female presents with heat intolerance, weight loss and palpitations. What diagnosis should you be thinking of?

A

Hyperthyroidism

64
Q

Pretibial myxedema should make you think of what diagnosis?

A

Graves’ disease

65
Q

Exophthalmos should make you think of what diagnosis?

A

Hyperthyroidism

66
Q

What is the best imaging for a thyroid nodule?

A

Ultrasound

67
Q

How much more potent is T3 than T4?

A

3-4x

68
Q

Diabetes insipidus is caused by a deficiency of which hormone?

A

Vasopressin

69
Q

Large doughy hands should make you think of what diagnosis?

A

Gigantism

70
Q

What is the most common pituitary adenoma?

A

Prolactinoma

71
Q

What is Sheehan’s syndrome?

A

Ischemia of the pituitary due to volume depletion during or after childbirth

72
Q

What is the most common cause of hypopituitarism?

A

Tumor

Physician Assistant Exam (14 decks)

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