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Internal Medicine > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Which HLA subtypes are associated with type 1 diabetes?

A

DQA and DQB

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2
Q

What single random plasma glucose level can you diagnose a person with diabetes?

A

> 200

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3
Q

Which medications have been shown to delay onset to DM2?

A

Metformin
Alpha glucosidase inhibitors (acarbose, voglibose)
Thiazolidinediones (rosiglitazone, pioglitazone)

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4
Q

What value on oral glucose tolerance test is consistent with diabetes?

A

> 200

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5
Q

When do you screen for gestational diabetes?

A 
24-28 weeks
Positive if: 
Fasting >92
1 hour > 180
2 hour > 153
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6
Q

What conditions can falsely lower HbA1C due to more rapid turnover of erythrocytes?

A

Hemodialysis
Hemolytic anemia
Blood transfusions
Hemoglobinopathies

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7
Q

What is average blood glucose for an A1C of 10?

A

240

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8
Q

Which patient populations should sulfonylureas (gluburide) be avoided?

A

Impaired kidney function

Elderly

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9
Q

Which sulfonylureas is potentially associated with increased risk of myocardial infarction?

A

Glyburide

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10
Q

What possible complication can occur if metformin is continued and IV contrast is given?

A

Lactic acidosis

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11
Q

What condition should thiazolidenidines be avoided?

A

Heart failure

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12
Q

What oral hypoglycemic drugs need to be avoided in liver disease?

A

Metformin

Thiazolidenidines

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13
Q

When do you start retinal screening in type 1 diabetics?

A

5 years after diagnosis

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14
Q

When do you screen for diabetic retinopathy in pregnant women with diabetes (either type)?

A

Every trimester

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15
Q

What level of microalbunuria indicates marcoalbunuria?

A

> 300

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16
Q

What is Whipples triad?

A
  1. Hypoglycemic symptoms
  2. Low plasma glucose documented by a lab
  3. Resolution of symptoms with glucose ingestion
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17
Q

What is the most common functional pituitary adenoma?

A

Prolactinoma

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18
Q

What is most common pituitary adenoma?

A

Non functional

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19
Q

Which MEN syndrome has pituitary adenomas?

A

MEN1

3Ps - pituitary, parathyroid, pancreas

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20
Q

What is the drug drug interaction between iron supplements and levothyroxine?

A

Impaired levothyroxine absorption leading to hypothyroid state

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21
Q

What is the thyroglobulin level in exogenous ingestion of thyroid hormone?

A

Low

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22
Q

Which MEN syndrome has marfanoid habitus?

A

MEN2b

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23
Q

What condition of Graves’ disease of present means you should not give radio iodine ablation?

A

Graves ophthalmopathy - can transiently worsen symptoms

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24
Q

What additional studies should all patients with medullary thyroid cancer have?

A

RET proto-oncogene sequencing

Metanephrine/norephrine testing for pheo

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25
Q

How much time after acute illness does euthyroid sick syndrome tend to recover?

A

8 weeks

26
Q

What level is elevated in euthyroid sick syndrome though it is rarely measured?

A

Reverse T3

27
Q

What dose increase is usually needed for levothyroxine in pregnant patients?

A

30-50% increase

28
Q

What is normal cortisol level in healthy individuals in response to cosyntrophin test?

A

Should be >18

29
Q

What is gold standard to diagnose Cushing syndrome?

A

24 hour urine cortisol

30
Q

What is normal cortisol level after dexamethasone suppression test?

A

5 suggestive of cushings

31
Q

What testing do you do to look for ACTH secreting pituitary adenoma if MRI does not localize tumor?

A

Bilateral Inferior petrosal sinus sampling

32
Q

Which form of Cushing syndrome is called Cushing disease?

A

ACTH producing pituitary adenoma

33
Q

What size of adrenal incidentaloma require surgical removal regardless if functional?

A

6 cm

34
Q

What houndsfield units is indicative of a malignant adrenal incidentaloma? Benign?

A

> 20

35
Q

What is the renin:aldosterone ratio suggestive of primary hyperaldosteronism?

A

> 20

36
Q

What is another names for Schmidts syndrome?

A

Autoimmune polyendocrinopathy syndrome type 2 (APS2)

37
Q

What is normal aldosterone level in response to salt load if no primary hyperaldosteronism?

A

Should be

38
Q

What adrenal cytotoxic drug aids in treatment of adrenal carcinoma?

A

Mitotane

39
Q

What defines secondary amenorrhea?

A

Absence of menstrual cycle for >6 months in previously menstruating female

40
Q

What is Asherman syndrome?

A

Uterine scarring from previous gynecological procedure causing uterine outflow obstruction

41
Q

What medication can mimic primary Hyperparathyroidism by resetting the set point for activation of calcium sensing receptor (CSR)?

A

Lithium

42
Q

Which type of lung cancer frequently secretes PTHrP?

A

SCC

43
Q

What is correction factor for hypocalcemia value with low albumin?

A

Add 0.8 for every 1 mg/dL below 4.0

44
Q

Does hypo or hyper calcemia prolong QTc interval?

A

Hypocalcemia

45
Q

What is most common medical condition that is contraindication to bisphosphate therapy?

A

CKD (CrCl

46
Q

Does laser photocoagulation improve central or peripheral vision?

A

Improves central but tends to lose peripheral vision

47
Q

What size adrenal mass always requires removal?

A

> 6 cm

48
Q

What FSH level is consistent with primary ovarian insufficiency?

A

> 35

49
Q

What FRAX risk of fracture indicates need for starting bisphosphanate?

A

Major fracture risk >20% or hip fracture risk >3% over next 10 years

50
Q

What is black box warning for use of teriparatife (recombinant PTH)?

A

Osteosarcoma risk - can be used with history of radiation therapy, Paget disease, Hyperparathyroidism, hypercalcemia

51
Q

What is goal TSH in first trimester of pregnancy?

A
52
Q

How much increased requirement of levothyroxine is needed during pregnancy?

A

30-50%

53
Q

What is the most common hormone deficiency following TBI?

A

Growth hormone

54
Q

What appetite stimulating drug can cause adrenal insufficiency if rapidly discontinued?

A

Megestrol

55
Q

What disease other than prolactinoma can cause secondary hypogonadism?

A

Hemachromatosis

56
Q

Does opiate induced Hypogonadism central or primary?

A

Central Hypogonadism

57
Q

What gene causes familial hypocalciuric hypercalcemia?

A

CASR gene

58
Q

What random cortisol level in critically ill patient excludes adrenal insufficiency?

A

> 12

59
Q

What size of adrenal incidentaloma requires adrenalectomy?

A

> 4 cm or houndsfield units > 20 is concerning

60
Q

What gene mutation should be checked with patients with medullary thyroid cancer?

A

RET proto-oncogene

Internal Medicine (12 decks)

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