Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Internal Medicine > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

appropriate starting dose for levothyroxine

A

1.6 microgram/kg lean body weight

25-50 microgram/day for older patients and those with cardiovascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pharmacologic therapy for patients with Type 2 DM and ASCVD or risk factors for ASCVD

A

Glucagon-like peptide 1 receptor agonist OR sodium glucose cotransporter 2 inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Indications for adrenalectomy

A

1) functioning pheochromocytoma
2)  Aldosterone-producing tumor
3) Hypercortisolism
4) suspicious imaging (size > 4 cm, > 10 Hfu, Absolute contrast wash out of > 60% in 10 min
5) growth of > 1cm/year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Most appropriate diagnostic test for evaluation of cause of hyperthyroidism

A

Thyroid scintigraphy with radioactive iodine uptake

If RAIU contraindicated, then Thyroid-stimulating immunoglobulin or thyrotropin receptor antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Elevated alkaline phosphatase, hypocalcemia, Whole-body bone scan showing increase update of technetium throughout the skeleton

A

Osteomalacia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

First-line diagnostic test for Cushing syndrome

A

1) overnight Low-dose dexamethasone suppression test
2) 24- hour urine free cortisol measurement
3) Late-night salivary cortisol measurement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Next step in evaluation for unilateral, nontender, fixed breast mass in male patient

A

Mammography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Initial treatment for myxedema coma

A

IV levothyroxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Percentage of radioactive Iodine uptake for

1) Graves’ disease
2) other causes of thyrotoxicosis such as destructive thyroiditis

A

1) > 30% (high)

2) < 10% (low)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Appropriate management for symptomatic thyroiditis

A

Beta-blockers (tachycardia and palpitations)

Anti-inflammatory (prednisone/NSAID; thyroid tenderness/pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Sudden hemorrhage or infarction of a pituitary adenoma

A

Pituitary apoplexy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Potential adverse effects of zolendronic acid that occurs within 1 to 3 days after first administration in 30% patients

A

Acute-phase response reaction characterized by low-grade fever, myalgia, arthralgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Most common cause of primary hypogonadism. Typically present in adulthood with tall stature; small, firm testes; infertility; and signs of androgen deficiency

A

Klinefelter syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Appropriate screening for diabetes mellitus in pregnant women with risk factors for type 2 DM

A

At time of their positive pregnancy test and again between 24 and 28 weeks gestation if initial test is negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Diagnostic values for type 2 diabetes mellitus

A

Fasting glucose: > 126 mg/dL
Random glucose: > 200 mg/dL + symptoms
2-hr OGTT: > 200 mg/dL
HgbA1c: > 6.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Diabetes medication that is contraindicated in patients with GFR < 30 and can cause vitamin B12 deficiency

A

Metformin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Diabetes medications that cause weight gain

A

Sulfonylureas, Thiazolidinediones, Meglitinides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Diabetes medications that reduce the rates of death by CVD, all cause mortality, and are FDA approved for reduction of CV death in adults with T2DM and CVD

A

Empagliflozin (also reduces rate of HF hospitalization)

Liraglutide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Diabetes medications that can possibly place patients at increased risk for pancreatitis

A

DPP-4 inhibitors and GLP-1 mimetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Diabetes medication that has an adverse effect of UTIs, can possibly increase risk for DKA, and should be used with caution with history of PVD

A

SGLT2 inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Screening for complications and patients with type 1 diabetes

A

Begin at 5 years after diagnosis and performed annually there after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Screening for complications in patients with type 2 diabetes

A

Begin at time of diagnosis and performed annually there after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

1) Dot and blot hemorrhages

2) Neovascularization

A

1) Nonproliferative diabetic retinopathy

2) Proliferative diabetic retinopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Indication to treat for subclinical hyperthyroidism

A

TSH < 0.1 microU/L + Symptoms, cardiac respecters, heart disease, or osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Indications for parathyroidectomy in patients with primary hyperparathyroidism

A

Fragility fractures, Vertebral fractures, DEXA T score < -2.5 (Lumbar, Yep, femoral neck, distal 1/3 radius)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Evaluation for symptomatic fasting hypoglycemia

