Endocrinology - random topics

Question 1

Treatment of choice in a patient with PCOS who does not desire pregnancy

Answer 1

OCPs

Question 2

Treatment of choice in a patient with PCOS who does desire pregnancy

Answer 2

Clomiphene citrate or letrozole

Question 3

Adjunctive treatment of PCOS if OCPs alone are not sufficient

Answer 3

Spironolactone can be added 6 months after OCP treatment for further antiandrogen activity

Question 4

DEXA scan indicated in who?

Answer 4

Women >65 yo
Women <65 yo with an elevated FRAX score

Question 4

When is progesterone required to be included in hormonal treatment of post menopausal symptoms?

Answer 4

If the woman still has a uterus (has not gotten hysterectomy)

Question 4

Risk factors for developing osteoporosis (prompting calculation of FRAX in a woman <65 yo)

Answer 4

Smoking, low body weight, alcohol, chronic steroid use, rheumatoid arthritis, previous fracture

Question 4

Test that should be ordered for evaluation of a breast mass in a woman <30 yo

Answer 4

Breast ultrasound

Question 5

Test that should be ordered for evaluation of a breast mass in a woman >30 yo

Answer 5

Diagnostic mammogram

Question 6

most effective emergency contraception option

Answer 6

copper IUD (if placed within 5 days of unprotected intercourse)

Question 7

emergency contraception PO option for women with BMI >26

Answer 7

ulipristal acetate (if taken within 5 days of unprotected intercourse)

Question 8

emergency contraception PO option for women with BMI <26

Answer 8

levonorgestrel (if taken within 3 days of unprotected intercourse)

Question 9

Screening tests for confirming hypercortisolism (Cushing)

Answer 9

1mg dexamethasone suppression test
24-hour urine free cortisol excretion
Evening salivary cortisol level

Question 10

Management of myxedema coma

Answer 10

supportive care (IV fluids, pressors, ventilation, passive rewarming)
IV hydrocortisone (until adrenal insufficiency is disproven)
IV thyroid replacement

Question 11

Low or normal TSH
Low or normal T4
Low T3
High reverse T3

Answer 11

Euthyroid sick syndrome (nonthyroidal illness syndrome) in the setting of critical illness

Question 12

Levothyroxine dosing for patients >65 or with cardiac disease

Answer 12

initial dose levothyroxine 25-50 micrograms/day

Question 13

Levothyroxine dosing for patients <65 or without cardiac disease

Answer 13

weight based levothyroxine dosing (1.6 micrograms/kg lean body weight)