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Step 2 CK > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

what lab test is used in diabetic patients to assess the adequacy of gloycemic control over the last three months?

A

HgbA1c

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2
Q

what is the leading cuase of death in diabetics?

A

CV disease

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3
Q

why must beta blockers be used with caution in diabetics

A

blcoks symptoms of hypoglycemia

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4
Q

what can cause hypoglycemia in nondiabetic patient?

A

insulinoma, iatrogenic, fasting, alcohol, pit/adrenal insufficiency

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5
Q

what are the underlying metabolic derangements in type 2 diabetes

A

incrs hgbAic
increased glucose
insulin resistance and deficiency

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6
Q

five categories for metabolic syndrome

A

abd obesity

triglycerides

HDL

BP

glucose

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7
Q

skin finding which can be a sign of insulin resistance

A

acanthosis nigricans

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8
Q

lifestyle changes for type 2 DM? drug recommended as first line therapy for these patients?

A

wt loss, increased exercise, diet

metformin

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9
Q

which type of insulin is used in continuous infusion insulin pumps and tx of DKA

A

insulin lispro/aspart

reg insulin

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10
Q

which diabetic medications should be avoided in patients with heart failure?

A

TZDs

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11
Q

Which medication from metformin, pioglitazone and glyburide is most likely to cause hypoglycemia

A

glyburide

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12
Q

mechanism of action of diabetes drug which decreases GI absorption of starch and disaccharides

A

acarbose

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13
Q

mechanism of action of diabetes drug which stimulates insulin release

A

sulfonylurea, meglitinides

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14
Q

mechanism of action of diabetes drug which decreases hepatic gluconeogenesis

A

metformin, TZDs

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15
Q

mechanism of action of diabetes drug which increases tissue glucose uptake and improves insulin sensitivity

A

TZDs, metformin

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16
Q

mechanism of action of diabetes drug which mimics action of GLP1, decr glucagon, incr insulin, delays gastric emptying

A

GLP1 agonist

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17
Q

mechanism of action of diabetes drug which inhibits DPP4 leading to decr glucagon, incr insulin, delayed gastric emptying

A

DPP4 inhibitor

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18
Q

mechanism of action of diabetes drug which increases urinary elimination of sugar

A

SGLT2 inhibitor

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19
Q

antidiabetic agent associated with lactic acidosis

A

metformin

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20
Q

which serum electrolytes are commonly low in patients with DKA

A

total body K, HCO3, Ca/Mg, Na, phosph

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21
Q

type 2 DM ran out of metformin, presents with 3 daysd of polyuria, dry mouth, vomiting. lethargic. Na 144, K 3.7, Cl 101, HCO3 18, glucose 413. Dx? Further testing?

A

DKA

abg and urine or serum ketones

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22
Q

antihypertensive drug class that reduces proteinuria and slows diabetic nephropathy

A

ACEI or ARB

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23
Q

treatment of proliferative diabetic retinopathy?

A

surgical, photocoag

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24
Q

treatment of peripheral neuroapthy?

A

amitryptilline, duloxetine, carbamazepine, gabapentin, pregabalin

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25
Q

common eye diseases in diabetics?

A

retinopathy, glaucoma, cataracts

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26
Q

tx and dx or diabetic gastroparesis

A

gastric emptying study

erythromycin, metoclopramide

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27
Q

tx for DKA

A

fluids, reg insulin, KCl

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28
Q

thyroid abnormalities in pregnancy?

A

increased TBG, increased total T4, normal free T4

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29
Q

patient has exophthalmos, What is the most likely cause?

A

hyperthyroid, Graves disease

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30
Q

treatment of the most common cause of hyperthyroidism

A

radioactive I

met, PTU, surgery

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31
Q

patient has exophthalmos, pretibial myxedema decreased zTSH, dx?

A

graves dx

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32
Q

major differences between de quervain thyroiditis and hashimoto

A

de quervain: decr TSH, incr T4, painful goiter

hasthimoto: incr TSH, decr T4, painless goiter

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33
Q

most common type of thyroid cancer

A

papillary

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34
Q

next step in management of newly found thyroid nodule in a patient with hyperthyroidism

A

check TSH, free T4

radioactive iodine scan

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35
Q

Vit D deficiency: Ca, PTH, phosphate

A

decr Ca, incr PTH, decr phosphate

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36
Q

What is the Ca, Phosph, alk phosph, PTH in paget disease

A

nl Ca

nl phosph

incr alk phosph

nl PTH

37
Q

What is the Ca, Phosph, alk phosph, PTH in osteomalacia

A

decr Ca

decr phosph

nl/incr alk phosph

incr PTH

38
Q

What is the Ca, Phosph, alk phosph, PTH in chronic renal failure

A

decr Ca

incr phosph

nl alk phosph

incr PTH

39
Q

What is the Ca, Phosph, alk phosph, PTH in osteoporosis

A

nl Ca

nl phosph

nl alk phosph

nl PTH

40
Q

What is the Ca, Phosph, alk phosph, PTH in osteopetrosis

A

nl Ca

nl phosph

nl alk phosph

nl PTH

41
Q

What is the Ca, Phosph, alk phosph, PTH in primary hyperparathyroidism

A

incr Ca

decr phosph

incr alk phosph

incr PTH

42
Q

What is the Ca, Phosph, alk phosph, PTH in hypoparathyroidism

A

decr Ca

incr phosph

nl alk phosph

decr PTH

43
Q

What is the Ca, Phosph, alk phosph, PTH in pseudohypoparathyroidism

A

decr Ca

incr phosph

nl alk phosph

incr PTH

44
Q

most common pituitary tumor, tx?

