Endocrinology

Question 1

Diabetes diagnosis: 
Two fasting glucose > \_\_
One random glucose >\_\_\_ with symptoms
Abnormal GTT
HbA1c > 6.5%

Answer 1

126

200

Question 2

The strongest indication for diabetes screening is

Answer 2

hypertension

Question 3

Metformin works by

Answer 3

blocking gluconeogenesis

• no risk of hypoglycemia
• no weight gain
• Don’t use in renal insufficiency or with contrast

Question 4

The sulfonylureas are

Answer 4

glyburide, glimepiride, and glipizide

• work by increasing release of insulin from the pancreas
• hypoglycemia and SIADH are risks

Question 5

The dipeptidyl peptidase IV (DPP-IV) inhibitors are

Answer 5

sitagliptin, linagliptin, alogliptin, and saxagliptin

-block metabolism of incretins such as glucagon-like peptide

Question 6

The thiazolidinediones are

Answer 6

rosiglitazone and pioglitazone

• increase peripheral insulin sensitivity
• DO NOT USE WITH CHF

Question 7

Alpha-glucosidase inhibitors are

Answer 7

acarbose and miglitol

• block absorption of glucose at intestinal lining
• BAD GI symptoms
• like making a person lactose intolerant!

Question 8

SGLT inhibitors such as ___ and ___ can lead to UTIs

Answer 8

canagliflozin and dapaglifozin

Question 9

Insulin glargine is __-acting

Answer 9

long
-injected once a day with an extremely steady state level of insulin, used in combo with a very-short acting insulin at mealtime

Question 10

Long-acting NPH insulin is administered ___ a day

Answer 10

twice a day

Question 11

Short acting insulin includes

Answer 11

aspart
lispro
glulisine
-given at mealtime and lasting about 2 hours

Question 12

Underproduction of insulin =

Answer 12

type 1 diabetes

Question 13

The best initial test for DKA is

Answer 13

serum bicarbonate! A low bicarb implies an elevated anion gap, a marker for serious DKA

Question 14

A marker of ketone production in DKA is

Answer 14

beta hydroxybutyrate

Question 15

Very high glucose ARTIFICIALLY drops ___ levels

Answer 15

sodium

Question 16

It is very important to supplement with ___ in DKA because a high level at first will quickly turn into a low level!

Answer 16

potassium

Question 17

DKA will show pseudohypo-

Answer 17

natremia

Question 18

High glucose + low bicarb = DKA; give __ and __

Answer 18

bolus saline and IV insulin

-add potassium when you notice the K level normalizing

Question 19

Treat severe proliferative retinopathy (diabetes complication) with

Answer 19

VEGF inhibitors like ranibizmab or bevacizumab

Question 20

If any form of protein is present in diabetics, treat with

Answer 20

ACE inhibitors

Question 21

Never give slidenafil with

Answer 21

nitrates!!

Question 22

The muscle that lifts the eyelid is the

Answer 22

levator palpebrae superioris, innervated by C3

-hyperthyroidism stimulates the beta receptors of C3

Question 23

The only cause of hyperthyroidism with elevated TSH is

Answer 23

pituitary adenoma

Question 24

Diagnose a solid thyroid nodule with

Answer 24

fine needle aspiration, ultrasound guided

Question 25

The most common cause of hypercalcemia in outpatients is

Answer 25

primary hyperparathyroidism

Question 26

Thiazide diuretics increase tubular reabsorption of

Answer 26

calcium, causing hypercalcemia

Question 27

Low calcium = ___-excitable

Answer 27

HYPERexcitable!

Question 28

When should you surgically remove the parathyroid gland? HyperPTH with:

Answer 28

``` symptoms (stones, bones, groans, moans) renal insufficiency very elevated serum calcium >12.5 Age <50 Osteoporosis ```

Question 29

If testing for Cushing Syndrome is inconclusive on MRI/CT, the next step is

Answer 29

petrosal sinus sampling

Question 30

Which CAH has both hypertension and virilization?

Answer 30

11 hydroxylase deficiency

Question 31

First test to confirm Acromegaly is

Answer 31

insulinlike growth factor

Question 32

The mechanism of diabetes and glucose intolerance in PCOS is

Answer 32

unknown