Midterms Case 3-5 Flashcards
typically extend deeper into the muscularis mucosa.
gastritis
erosions
peptic ulcer
peptic ulcer disease (PUD)
The most important factors that influence ulcer recurrence are:
H. pylori infection & NSAID use.
Which of the following medications is the first-line treatment for peptic ulcer disease?
a. Antibiotics (clarithromycin, amoxicillin, metronidazole)
b. Proton pump inhibitors (omeprazole, lansoprazole, esomeprazole)
c. H2 blockers (ranitidine, famotidine, cimetidine)
d. Antacids (magnesium hydroxide, aluminum hydroxide, calcium carbonate)
Answer: b.
Proton pump inhibitors are the first-line treatment for peptic ulcer disease, as they help reduce stomach acid production and promote healing of the ulcer. Antibiotics may also be prescribed if the underlying cause of the ulcer is determined to be an infection with H. pylori. H2 blockers and antacids may be used to manage symptoms, but are not typically used as first-line treatments for PUD.
What is the gold standard diagnostic test for diagnosing peptic ulcer disease caused by Helicobacter pylori infection?
stool antigen testing
Urea breath test (UBT)
serologic antibody tests
Histology (endoscopy with biopsy)
Histology (endoscopy with biopsy)
This type of PUD is associated w/ weight gain
Duodenal ulcers
Gastric ulcers
Duodenal ulcers
This type of PUD is associated w/ weight loss
Duodenal ulcers
Gastric ulcers
Gastric ulcers
A condition in which the stomach produces too much acid?
Zollinger-Ellison disease (ZES)
Among this PPI-based combination who is less effective?
amoxicillin + metronidazole
clarithromycin + amoxicillin
clarithromycin + metronidazole
amoxicillin + metronidazole
Omeprazole and esomeprazole selectively inhibit hepatic cytochrome P450 (CYP450) isoenzyme 2C19 and decrease the elimination of phenytoin, and diazepam
T/F
T
a synthetic prostaglandin E1 analog, moderately inhibits acid secretion and enhances mucosal defense?
Misoprostol
They are the mainstay of today’s treatment strategies for PUD?
H. pylori eradication & antisecretory drugs
a condition in which there is an overproduction of the thyroid gland?
Thyrotoxicosis
Which among these reduce the synthesis of thyroid hormones and are similar in efficacy and adverse effects, but their dosing ranges differ by 10-fold.
Radioactive Iodine and Lugol’s iodine
PTU and MMI
Propranolol and Prednisone
PTU and MMI
What is the most common cause of primary hypothyroidism?
A. Autoimmune thyroiditis
B. Pituitary gland dysfunction
C. Iodine deficiency
D. Medication side effects
A. Autoimmune thyroiditis is the most common cause of primary hypothyroidism.
Which thyroid hormone is most commonly used to treat hypothyroidism?
A. Triiodothyronine (T3)
B. Thyroxine (T4)
C. Thyroid-stimulating hormone (TSH)
D. Calcitonin
B. Thyroxine (T4) is the most commonly used thyroid hormone replacement therapy for hypothyroidism.
Which of the following is a symptom of hypothyroidism?
A. Weight loss
B. Heat intolerance
C. Palpitations
D. Fatigue
D. Fatigue is a common symptom of hypothyroidism.
What is the recommended treatment for hypothyroidism during pregnancy?
A. Increase the dosage of levothyroxine
B. Decrease the dosage of levothyroxine
C. Monitor thyroid hormone levels and adjust medication as necessary
D. No treatment is necessary, as hypothyroidism does not affect pregnancy
A. Increasing the dosage of levothyroxine is the recommended treatment for hypothyroidism during pregnancy.
Which of the following tests is used to diagnose hypothyroidism?
A. Complete blood count (CBC)
B. Electrocardiogram (ECG)
C. Thyroid function tests (TFTs)
D. Urine analysis
C. Thyroid function tests (TFTs), including TSH and T4 tests, are used to diagnose hypothyroidism.
What is the most common age group affected by hypothyroidism?
A. Children and teenagers
B. Young adults
C. Middle-aged adults
D. Elderly adults
C. Middle-aged adults are the most commonly affected age group for hypothyroidism.
Which of the following is a potential complication of untreated hypothyroidism?
