Endocrinology

Question 1

anti-GAD antibodies

Answer 1

Type 1 DM

Question 2

Treatment goals for Type 2 DM, preventative measurements

Answer 2

glucose 80-120mg.dl

HbA1c

Question 3

For which patients is metformin contraindicated? Important side effect

Answer 3

Renal insufficiency, hepatic insufficiency, heart failure

Lactic acidosis

Question 4

Glipizide, glyburide, Glimepiride: class, mechanism, side effects

Answer 4

Sulfonylureas
Incr endogenous insulin secr
Hypoglycemia

Question 5

Rosaglitazone, pioglitazone: class, mechanism, side effects

Answer 5

Thiazolidinediones

Question 6

Treatment of hyperthyroid

Answer 6

Methimazole, propylthiouracil

Question 7

Treatment of thyroid storm

Answer 7

IV propanolol, propylthiouracil, corticosteroids

High dose postassium iodide

Question 8

Delayed relaxation of DTRs

Answer 8

Assoc with hashimotos

Question 9

Treatment myxedema coma

Answer 9

IV levothyroxine, IV hydrocortisone

Question 10

MEN1 vs MEN2A vs MEN2B

Answer 10

MEN1: pancreatic neuroendocrine, pituitary adenoma, parathyroid hyperplasia
MEN2A: Pheo, medullary thyroid ca, parathyroid hyperplasia
MEN2B: Pheo, medullary thyroid ca, mucosal neuroma

Question 11

criteria for osteoporosis; common fxs

Answer 11

BMD

Question 12

“mosaic” lamellar bone pattern on xray; assoc lab abnormality

Answer 12

Paget’s

incr alk phos, normal ca, phos

Question 13

secondary vs tertiary hyperparathyroid

Answer 13

secondary: physiologic incr PTH after renal insufficiency, Ca def, Vit D def
tertiary: dialysis pts, long-standing secondary hyperplasia leads to parathyroid hyperlasia, autonomous PTH secr

Question 14

hypercalcemia: sx and treatment

Answer 14

Sx: stones, bones, moans, groans, psychiatric overtones
Tx: IV fluids, loop diuretics, IV bisphosphonates

Question 15

Ectopic PTHrP: assoc cancers, PTH/Ca/PO4

Answer 15

Breast, lung

Decr PTH, Incr Ca, Decr PO4

Question 16

primary hyperparathyroidism: Assoc labs, workup, medical treatment

Answer 16

hypercalcemia, hypophosphate, hypercalciuria
DEXA, 99mTC sestamibi scan, thyroid ultrasound
cancalcet: calcimimetic

Question 17

cushing syndrome vs cushing disease

Answer 17

syndrome: too much cortisol
disease: ACTH-producing pituitary adenoma

Question 18

Cushing syndrome: screening tests, pituitary vs adrenal

Answer 18

24hr free urine cortisol
2 midnight salivary cortisol
1mg dexamethasone suppression test

ACTH dep vs indep:
AM cortisol and ACTH

Question 19

Tx + Dx of acromegaly

Answer 19

Dx: IGF1 incr, confirm with glucose suppression test
Tx: octreotide (somatostatin analog)
pegvisomant (GH receptor antagonist)

Question 20

Dx + tx hyperprolactinemia

Answer 20

Prolactin >200

Tx: dopamine agonist (cabergoline, bromocriptine)

Question 21

dx + tx central vs nephrogenic di

Answer 21

Dx: DDAVP admin:
central: decr UOP, incr urine osm
nephrogenic: no effect
Tx: 
Central: DDAVP
nephrogenic: salt restriction, water intake; thiazide diuretics

Question 22

dx, tx SIADH

Answer 22

Dx: urine osm >50-100 mosm/kg, serum hypoosm; urinary sodium > 20meq/L
Tx: restrict fluid, hypertonic saline if

Question 23

Dx of adrenal insufficiency

Answer 23

Hyponatremia and eosinophilia
Hyperkalemia in primary AI only
Confirm with 8Am cortisol (18ug/dl)

Question 24

hyperaldosteronism: dx and tx

Answer 24

Dx: hypokalemia, mind hypernatremia, alkalosis, hypomagnesemia, incr aldost/plasma renin activity
Tx: surgical or spironolactone