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Endocrinology Fellowship > Fellowship - September 2014 > Flashcards

Fellowship - September 2014 Flashcards

0
Q

What kind of stones does high urine pH predispose to?

A

Calcium phosphate

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1
Q

What does potassium citrate do to urine pH?

A

Makes it higher.

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2
Q

Is it preferable to be NPO before calcium measurement?

A

Yes

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3
Q

How long should you overlap the insulin infusion and the insulin pump when transitioning from the drip?

A

4 hours

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4
Q

What two circumstances need to be present to get hypercalcemia in Paget’s Disease?

A
  • Immobilization

- Impaired renal function

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5
Q

How many types of FHH (familial hypocalciuric hypercalcemia) are they?

A

3

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6
Q

If you are ruling out FHH with a 24-hour urine then the patient should be vitamin D replete?

True or false?

A

True

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7
Q

How many milligrams is Zometa injection?

A

4 mg

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8
Q

How many milligrams is Reclast?

A

5 mg

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9
Q

Should you order a karyotype in a female with primary amenorrhea if the the FSH is high or low?

A

High

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10
Q

Can prolactinomas cause unilateral breast discharge?

A

Yes

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11
Q

How does fat appear on a T1 acquisition MRI?

A

Bright / white

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12
Q

How does the CSF appear on T1 acquisition image MRI?

A

Dark

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13
Q

What does Angptl3 do to lipoprotein lipase?

A

Inhibits it

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14
Q

What does Angplt4 do to lipoprotein lipase?

A

Inhibits it

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15
Q

Which is better at inhibiting lipoprotein lipase…

Angplt3 or Angptl4?

A

Angptl4

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16
Q

Betatrophin and Angptl8 are the same thing.

True or false?

A

True

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17
Q

Betatrophin and Angptl3 are the same thing.

True or false?

A

False

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18
Q

Betatrophin and Angptl4 are the same thing.

True or false?

A

False

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19
Q

How wide is a normal Achilles’ tendon?

A

15 mm or less

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20
Q

What’s the most specific physical exam finding for familial hypercholesterolemia?

A

Tendon xanthomas

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21
Q

When you are converting mmol/L to mg/dL does it matter whether you use the glucose, triglyceride or cholesterol one?

A

Yes it does.

They convert to different values.

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22
Q

99% of iodine goes to the thyroid cells, where does the remaining 1% go?

A

Salivary glands.

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23
Q

When is sperm count zero with low semen volume?

2 conditions

A
  • Obstruction (partial or complete)

- Retrograde ejaculation.

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24
Q

What does IGF-1 do to bone and cartilage?

A

Causes growth.

25
Q

Does IGF-1 worsen or improve glucose tolerance?

A

Worsens glucose tolerance.

26
Q

Does IGF-1 change protein and fat metabolism?

A

Yes

27
Q

Which type of type 1 diabetes does not have antibodies?

A

Type 1b diabetes mellitus

28
Q

When do you lower the dose of a statin?

A

Consider lowering the dose if the LDL less than 40 mg/dL on two occasions.

29
Q

What syndrome occurs if you treat refractory Cushing’s disease (pituitary adenoma) with bilateral adrenalectomy?

A

Nelson’s syndrome

30
Q

What is the best anti-diabetic agent to use in cirrhosis?

A

Insulin

31
Q

How much glucose load is given during an oral glucose tolerance test to confirm acromegaly?

A

75 grams

32
Q

What two things are tested for at baseline when an oral glucose tolerance test to confirm acromegaly is done?

A
  • Glucose

- Growth Hormone

33
Q

How often and for how long are glucose and growth hormone levels drawn during oral glucose tolerance test to confirm acromegaly?

A

Every 30 minutes for two hours.

34
Q

At what level of growth hormone is the oral glucose tolerance test negative for acromegaly?

A

When the Growth Hormone level falls to less than 0.3 mcg/L.

35
Q

Does acromegaly cause diastolic dysfunction or systolic dysfunction?

A

Diastolic dysfunction.

36
Q

What two findings on echocardiography contribute to diastolic dysfunction in acromegaly?

A
  • Intraventricular septum thickening.

- Left posterior wall hypertrophy.

37
Q

Which cells do pheochromocytomas arise from?

A

Catecholemine-producing chromaffin cells in the adrenal medulla.

38
Q

Average blood glucose = 126 mg/dL

HbA1c = ?

A

6%

39
Q

Where are extra-adrenal pheochromocytomas most commonly located?

(Hint: 5 places)

A
  • Carotid body of the head and neck.
  • Mediastinum.
  • Along-side sympathetic ganglia close to IVC and abdominal aorta.
  • Organ of Zuckerkandl
  • Near urinary bladder.
40
Q

If a patient has polyuria in the setting of Uosm > 300 mOsm/kg then what it is usually due to?

A

Solute diuresis: most commonly because of diuretics or hyperglycemia.

41
Q

What represents a person’s vitamin D stores?

25-hydroxy vitamin D or 1,25-hydroxy vitamin D?

A

25-hydroxy vitamin D.

42
Q

If someone has been on high dose steroids intermittently every few days for a number of years - how would you taper their steroids?

A

Check their adrenal axis and if normal then just stop them.
If adrenal axis cannot be checked because of recent steroid use then put them on a physiologic dose of steroids and check the adrenal axis when convenient.

43
Q

Should type 1 diabetics be taken off insulin for any amount of time?

(Excepting hypoglycemia recovery because there is too much insulin on board).

A

No.

44
Q

What is the mechanism of action of Mipomerson (Kynamro)?

Hint: Inhibits synthesis of… ?

A

Inhibits apolipoprotein B-100 synthesis.

45
Q

What are the three main side effects of Somatostatin Analogs?

A
  • Abdominal cramping and bloating: usually improves over the first few months of treatment.
  • Gallstones: usually do not cause acute cholecystitis.
  • Pancreatitis: rare.
46
Q

What is the initial dose of octreotide LAR in acromegaly?

A

10 mg IM qMonth

47
Q

How often is the dose of octreotide LAR increased when titrating up for the treatment of acromegaly?

A

Every 2 - 3 months.

48
Q

What is the maximum dose of octreotide LAR?

A

40 mg IM qMonth

49
Q

Does increased calcium intake during lactation completely prevent bone loss?

A

No.

50
Q

Does having celiac’s disease, increase or decrease the risk of hip fracture?

A

Increases risk.

51
Q

Do diabetics have an increased incidence of pancreatitis?

A

Yes.

52
Q

Which sulfonylurea is best to use in renal failure?

A

Glipizide.

53
Q

How many types of familial partial lipodystrophies are they?

A

7

(5 in the literature, and 1 recently reported autosomal recessive (CIDEC) and 1 new gene to be reported by Dr. Garg).

54
Q

What is a minimal trauma fracture?

A

Falling from standing height.

55
Q

What are the two main components of bone volume?

A
  • Osteoid

- Bone Mineral

56
Q

Which 3 statins are not affected by grapefruit juice?

A

Fluvastatin
Pravastatin
Rosuvastatin

57
Q

Pomegranate juice used with statins may precipitate rhabdomyolysis.

True or false?

A

True.

There are some case reports.

58
Q

What do high levels of corticosterone do to aldosterone synthetase?

A

Inhibits it (down-regulates expression).

59
Q

Mechanism of ivacaftor?

A

Opens up the sweat chloride channels in cystic fibrosis with certain genotypes causing narrow channel.

60
Q

One of two things must be shown in a paper demonstrating a new association of a SNP with disease. What are these two things?

A
  • Replication of association in an independent cohort.

- Functional data for that particular SNP.

Endocrinology Fellowship (30 decks)

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