A. Hyperthyroidism
B. Osteoporosis
C. Hypertension
D. Hyperglycemia
B. Osteoporosis is a potential complication of untreated hypothyroidism.
Which of the following conditions is commonly associated with autoimmune thyroiditis?
A. Type 1 diabetes
B. Rheumatoid arthritis
C. Systemic lupus erythematosus
D. All of the above
D. Autoimmune thyroiditis is commonly associated with type 1 diabetes, rheumatoid arthritis, and systemic lupus erythematosus.
Which of the following medications can interfere with thyroid hormone production and lead to hypothyroidism?
A. Amiodarone
B. Furosemide
C. Metoprolol
D. Aspirin
A. Amiodarone is a medication that can interfere with thyroid hormone production and lead to hypothyroidism.
What is the target range for TSH levels in patients receiving levothyroxine treatment for hypothyroidism?
A. 0.1-1.0 mIU/L
B. 0.3-3.0 mIU/L
C. 1.0-2.0 mIU/L
D. 2.0-4.0 mIU/L
B. The target range for TSH levels in patients receiving levothyroxine treatment for hypothyroidism is typically 0.3-3.0 mIU/L.
What is the most common cause of hyperthyroidism?
A. Graves’ disease
B. Toxic multinodular goiter
C. Thyroiditis
D. Pituitary gland dysfunction
Answer: A. Graves’ disease is the most common cause of hyperthyroidism, accounting for about 80% of cases.
What is the primary thyroid hormone responsible for the symptoms of hyperthyroidism?
A. Triiodothyronine (T3)
B. Thyroxine (T4)
C. Thyroid-stimulating hormone (TSH)
D. Calcitonin
Answer: A. Triiodothyronine (T3) is the primary thyroid hormone responsible for the symptoms of hyperthyroidism.
Which of the following is a symptom of hyperthyroidism?
A. Weight gain
B. Fatigue
C. Cold intolerance
D. Heat intolerance
Answer: D. Heat intolerance is a common symptom of hyperthyroidism.
What is the treatment of choice for hyperthyroidism caused by Graves’ disease?
A. Radioactive iodine therapy
B. Antithyroid medication
C. Thyroidectomy
D. Beta-blockers
Answer: A. Radioactive iodine therapy is the treatment of choice for hyperthyroidism caused by Graves’ disease.
Which of the following laboratory tests is used to diagnose hyperthyroidism?
A. Thyroid-stimulating hormone (TSH)
B. Triiodothyronine (T3)
C. Thyroxine (T4)
D. All of the above
Answer: D. All of the above laboratory tests can be used to diagnose hyperthyroidism.
What is the target range for TSH levels in patients with hyperthyroidism?
A. Less than 0.1 mIU/L
B. 0.1-0.4 mIU/L
C. 0.4-4.0 mIU/L
D. Greater than 4.0 mIU/L
Answer: A. In patients with hyperthyroidism, TSH levels are typically suppressed and kept below 0.1 mIU/L.
Which of the following is a potential complication of untreated hyperthyroidism?
A. Hypothyroidism
B. Osteoporosis
C. Hypertension
D. Hypoglycemia
Answer: B. Osteoporosis is a potential complication of untreated hyperthyroidism.
What is the role of beta-blockers in the treatment of hyperthyroidism?
A. To reduce thyroid hormone production
B. To treat the underlying cause of hyperthyroidism
C. To relieve symptoms such as palpitations and tremors
D. To prevent complications such as osteoporosis
Answer: C. Beta-blockers are used in the treatment of hyperthyroidism to relieve symptoms such as palpitations and tremors.
What is the most common age group affected by hyperthyroidism?
A. Children and teenagers
B. Young adults
C. Middle-aged adults
D. Elderly adults
Answer: B. Hyperthyroidism is most commonly diagnosed in young adults.
Which of the following conditions is commonly associated with hyperthyroidism?
A. Type 1 diabetes
B. Rheumatoid arthritis
C. Systemic lupus erythematosus
D. None of the above
Answer: D. None of the above conditions are commonly associated with hyperthyroidism.
first line treatment for hyperthyroidism?
A. Radioactive iodine therapy
B. Antithyroid medication
C. Thyroidectomy
D. Beta-blockers
Answer: B. Antithyroid medication, such as methimazole or propylthiouracil, is typically the first line treatment for hyperthyroidism, unless there is an urgent need to lower thyroid hormone levels, in which case beta-blockers may be used as a temporary measure.
what is the golden standard for diagnosing hyperthyroidism?
A. Thyroid-stimulating hormone (TSH) level
B. Triiodothyronine (T3) level
C. Thyroxine (T4) level
D. Radioactive iodine uptake (RAIU) test
Answer: A. The golden standard diagnosis for hyperthyroidism is a low serum thyroid-stimulating hormone (TSH) level in combination with elevated serum triiodothyronine (T3) and/or thyroxine (T4) levels.
Which of the following is a feature of Graves disease?
A. Hypothyroidism
B. Weight gain
C. Exophthalmos
D. Cold intolerance
Answer: C. Exophthalmos, or bulging eyes, is a characteristic feature of Graves disease, which is an autoimmune disorder that results in hyperthyroidism. Other features of Graves disease may include goiter, weight loss, heat intolerance, tremors, and palpitations. Hypothyroidism is not a feature of Graves disease, as it is a condition characterized by low levels of thyroid hormone, whereas Graves disease results in excess thyroid hormone production. Weight gain and cold intolerance are also not typical features of Graves disease, as hyperthyroidism generally leads to weight loss and heat intolerance.
Best treatment for toxic nodules and toxic multinodular goiter. It cures hyperthyroidism and it is the most cost effective.
Radioactive iodine (131I)
the most serious adverse effect of thiourea drug therapy and is characterized by fever, malaise, gingivitis, oropharyngeal infection, and a granulocyte count less than 250/mm
Agranulocytosis
It is the most common cause of spontaneous hypothyroidism in the adult?
Autoimmune thyroiditis (Hashimoto’s disease)
considered to be the drug of choice to treat hypothyroidism?
levothyroxine (L-thyroxine; T4)
Why LT4 is considered as the treatment of choice?
Chemically stable,
Relatively inexpensive
Free of antigenicity
Has uniform potency
medications that can cause hypothyroidism or interfere with thyroid function:
Lithium, Amiodarone, Interferon alpha, Tyrosine kinase inhibitors (sunitinib, sorafenib), Immune checkpoint inhibitors, and Anti-seizure medications (phenytoin, carbamazepine)
It is recommended to take ferrous sulfate and calcium carbonate together?
T/F
F.
Taking ferrous sulfate and calcium carbonate together can interfere with the absorption of both supplements, as they both compete for absorption in the gastrointestinal tract. Calcium can bind with ferrous sulfate, forming an insoluble complex that is poorly absorbed by the body.
a rare consequence of decompensated hypothyroidism. Clinical features include hypothermia, advanced stages of hypothyroid symptoms, and altered sensorium ranging from delirium to coma.
Myxedema coma
Which of the following is the most commonly prescribed medication for hypothyroidism?
A) Levothyroxine
B) Liothyronine
C) Propylthiouracil
D) Methimazole
Answer: A) Levothyroxine
Which of the following medications can interfere with the absorption of levothyroxine?
A) Calcium carbonate
B) Metformin
C) Propranolol
D) Hydrochlorothiazide
Answer: A) Calcium carbonate
Which of the following is a potential adverse effect of levothyroxine therapy?
A) Hypertension
B) Weight gain
C) Fatigue
D) Bradycardia
Answer: D) Bradycardia
Which of the following medications should be used with caution in patients with hypothyroidism due to the risk of inducing hyperthyroidism?
A) Lithium
B) Amiodarone
C) Propranolol
D) Levothyroxine
Answer: B) Amiodarone
In patients with severe hypothyroidism, which of the following should be monitored closely when initiating levothyroxine therapy?
A) Blood pressure
B) Serum electrolytes
C) Serum cholesterol levels
D) Heart rate
Answer: D) Heart rate
What is the most common cause of primary hypothyroidism?
A) Autoimmune thyroiditis
B) Pituitary dysfunction
C) Iodine deficiency
D) Medications
Answer: A) Autoimmune thyroiditis
Which of the following laboratory tests is most commonly used to diagnose hypothyroidism?
A) Thyroid-stimulating hormone (TSH)
B) Free thyroxine (FT4)
C) Total triiodothyronine (TT3)
D) Thyroid peroxidase antibody (TPOAb)
Answer: A) Thyroid-stimulating hormone (TSH)
Which of the following is a characteristic finding on physical examination in patients with severe hypothyroidism?