A

prolactinoma

bromocriptine, cabergoline

45
Q

difference between macro and micro adenoma?

A

10 mm

46
Q

tx of macro adenoma?

A

dopamine agonists (bromo, cabergoline)

surgery

47
Q

tx of micro adenoma

A

dopamine agonists (bromocriptine, cabergoline)

48
Q

Presentation of hyperprolactinemia?

A

hypogonad: galactorrhea, amenorrhea

49
Q

next step for patient found to have an absent pituitary on MRI

A

check hormone levels

50
Q

visual field defect associated with prolactinoma?

A

bitemporal hemianopsia

51
Q

complications from acromegaly?

A

cardiac failure

DM

spinal cord compression

organomegaly

compression of optic nerve

52
Q

first line treatment for moderate hypercalcemia

A

IV hydration

loop diuretics

53
Q

What is made only in adrenals and used as a more specific marker for androgen producing adrenal tumor in women?

A

DHEAs (zona reticularis)

54
Q

electrolyte abnormalities found in hyperaldosteronism?

A

decr K, metabolic alkalosis

55
Q

specific lab finding in making diagnosis of primary hyperaldosteronism

A

decr renin

incr PAC: PRA ratio: incr PAC, decr PRA

56
Q

patient’s work up reveals high aldo concentration and low renin. Dx? tx?

A

Conn syndrome, primary hyperaldosteronism

spironolactone, surgical removal

57
Q

patient with elevated BP, palpitations, HA, excessive perspiration has elevated urine vanillylmandelic acid leves. What effect would beta blocker have on patient?

A

vasoconstriction from unopposed alpha

58
Q

likely condition of female infant with virilization of genitalia an dhypotension?

A

21 alpha hydroxylase def –> CAH

59
Q

serum abnormalities in 17 alpha hydroxylase deficiency?

A

incr Na, decr K

60
Q

serum abnormalities in 21 alpha hydroxylase deficiency?

A

decr Na, incr K

61
Q

patient with acromegaly is found to have elevated Ca on blood draw during a work up of peptic ulcer. WHat is the mjost liekly diagnosis?

A

MEN 1

62
Q

lab changes in hyperaldosteronemia?

A

incr Na, decr K, metabolic alkalosis

63
Q

lab findings in hashimoto?

A

incr TSH, decr free T4, antiperoxidase abd, antithyroglobulin abd

64
Q

40 year old obese patient presents with acanthosis nigricans. Dx and initial workup?

A

DM

TSH, BSG, cortisol

65
Q

tx of HTN in pheochromocytoma?

A

alpha and beta blocker

phentolamine

66
Q

tx of parathyroid hyperplasia?

A

surgical, 3.5 PTH glands

67
Q

which endocrine disorder might weight loss eliminate need for meds?

A

DM

PCOS

68
Q

patient presents with weakness, nausea, vomiting, weight loss, and new skin pigmentation. Dx? Tx?

A

addison’s disease

corticosteroids/mineralocorticoids

69
Q

chvostek and trousseau signs are associated with what metabolic abnormalitY?

A

hypocalcemia

70
Q

sx of hyperthyroid and extremely tender thyroid gland

A

subacute thyroiditis

71
Q

sx of hyperthyroid and pretibial myxedema

A

graves

72
Q

sx of hyperthyroid and pride in recent weight loss, medical professional

A

factitious insulin

73
Q

sx of hyperthyroid and palpation of single thyroid nodule

A

toxic adenoma

74
Q

sx of hyperthyroid and multiple thyroid nodules

A

multinodular goiter

75
Q

sx of hyperthyroid and recent study using IV contrast?

A

jod-basedow phenom

76
Q

sx of hyperthyroid and eye changes, proptosis, edema, injection

A

graves

77
Q

sx of hyperthyroid and history of thyroidectomy or radioablation of thyroid

A

excess thyroid hormone replacement

78
Q

first line treatment of GH secreting pituitary adenoma

A

surgical

79
Q

what causes stones, bones, and psychiatric overtones

A

hypercalcemia

80
Q

what causes hypocalcemia, high phosphorous, low PTH

A

hypoparathyroidism

81
Q

most common cause of cushing syndrome

A

steroid use

82
Q

two most common causes of primary hyperparathyroidism

A

parathyroid adenoma

parathyroid hypoplasia

83
Q

patient has history of intermittent tachycardia, fluctuations in BP, HA, diaphoresis, panic attacks. Dx?

A

pheochromocytoma

84
Q

indications for surgical parahyroidectomy of PTH adenoma?

A

symptomatic incr Ca

serum Ca > 1 above upper limit nl

creatinine clearance decr 30%

T score -2.5 at any site

age

85
Q

patient with type 2 DM needs CT scan with IV contrast. WHat medication should be temporarily held?

A

metformin

86
Q

tx for acromegaly?

A

resection of pituitary adenoma

octreotide, cabergoline, pegvisolant

87
Q

Patient presents with hypertension, depression, kidney stones. What is the most likely underlying diagnosis?

A

hypercalcemia from hyperPTH

88
Q

Causes of hypovolemic hyponatremia?

A

diuretics (thiazide)
addison disease
fluid loss and free water replacement

Step 2 CK (16 decks)

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