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ABIM - Endocrinology > ESAP 2014 > Flashcards

ESAP 2014 Flashcards

1
Q

What does hCG do to thyroid function tests?

A

Causes hyperthyroidism - suppressed TSH and high free T4

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2
Q

When do you do embryo cryopreservation as opposed to oocyte cryopreservation?

A

Embryo cryopreservation is preferred when the woman has a partner.
Oocyte cryopreservation is done when the woman does not have a partner and does not want to use a donor sperm.

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3
Q

When detecting androgen abuse (testosterone doping tests) what enzyme deficiency can cause false negative results?

A

Uridine diphosphoglucuronosyl transferase 2B17 (UGTB217)

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4
Q

What causes episodes of hypoglycemia occurring 30 to 60 minutes after mealtime insulin dosing?

A

Diabetic gastroparesis

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5
Q

How do you treat diuretic-induced hyponatremia in patients who are mildly symptomatic?

A

Normal saline infusion

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6
Q

The ADA recommends that all diabetics (adults) with diabetes undergo annual measurement of creatinine.

True or false?

A

True

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7
Q

Pheochromocytomas in MEN 2 often secrete ________, while those in patients with VHL produce high levels of ________.

A
  • epinephrine

- norepinephrine

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8
Q

What are SDHD mutations associated with…

Pheochromocytomas or paraglangliomas?

A

Paragangliomas

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9
Q

With intensive glycemic control to lower patient’s blood glucose (HbA1c: 6 - 6.5%) over 5 years compared to normal control (HbA1c: 7 - 8%) the patient has greater weight gain.

True or false?

A

True (ACCORD study)

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10
Q

Which diabetic complication are Hispanic Americans more likely to develop?

A

Retinopathy

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11
Q

Which diabetic complication are Black Americans more likely to develop?

A

End-stage renal disease

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12
Q

Should a patient with a Roux-en-Y bypass have a mixed meal test with a meal that typically provokes symptoms or a standard meal?

A

A standard meal
(People with Roux-En-Y gastric bypass will always have symptoms with a meal containing calories in liquid or semi-liquid form)

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13
Q

What is the underlying mechanism of lithium-induced nephrogenic diabetes insipidus?

A

Resistance to action of ADH on distal nephron.

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14
Q

Does ADH concentrate or dilute urine?

A

Concentrates urine

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15
Q

What is the risk of doing an ethanol ablation of an insulinoma in a patient with portal hypertension?

A

Risk of complications such as bleeding is increased

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16
Q

What should you think of when hypocalcemia and hyperphosphatemia develop in the setting of treating a hematologic malignancy?

A

Tumor lysis syndrome

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17
Q

What is a common obstacle to effective management of elderly type 2 diabetics?

A

Untreated depression

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18
Q

Should family members be tested if a patient has an HRPT2 mutation?

A

Yes.

It may lead to early detection and prevention of parathyroid malignancy.

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19
Q

What kind of tumors secrete beta hCG?

A

Choriocarcinomas

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20
Q

Are the testosterone levels increased or decreased when the patient has a choriocarcinoma?

A

Normal

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21
Q

Are the estradiol levels increased or decreased when the patient has a choriocarcinoma?

A

Increased

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22
Q

Are the TSH levels increased or decreased when the patient has a choriocarcinoma?

A

Decreased

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23
Q

Are the LH levels increased or decreased when the patient has a choriocarcinoma?

A

Decreased

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24
Q

What should you suspect in a patient with very low LDL cholesterol levels?

A

Hypobetalipoproteinemia

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25
Q

A patient must be able to independently manage the pump if it is initiated in a hospital setting.

True or false?

A

True

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26
Q

What genetic testing should be done in case of an insulinoma?

A

MEN 1

27
Q

What is the only agent approved for management of pre-existent diabetes in the second trimester of pregnancy?

A

Insulin

28
Q

Patient has:

  • Primary hypogonadism
  • Frontal balding
  • Insulin resistance
  • Premature cataracts
  • Cardiac conduction deficits
  • Percussion myotonia

Diagnosis?

A

Myotonic dystrophy type 1 (Steinert disease)

29
Q

Defect in which gene causes myotonic dystrophy type 1?

A

DMPK (dystrophia myotonica-protein kinase)

30
Q

Can long-standing idiopathic hypercalciuria cause parathyroid autonomy?