A

Prolonged fast, up to 72 hours, with measurement of plasma glucose, C-peptide, insulin, proinsulin, BHB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Image modality to distinguish type 1 amiodarone-induced thyrotoxicosis (hyperthyroidism) from type 2 (destructive thyroiditis)

A

Thyroid US with Doppler studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Diagnostic evaluation for Paget disease of bone

A

Whole body radionuclide bone scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Appropriate management For gestational diabetes refractory to therapeutic lifestyle interventions

A

Insulin

30
Q

Timing of repeat US for thyroid nodules

A

High-suspicion: 6 to 12 mo
Intermediate/Low-suspicion: 12-24 mo
Very low-suspicion: 24 mo or longer

31
Q

Timing of when to screen pregnant women for gestational diabetes

A

24 to 28 weeks of gestation

32
Q

Glycemic targets in pregnancy

A

Plasma glucose < 95 mg/dL
1hr postprandial < 140 mg/dL
2hr postprandiak < 120 mg/dL

33
Q

Serum C-peptide level in surreptitious ue of insulin

A

Low

34
Q

Serum C-peptide level in surreptitious use of oral hypoglycemic agents

A

High

35
Q

Sudden pituitary hemorrhage or infarction associated with sudden headache, visual change, Ophthalmoplegia, AMS

A

Pituitary apoplexy

36
Q

Silent pituitary infarction associated with obstetric hemorrhage and hypertension and follwed by amenorrhea

A

Sheehan syndrome (postpartum pituitary necrosis)

37
Q

Preferred treatment for primary adrenal insufficiency

A

Hydrocortisone + fludrocortisone

38
Q

Appropriate management of postmenopausal osteoporosis in patients intolerant of or incomptely responsive to bisphosphonate therapy

A

Denosumab

39
Q

Appropriate diagnostic evaluation for patients with thyroid nodules and a suppressed TSH

A

Thyroid scintigrqphy with radioactive iodine uptake

40
Q

ACTH-independent cortisol secretion that may result in metabolic (hyperglycemia and HTN) and bone (osteoporosis) effects of hypercortisolism, but not the more specific features of Cushing syndrome

A

Mild autonomous cortisol excess (MACE)

41
Q

ADA recommendation for neuropathic pain

A

Pregabalin, gabapentin, or duloxetine

42
Q

First steps in management of functional hypothalamic amenorrhea (hypogonadotropic hypogonadism in the setting of excess exercise/energy expenditure or decreased caloric intake)

A

Increase caloric intake to match energy expenditure and to reduce exercise

43
Q

Management for the following:

1) Women with microprolactinoma and normal menses or patients with non-functioning pituitary microadenoma
2) Symptomatic prolactinoma
3) I don’t know Miss secreting GH, ACTH, TSH; or Associated with mass effect, visual field defects or hypopituitarism

A

1) observation
2) Medication such as dopamine agonist (carbergoline)
3) Surgery

44
Q

1) diffuse homogenous increased radioactive iodine uptake (RIU)
2) Patch areas of increased RIU
3) Focal increased RIU with decreased RIU in the rest of the glan
4) Decreased or no RIU

A

1) Graves disease
2) Toxic multinodular goiter
3) solitary adenoma
4) Iodine load (IV contrast or Amiodarone) or Thyroiditis (silent, subacute, postpartum, amiodarone induced) or Surreptitious ingestion

45
Q

Treatment of choice for toxic multinodular goiter or toxic adenoma

A

Radioactive iodine or surgery

46
Q

First line anti-thyroid medication for most patients

A

Methimazole

47
Q

Treatment of choice for hyperthyroidism in first trimester of pregnancy

A

Propylthiouracil

48
Q

Indication for treatment of subclinical hypothyroidism

A

Pregnancy are soon to be

49
Q

Levothyroxine management of hypothyroidism

1) Age < 60
2) Age > 60
3) Heart disease
4) myxedema coma
5) pregnancy 

A

1) full dose of 100 microg/day
2) 25-50 microg/day. Increase by 25 microg every 6 wks until TSH is 1.0-2.5
3) 12.5-25 microg/day. Increase by 12.5-25 microg every 6 wks until TSH is 1.0-2.5
4) add hydrocortisone
5) increase dose by 30%

