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Endocrinology Fellowship > Fellowship - August 2014 > Flashcards

Fellowship - August 2014 Flashcards

0
Q

Does calcitonin cause diarrhea?

A

Yes

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1
Q

What percentage of thyroid nodules are benign?

A

95%

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2
Q

What happens to the labs from 24-hour urine when the pH is lowered artificially?

A

The readings are falsely lowered.

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3
Q

If the urine pH is extremely low (less than 4) what should you think of?

A

That the HCl from the urine container leaked.

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4
Q

What is a significant change in bone density on DXA?

A

More than 3%

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5
Q

What is the maximum cumulative dose of radioactive iodine you would want to give someone (roughly)?

A

600 mCi

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6
Q

If you have high pH and high uric acid what kind of stones are you at risk for?

A

Calcium oxalate stones

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7
Q

Name two causes of calcium phosphate stones.

A
  • Frequent urinary tract infections.

- Hyperparathyroidism.

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8
Q

What Z-score is considered low density for age?

A

-2 or less

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9
Q

What happens to the phosphorus in hypoparathyroidism?

A

It is increased.

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10
Q

How often does the sestimibi scan not pick up parathyroid adenomas?

A

10 - 20%

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11
Q

How long does hypercalcemia secondary to sarcoidosis take to correct once steroids are started in the acute setting?

A

A few days.

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12
Q

What is the long term treatment of hypercalcemia secondary to sarcoidosis?

A

Hydroxychloroquine 200 mg PO qDay.

Treat the underlying disorder

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13
Q

Pioglitazone treats non alcoholic fatty liver disease.

True or false?

A

True

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14
Q

What is the detection rate of insulinomas with endoscopic US?

A

90%

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15
Q

Can chronic hepatitis C cause thyroiditis?

A

Yes

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16
Q

Is the cholesterol level low or high in abetalipoproteinemia?

A

Low

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17
Q

A mutation in which gene causes abetalipoproteinemia?

A

MTP

Microsomal transfer protein

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18
Q

What is the pattern of inheritance for abetalipoproteinemia?

A

Autosomal recessive.

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19
Q

Which vitamin deficiencies should you check for in abetalipoproteinemia?

A

Fat soluble vitamins;

  • Vitamin A
  • Vitamin D
  • Vitamin E
  • Vitamin K
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20
Q

What is Bassen-Kornzweig disease also known as?

A

Abetalipoproteinemia

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21
Q

What kind of red blood cells are found in abetalipoproteinemia?

A

Acanthocytes

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22
Q

If transaminases are elevated in a patient with abetalipoproteinemia then what is it likely due to?

A

Hepatic steatosis

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23
Q

Is molecular genetic testing of the MTP gene commercially available?

A

No

Not currently available.

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24
Q

Is low HDL associated with cataracts?

A

Yes

25
Q

What syndrome should you think of in a patient with a goiter and sensorineural hearing loss?

A

Pendred Syndrome

26
Q

Which gene is mutated in Pendred syndrome?

A

SLC26A4

27
Q

Which organs is pendrin located in?

A
  • Thyroid
  • Inner ear
  • Kidney
28
Q

How long should you wait before doing a repeat FNA biopsy of the thyroid after the first one is indeterminate?

A

2 months

29
Q

If you get a thyroid FNA biopsy result that shows atypical cells - what will happen if you repeat the biopsy in a couple of weeks?

A

You will get the same result - atypical cells. Because you disturbed the area with your needle.

30
Q

Do you need to have a fasting laboratory value to evaluate the thyroid?

A

No

31
Q

Is a thyroid lobectomy indicated if a thyroid nodule is greater than 4 cm?

A

No.

Not according to the guidelines but some people believe so.

32
Q

Should you check for primary hyperaldosteronism when the potassium is low?

A

No

33
Q

So you need to stop the aspirin before or after a thyroid fine needle aspiration?

A

No

34
Q

What is the most common side effect of testosterone therapy in men older than 50 years?

A

Erythrocytosis

35
Q

How much does the BMD increase with testosterone therapy?

A

2 - 10%

36
Q

How much does testosterone therapy raise PSA?

A

0.3 - 0.6 ng/mL

37
Q

If the PSA rises by ____ or more on testosterone therapy then the patient should be evaluated by a urologist.

A

1.5 ng/mL

38
Q

A combination of goiter and sensorineural hearing loss raises the possibility of which syndrome?

A

Pendred syndrome.

39
Q

What is the maximal dilution of urine?

A

50 mOsm/L

40
Q

What are the serum urea levels in beer potomania?

A

Low

Because they don’t eat much protein.

41
Q

How would you quickly correct hyponatremia in an acute setting?

A

100 ml of 3%

42
Q

If a patient is on an insulin drip for any reason - how often should you check for electrolytes (potassium)?

A

At least every 4 - 6 hours.

43
Q

Does hyperlipidemia type 4 or type 5 have triglycerides above 1000 mg/dL?

A

Type 5

44
Q

Familial dysbetalipoproteinemia (type 3) has what configuration of Apolipoprotein E?

A

e2/e2

45
Q

What is there more of when you get higher than 1000 mg/dL triglycerides…

VLDL or chylomicrons?

A

Chylomicrons.

46
Q

Can Rosuvastatin decrease the HDL?

A

Yes

47
Q

What hormone is a major trophic factor in fetal life?

A

Insulin

48
Q

What is the best management step for hypertriglyceridemia?

A

Making the patient NPO.

Eating makes triglycerides go up.

49
Q

What should you be concerned about if the thyroglobulin of a patient with known metastatic thyroid cancer suddenly drops (after it was previously detectable) with no intervention?

A

That the cancer is now de-differentiated and more aggressive.

50
Q

How do you assess the progress of de-differentiated thyroid cancer?

A

PET scan

51
Q

Why would a radiologist be uncomfortable ablating a toxic multinodular goiter if the thyroid uptake was normal?

A

Because a high dose of radioactive iodine needs to be used.

52
Q

Do opioids inhibit or stimulate ACTH release?

A

Inhibit ACTH release.

53
Q

Does IGF-1 level change with food intake?

A

Yes

54
Q

What ratio of alpha to beta blockade do you need for pheochromocytomas/paragangliomas?

A

4:1

55
Q

What is the ratio of alpha to beta blockade when using labetalol?

A

1:7

56
Q

What endocrine disorder can cause auricular cartilage calcification?

A

Adrenal insufficiency

57
Q

What happens to DHEA-S with age?

A

It decreases

58
Q

If the DHEA-S is higher than ____ then you can rule out adrenal insufficiency?

A

53.5 microgram/dL

59
Q

Should you check a DHEA-S if the patient has been on steroids recently?

A

No

60
Q

What do steroids do to DHEA-S?

A

Suppress it.

Endocrinology Fellowship (30 decks)

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