A

Yes

31
Q

Can long-standing idiopathic hypercalciuria cause tertiary hyperparathyroidism?

A

Yes

32
Q

What should you suspect if different tests for Cushing’s syndrome are discordant?

A

Steroids in over-the-counter medications - these need to be reviewed.

33
Q

Does hypothyroidism cause delayed ejaculation?

A

Yes

34
Q

Are alpha-glucosidase inhibitors recommended in patients with renal disease?

A

No - because they have not been studied in this population.

35
Q

What is the differential diagnosis of elevated FGF-23?

A
  • Tumor-induced osteomalacia
  • X-linked hypophosphatemia
  • Autosomal dominant hypophosphatemic rickets (ADHR)
36
Q

New presentation of diabetes insipidus and pituitary mass suggests…

A

Pituitary metastasis

37
Q

Pituitary mass with cystic and solid components on T1 weighted imaging…

Diagnosis?

A

Craniopharyngioma

38
Q

If the free T3 or free T4 levels in pregnancy are a little low but the TSH is at goal then should the levothyroxine dose be changed?

A

No - the levothyroxine dose during pregnancy should be titrated according the TSH.

39
Q

Mutations in which genes are associated with Osteogenesis imperfecta?

A

COLIA1 and COLIA2

40
Q

Do patients with osteogenesis imperfecta develop conductive or sensorineural hearing loss?

A

They can develop both.

41
Q

Is basilar skull invagination a complication of osteogenesis imperfecta?

A

Yes

42
Q

What happens to the urinary excretion of calcium after gastric bypass surgery?

A

It is decreased (calcium deficiency)

43
Q

What happens to the femoral bone mineral density after a Roux-en-Y gastric bypass?

A

Decreases

44
Q

What is a common cause for obstruction causing azoospermia and no fructose?

A

Cystic fructose

45
Q

If the blockage is present at the level of the ejaculatory duct then is fructose present or absent?

A

Absent

46
Q

If the blockage is present at the level of the vas deferens then is fructose present or absent?

A

Present

47
Q

How do you treat male infertility caused by cystic fibrosis?

A

Percutaneous epididymal aspiration

48
Q

Can prednisone increase cholesterol and triglyceride levels?

A

Yes

49
Q

Hypercalcemia associated with elevated 1,25 (OH) vitamin D…

Diagnosis?

A

Sarcoidosis

50
Q

How does hypertriglyceridemia affect TPN?

A

May limit the addition of lipid emulsion

51
Q

Is FHH caused by an activating mutation or an inactivating mutation in CaSR?

A

Inactivating mutation

52
Q

The degree of elevated calcium levels in FHH reflect a gene-dose effect.

True or false?

A

True

53
Q

Patient has a triad of anemia, renal insufficiency and proteinuria. What’s the diagnosis?

A

Multiple myeloma

54
Q

What is the lowest dose of ethinyl estradiol that should be given to ameliorate hot flash symptoms?

A

10 - 20 mcg

55
Q

Which is the most common risk of subclinical hyperthyrodism?

A

Atrial fibrillation.

56
Q

How do you treat patients with symptoms of adrenal insufficiency (hypoaldosteronism and hypocortisolism) after an adrenalectomy?

A

Conservatively manage following a high sodium and low potassium diet.

57
Q

What is one of the risks of immunotherapy after pancreatic transplant?

A

Pancreatitis

58
Q

When is nutritional support considered in critically ill patients?

A

Weight losses greater than 10% from initial weight.

59
Q

Are there any studies showing that dextrose containing fluids are better than normal saline?

A

No

60
Q

Pancreas plus kidney transplant is associated with better outcomes than kidney transplant alone whether the transplants are performed simultaneously or sequentially.

True or false?

A

True

61
Q

Survival after transplant of a transplant of a kidney alone from a living donor is superior to that after simultaneous pancreas-kidney transplant.

True or false?

A

False

62
Q

What does a parathyroidectomy in hyperparathyroidism do to bone density?

A

Increases it

63
Q

What disease should you suspect if a patient has massive xanthomas and premature cardiovascular disease?

A

Sitosterolemia

consider evaluation by a cardiologist

64
Q

What is the mutation in autoimmune polyglandular syndrome type 1 (APS 1)?

A

Mutation in the autoimmune regulator gene

ABIM - Endocrinology (17 decks)

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