50
Q

Indication for FNA biopsy

A

1) Thyroid nodules > 1 cm With suspicious sonographic features in normal TSH level
2) nodules < 1 cm With risk factors for thyroid cancer or suspicious US characteristics

51
Q

Appropriate lab value to obtain for the diagnosis of hypercalcemia due to immobilization

A

Elevated serum bone alkaline phosphatase

52
Q

Treatment of choice for primary aldosteronism caused by idiopathic hyperaldosteronism

A

Aldosterone receptor blocker (Spironolactone or eplerenone)

53
Q

First line diagnostic studies for Cushing syndrome

A

1) 1mg overnight dexamethasone suppression test (failure to suppress < 3 microg/dL)
2) 24hr urine cortisol level (elevated)
3) late night salivary cortisol level (elevated)

54
Q

Evaluation of hypercorticolism if

1) morning ACTH elevated (>20 pg/mL)
2) morninf ACTH suppressed or normal (<5 pg/dL)

A

1) pituitary MRI or CT

2) Adrenal CT

55
Q

Evaluation for adrenal incidentalomas in asymptomatic patients

A

1mg dexamethasone suppression test + 24hr urine levels of metanephrines and catecholamines

56
Q

Evaluation for adrenal incidentaloma in patients with hypertension or spontaneous hypokalemia

A

Addition of plasma aldosterone-plasma renin ratio

57
Q

Evaluation of choice for pheochromocytoma if clinical suspicion is

1) low
2) high

A

1) 24hr urine metabephrines and catecholamines

2) plasma metanephrines

58
Q

Lab values suggesting diagnosis of primary hyperaldosteronism

A

Plasma aldosterone-plasma renin activity ratio > 20

Aldosterone level > 15 ng/dL

59
Q

Treatment of choice for

1) adrenal hyperplasia
2) aldosterone producing adenoma

A

1) spironolactone or eplerenone

2) laparoscopic adrenalectomy

60
Q

Hyper parathyroidism, pituitary neoplasm, pancreatic NETs

A

MEN 1

61
Q

Hyperparathyroidism, medullary thyroid cancer, pheochromocytoma

A

MEN 2

62
Q

First line therapy for osteoporosis

A

Alendronate or risedronate

63
Q

Treatment for osetomalacia if secondary to Vit D deficiency

A

PO ergocalciferol 1000 - 2000 U/day + elemental Ca 1 g/day

64
Q

Management for Vit D deficiency

A

50k U of either ergocalciferal or cholecalciferol followed by maintenxe therapy of 1500 to 2000 U/day

65
Q

Isolated elevation of ALP in the absence of liver disease

Focal osteolysis with coarsening of the trabecular pattern, Cotton wool skull, cortical thickening

First line therapy?

A

Paget Disease

Bisphosphonates

66
Q

Acute, asymmetric, focal onset of pain followed by weakness in the proximal leg in a diabetic patient

A

Diabetic amyotrophy

67
Q

Causes for focal increase in bone density

A

Osteophytes, osteoplastic metastasis, compression fracture, Paget disease

68
Q

Management for amiodarone induced hypothyroidism (high TSH, low T4)

A

Continue amiodarone and start levothyroxine

69
Q

Amiodarone induced thyrotoxicosis (low TSH, high T4) with increase vascularity on thyroid US

A

Type 1 AIT

70
Q

Management for type 1 AIT

A

1) Consider stopping amiodarone unless clinically necessary

2) Treat with methimazole
3) thyroidectomy for refractory cases

71
Q

Amiodarone induced thyrotoxicosis (low TSH, high T4) with decreased vascularity on thyroid US

A

Type 2 AIT

72
Q

Management for type 2 AIT

A

1) May continue amiodarone unless not indicated clinically

2) Treat with corticosteroids

Internal Medicine (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions