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Endocrinology and Metabolism Flashcards

1
Q

Test for vitamin D sufficiency

A

25-Hydroxyvitamin D measurement

This is the standard test used to assess vitamin D levels in the body.

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2
Q

Treatment of primary adrenal insufficiency

A

Glucocorticoid and mineralocorticoid replacement

This treatment is necessary to replace hormones that the adrenal glands are not producing.

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3
Q

Common hyperparathyroidism-related vitamin deficiency

A

Vitamin D

Vitamin D deficiency often occurs due to malabsorption and lack of sunlight exposure.

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4
Q

Bone complications of bisphosphonates

A

Osteonecrosis of jaw, atypical femur fracture

These are serious side effects that can occur with long-term use of bisphosphonates.

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5
Q

Prolactin level suggestive of macroprolactinoma

A

> 200 ng/mL

Elevated levels of prolactin can indicate the presence of a macroprolactinoma.

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6
Q

Electrolyte disorder causing functional hypoparathyroidism

A

Magnesium deficiency

Low magnesium levels can impair parathyroid hormone secretion and action.

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7
Q

Most common cause of primary amenorrhea

A

Gonadal dysgenesis (e.g., Turner syndrome)

Turner syndrome is a genetic condition that affects females and is characterized by the absence of one X chromosome.

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8
Q

T1DM antibody testing in new diagnosis

A

Glutamic acid decarboxylase (GAD)

GAD antibodies are commonly tested in the diagnosis of Type 1 Diabetes Mellitus.

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9
Q

First test in patients with secondary amenorrhea

A

Pregnancy test

A pregnancy test is essential to rule out pregnancy as the cause of secondary amenorrhea.

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10
Q

Diagnosis suggested by thionamide use, fever, sore throat

A

Agranulocytosis

Agranulocytosis is a potentially life-threatening condition characterized by a dangerously low white blood cell count.

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11
Q

Treatment of macroprolactinoma

A

Dopamine agonist

Dopamine agonists such as cabergoline are the first-line treatment for macroprolactinomas.

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12
Q

Initial treatment of Graves disease

A

Thionamides (methimazole or propylthiouracil)

These medications reduce thyroid hormone production in hyperthyroidism.

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13
Q

Treatment following adrenalectomy for Cushing syndrome

A

Glucocorticoid replacement

After adrenalectomy, glucocorticoid replacement is necessary due to loss of cortisol production.

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14
Q

Screening test for mild autonomous cortisol secretion in adrenal incidentaloma

A

1-mg overnight dexamethasone suppression test

This test helps to evaluate cortisol secretion from adrenal tumors.

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15
Q

Diagnosis suggested by secondary amenorrhea, elevated FSH, low estradiol

A

Turner syndrome, POI

Primary ovarian insufficiency (POI) can lead to similar hormonal profiles.

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16
Q

Treatment of DM-related macular edema

A

Intravitreal anti-VEGF

Anti-VEGF injections help reduce fluid leakage and improve vision in diabetic macular edema.

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17
Q

Frequency of TSH measurement in pregnant patient with hypothyroidism

A

Every 4 weeks for first half of pregnancy and at 30 weeks

Regular monitoring is crucial to adjust thyroid hormone replacement in pregnancy.

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18
Q

Morning cortisol level strongly suggestive of deficiency

A

<3 µg/dL

Very low morning cortisol levels can indicate adrenal insufficiency.

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19
Q

Uterine cause of secondary amenorrhea

A

Intrauterine adhesions (Asherman syndrome)

Asherman syndrome can result from surgical procedures like dilation and curettage (D&C).

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20
Q

Timing of infertility evaluation in women <35 years

A

≥1 year of regular unprotected intercourse

This duration is recommended before further evaluation for infertility.

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21
Q

Diagnosis of osteoporosis in postmenopausal women and men >50 years

A

T-score ≤−2.5 or fragility fracture (especially hip or vertebral compression fracture)

A T-score of -2.5 or lower indicates osteoporosis.

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22
Q

Treatment needed after denosumab or teriparatide discontinuation

A

Alternative antiresorptive therapy (e.g., oral bisphosphonate)

This is necessary to maintain bone density after stopping these treatments.

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23
Q

eGFR contraindication to metformin therapy

A

<30 mL/min/1.73 m2

A low eGFR increases the risk of lactic acidosis with metformin.

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24
Q

First lab test for thyroid nodule

A

TSH level

TSH levels help determine the need for further evaluation of thyroid nodules.

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25
Most common cause of primary adrenal insufficiency (Addison disease)
Autoimmune adrenalitis ## Footnote Autoimmune destruction of the adrenal cortex is the leading cause of Addison's disease.
26
Treatment of adrenergic symptoms in thyrotoxic patients
β-Blockers ## Footnote β-Blockers are commonly used to manage symptoms such as tachycardia and tremors in thyrotoxic patients.
27
Empiric levothyroxine dose change during pregnancy
30% increase ## Footnote Pregnant women may require an increase in their levothyroxine dosage to maintain adequate thyroid hormone levels.
28
Prophylaxis for glucocorticoid-related osteoporosis
Bisphosphonate, denosumab ## Footnote These medications are used to prevent bone loss in patients receiving glucocorticoids.
29
Treatment of arginine vasopressin deficiency (central diabetes insipidus)
Desmopressin ## Footnote Desmopressin is a synthetic analog of vasopressin used to treat diabetes insipidus.
30
Treatment of ACTH-secreting pituitary adenoma
Surgical resection ## Footnote Surgery is often the first-line treatment for ACTH-secreting tumors causing Cushing's disease.
31
DM diagnostic tests
HgbA1c, FBG, OGTT; random glucose if hyperglycemic symptoms ## Footnote These tests are utilized to diagnose diabetes mellitus.
32
ACP-recommended goal HgbA1c in most patients with T2DM
7% to 8% ## Footnote This range is recommended to balance the benefits of glycemic control with the risks of treatment.
33
Frequency of HgbA1c assessment in T2DM not at glycemic goal
3 months ## Footnote Increased monitoring is necessary for patients who are not achieving their glycemic targets.
34
Diagnosis suggested by primary amenorrhea, short stature
Turner syndrome ## Footnote Turner syndrome is a chromosomal disorder affecting females, often characterized by these symptoms.
35
HgbA1c level below which to consider deintensifying pharmacologic therapy
6.5% ## Footnote A lower level may indicate that the patient is at risk for hypoglycemia with continued therapy.
36
Age-related indication for osteoporosis screening in average-risk postmenopausal women
Age ≥65 years ## Footnote Screening is recommended for women starting at this age to assess fracture risk.
37
Most common cause of hirsutism/androgen excess in women
PCOS ## Footnote Polycystic ovary syndrome is the leading cause of hirsutism due to elevated androgen levels.
38
Initial test for suspected acromegaly
IGF-1 level ## Footnote Insulin-like growth factor 1 levels are typically elevated in acromegaly.
39
Recommended initial antihypertensive medications in T2DM
ACE inhibitors or ARBs; dihydropyridine CCBs; thiazide diuretics ## Footnote These medications are preferred to manage hypertension in diabetic patients.
40
Diabetic proliferative retinopathy treatment
Photocoagulation or intravitreal anti-VEGF ## Footnote These treatments aim to prevent vision loss from diabetic retinopathy.
41
Diagnosis suggested by hyperthyroidism, elevated TSH, and elevated free T4
TSH-secreting pituitary tumor ## Footnote This condition results in excessive thyroid hormone production despite high TSH levels.
42
Most common type of familial hypercalcemia
Familial hypocalciuric hypercalcemia ## Footnote This genetic condition leads to elevated calcium levels due to impaired renal calcium excretion.
43
Initial imaging test for ACTH-independent Cushing syndrome
Adrenal CT or MRI ## Footnote Imaging is critical to identify adrenal tumors causing Cushing syndrome.
44
Diagnosis suggested by tall stature, small testes, primary hypogonadism
Klinefelter syndrome (47,XXY) ## Footnote This genetic disorder affects male physical and cognitive development.
45
Treatment of Paget disease of bone
Single dose of zoledronic acid ## Footnote Zoledronic acid is effective in reducing bone turnover in Paget's disease.
46
Treatment of thyroid hormone deficiency
Levothyroxine ## Footnote Levothyroxine is the standard treatment for hypothyroidism.
47
Most reliable case-detection test for primary aldosteronism
PAC/PRA ## Footnote The plasma aldosterone concentration to plasma renin activity ratio is crucial for diagnosing this condition.
48
Potential benefits of testosterone therapy in men with hypogonadism
Increased libido, lean muscle mass, fat-free mass, bone density, and secondary sexual characteristics ## Footnote These benefits highlight the importance of testosterone in male health.
49
Drug class associated with euglycemic ketoacidosis
SGLT2 inhibitors ## Footnote This class of medications can lead to ketoacidosis even in the presence of normal blood glucose levels.
50
Diagnosis suggested by rapid-onset virilization, menstrual irregularities
Androgen-secreting adrenal tumor ## Footnote These tumors can produce excess androgens, leading to virilization in women.
51
Diagnosis suggested by hyperthyroidism, diffusely enlarged thyroid
Graves disease
52
Frequency of DM-related dilated eye exams during pregnancy
Every trimester
53
Invasive test to confirm source of hyperaldosteronism
Adrenal vein sampling
54
Impact of chronic opioid therapy on gonadal function
Hypogonadotropic hypogonadism
55
Diagnosis suggested by low cortisol, elevated ACTH
Primary adrenal insufficiency
56
BMI threshold for bariatric surgery in patients with comorbidities
≥30
57
Most common cause of subclinical hyperthyroidism
Toxic multinodular goiter
58
Nonpituitary endocrine cause of hyperprolactinemia
Hypothyroidism
59
Lab test diagnostic criteria for male hypogonadism
Two low 8 am serum total testosterone measurements
60
Hormone replacement for all patients with panhypopituitarism
T4 and cortisol
61
Treatment of adrenal mass >4 cm
Resection
62
Order of drugs for treating adrenal crisis and hypothyroidism
Hydrocortisone, then thyroid hormone replacement
63
Pharmacologic PCOS treatment when fertility desired
Clomiphene citrate or letrozole
64
Bone indication for hyperparathyroidism-related parathyroidectomy
T-score ≤−2.5 or vertebral fracture
65
Route of insulin administration recommended for critically ill hospitalized patients
Intravenous
66
Thyroid cancer associated with MEN types 2A and 2B
Medullary
67
Thyroid storm treatment
β-Blockers, PTU, glucocorticoids, and potassium iodide
68
Painful thyroiditis associated with elevated ESR/CRP, typically following viral URI
Subacute thyroiditis
69
Contraindications to initial full-dose thyroid hormone replacement
Age ≥65 years, cardiac disease
70
Condition that is a common cause of acquired hypocalcemia
CKD
71
Inpatient glucose threshold for insulin initiation
180 mg/dL
72
Most common manifestation of primary aldosteronism
Hypertension
73
Treatment of hypoglycemia unawareness
Relax glycemic targets, modify hypoglycemia-inducing therapies
74
Most common optic chiasm compression–related visual field defect
Bitemporal hemianopsia
75
Indication for weight loss pharmacotherapy after unsuccessful lifestyle modification trial
BMI ≥30 or BMI ≥27 with ≥1 obesity-associated comorbid condition
76
First drug administered in treatment of myxedema coma
Hydrocortisone
77
Hormonal treatment of POI
Estrogen-progestin therapy until age 51 years
78
Most common cause of osteomalacia
Severe and prolonged vitamin D deficiency
79
Test for thyroid nodule with normal TSH
Ultrasonography
80
Initial testing for hypercalcemia
Serum calcium and PTH levels
81
Most common cause of non–PTH-mediated hypercalcemia
Malignancy
82
TSH level indication for subclinical hypothyroidism treatment
>10 µU/mL
83
Endocrine adverse effect of checkpoint inhibitor drugs
Hypophysitis
84
Treatment of men with biochemically proven hypogonadism
Testosterone therapy
85
BMI threshold for bariatric surgery in patients with no comorbidities
≥35
86
Hormonal or surgical therapy to adapt patient's body to experienced gender
Gender-affirming treatment
87
Treatment of Graves ophthalmopathy
Glucocorticoids, surgery, rituximab, tocilizumab, teprotumumab
88
Teriparatide treatment duration
2 years
89
UACR cutoff for consideration of ACE inhibitor/ARB in T2DM with hypertension
UACR ≥30 mg/g
90
Test for thyroid nodule with suppressed TSH
Thyroid scintigraphy
91
Most common cause of hypoparathyroidism
Neck surgery–associated injury
92
Genetic testing for medullary thyroid cancer
RET oncogene
93
Initial treatment of severe hypercalcemia
Aggressive hydration with 0.9% saline
94
Most common cause of familial hyperparathyroidism
MEN1
95
Osteoporosis testing interval in low-risk patient with T-score of −1 to −2
3 to 5 years
96
Diseases associated with acanthosis nigricans
Insulin resistance/T2DM, malignancy
97
Initial pharmacologic treatment of PCOS
Combined oral contraceptive (unless fertility desired)
98
Feminizing gender-affirming hormone therapy
Estradiol and androgen blocker (both used off label)
99
Morning cortisol level that rules out deficiency
>15 µg/dL
100
Diagnosis suggested by acne, gynecomastia, small testes, low gonadotropins, erythrocytosis
Anabolic steroid use
101
Most common cause of primary hypothyroidism in U.S.
Hashimoto thyroiditis (chronic lymphocytic thyroiditis) ## Footnote Hashimoto thyroiditis is an autoimmune disorder that leads to destruction of the thyroid gland.
102
Waist circumference associated with increased risk for DM, ASCVD, and mortality
>40 inches in men, >35 inches in women ## Footnote Increased waist circumference is a significant indicator of metabolic syndrome.
103
Indication for insulinoma localization imaging in hypoglycemia
After confirmation of endogenous hyperinsulinism ## Footnote Imaging is essential to locate insulinomas which cause hypoglycemia.
104
Treatment of nonthyroidal illness syndrome
Observation ## Footnote Nonthyroidal illness syndrome often resolves with treatment of the underlying condition.
105
Initial duration of oral bisphosphonate therapy for low-risk osteoporosis
5 years ## Footnote This duration may vary based on individual risk assessments.
106
Diagnosis suggested by small/absent pituitary gland on MRI
Empty sella syndrome ## Footnote This condition is characterized by the herniation of the arachnoid membrane into the sella turcica.
107
Diagnosis suggested by low testosterone, normal LH and FSH in men
Secondary (pituitary) hypogonadism ## Footnote This indicates a malfunction of the pituitary gland affecting testosterone production.
108
Initial tests in nonpregnant women with secondary amenorrhea
FSH, estradiol, TSH, free thyroxine, and prolactin levels ## Footnote These tests help determine the underlying cause of amenorrhea.
109
Strongest environmental risk factor for thyroid cancer
Radiation ## Footnote Exposure to radiation, especially during childhood, significantly increases thyroid cancer risk.
110
T2DM medications beneficial in heart failure
SGLT2 inhibitors ## Footnote SGLT2 inhibitors have shown cardiovascular benefits in patients with type 2 diabetes.
111
Tests for pituitary hypersecretion in all pituitary incidentalomas
Prolactin and IGF-1 levels ## Footnote These tests assess for possible hormone overproduction from incidentalomas.
112
Drug class used before adrenalectomy for pheochromocytoma
α-Receptor blocker ## Footnote α-Receptor blockers are used to control hypertension related to catecholamine release.
113
Contraindications to 131I therapy
Pregnancy, significant Graves ophthalmopathy ## Footnote These conditions increase the risk of complications from radioactive iodine treatment.
114
Drugs for diabetic peripheral neuropathy
Gabapentinoids, SNRIs, tricyclic antidepressants, sodium channel blockers ## Footnote These medications help manage neuropathic pain in diabetic patients.
115
Universal vitamin deficiency after bariatric surgery
Vitamin D ## Footnote Bariatric surgery can significantly affect nutrient absorption, leading to deficiencies.
116
Monitoring in secondary hypothyroidism
Free T4 measurement ## Footnote Free T4 levels are crucial for assessing thyroid function in secondary hypothyroidism.
117
Electrolyte abnormality following thyroid surgery
Hypocalcemia (from parathyroid injury) ## Footnote Parathyroid injury during thyroid surgery can lead to decreased calcium levels.
118
First step in evaluation of female infertility
Assessment of ovulatory function ## Footnote Evaluating ovulation is critical in determining the cause of infertility.
119
Main two options for blood glucose monitoring (BGM)
Fingerstick BGM and continuous glucose monitoring (CGM) ## Footnote Both methods are essential for managing diabetes effectively.
120
Cause of hypocalcemia after first dose of bisphosphonate
Vitamin D deficiency ## Footnote Vitamin D is crucial for calcium metabolism, and deficiency can lead to hypocalcemia.
121
In T1DM, percentage of total daily insulin dose typically consisting of basal insulin
Approximately 50% ## Footnote This ratio can vary based on individual insulin sensitivity and requirements.
122
Antibody test for autoimmune adrenalitis
21-Hydroxylase antibodies ## Footnote The presence of these antibodies indicates autoimmune adrenalitis, leading to adrenal insufficiency.
123
Initial localization study of choice for primary aldosteronism
Dedicated adrenal CT ## Footnote This imaging is crucial for identifying adrenal adenomas causing excess aldosterone production.
124
Thyroid effects of amiodarone
Hypothyroidism, hyperthyroidism, thyroiditis ## Footnote Amiodarone can impact thyroid function due to its iodine content.
125
Test following male hypogonadism diagnosis
LH and FSH levels ## Footnote These hormone levels help determine the cause of hypogonadism.
126
What are the treatment options for toxic adenoma?
Radioactive iodine, surgery, or thionamides ## Footnote Toxic adenoma is a type of hyperfunctioning thyroid nodule that can lead to hyperthyroidism.
127
Which vitamin interferes with thyroid function assays?
Biotin ## Footnote Biotin can cause falsely elevated thyroid hormone levels in laboratory tests.

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