A) Tachycardia
B) Hyperreflexia
C) Goiter
D) Dry skin
Answer: C) Goiter
Which of the following imaging studies may be useful in the diagnosis of hypothyroidism?
A) Thyroid ultrasound
B) Magnetic resonance imaging (MRI)
C) Computed tomography (CT) scan
D) X-ray
Answer: A) Thyroid ultrasound
In patients with suspected hypothyroidism, which of the following should be evaluated to determine the cause of the disorder?
A) Serum electrolytes
B) Adrenal function
C) Antinuclear antibody (ANA) test
D) Thyroid peroxidase antibody (TPOAb) test
Answer: D) Thyroid peroxidase antibody (TPOAb) test
a pathologic condition characterized by excessive production of GH?
Acromegaly
even more rare than acromegaly, is the excess secretion of GH prior to epiphyseal closure in children.
Gigantism
commonly used as an important diagnostic tool of acromegaly?
Oral Glucose Tolerance Test (OGTT)
Which of the following is the first-line treatment for acromegaly?
a) Somatostatin analogs (e.g.Ocreotide (Sandostatin))
b) Dopamine agonists (bromocriptine, pergolide, cabergoline, lisuride, quinagolide)
c) GH receptor antagonists (e.g. Pegvisomant (Somavert))
d) GH secretagogues
Answer: a) Somatostatin analogs
Answer: a) Somatostatin analogs
Which of the following medications can be used as second-line treatment for acromegaly?
a) Bromocriptine
b) Pegvisomant
c) Lanreotide
d) Octreotide
Answer: b) Pegvisomant (GH receptor antagonist)
How do somatostatin analogs work in the treatment of acromegaly?
a) They inhibit GH secretion from the pituitary gland
b) They stimulate GH secretion from the pituitary gland
c) They block the GH receptor
d) They promote GH degradation
Answer: a) They inhibit GH secretion from the pituitary gland
Which of the following is a potential adverse effect of GH receptor antagonists?
a) Hypertension
b) Hypoglycemia
c) Nausea and vomiting
d) Injection site reactions
Answer: b) Hypoglycemia
Which of the following medications is a GH secretagogue?
a) Somatostatin analogs
b) Dopamine agonists
c) GH receptor antagonists
d) GHRH analogs
Answer: d) GHRH analogs
Which of the following is the most common cause of acromegaly?
a) Pituitary adenoma
b) Ectopic growth hormone-releasing hormone (GHRH) secretion
c) Adrenal gland tumor
d) Thyroid gland tumor
Answer: a) Pituitary adenoma
What is the gold standard diagnostic test for acromegaly?
a) Insulin-like growth factor-1 (IGF-1) level
b) Growth hormone (GH) suppression test
c) Magnetic resonance imaging (MRI) of the pituitary gland
d) Physical examination
Answer: c) Magnetic resonance imaging (MRI) of the pituitary gland
Which of the following is a sign of acromegaly?
a) Hyperpigmentation
b) Hypoglycemia
c) Enlarged hands and feet
d) Tachycardia
Answer: c) Enlarged hands and feet
What is the normal range for IGF-1 level in adults?
a) 50-100 ng/mL
b) 100-250 ng/mL
c) 250-500 ng/mL
d) 500-1000 ng/mL
Answer: b) 100-250 ng/mL
How is acromegaly treated?
a) Surgery
b) Medications
c) Radiation therapy
d) All of the above
Answer: d) All of the above
currently considered as the mainstay therapy for treatment of GHD short stature
Recombinant GH
a state of persistent prolactin elevation (2o mcg/L).
Hyperprolactinemia
Medications most frequently associated with hyperprolactinemia?
SSRIs (fluoxetine, paroxetine, sertraline, fluvoxamine)
D2 receptor antagonist (metoclopramide, domperidone)
a dopamine-receptor agonist that is 10 -1,000x more potent than bromocriptine per mg
Bromocriptine
Cabergoline
Pergolide
Quinagolide
Pergolide
long-acting dopamine agonist w/ high selectivity for dopamine D2-receptors.
Bromocriptine
Cabergoline
Pergolide
Quinagolide
Cabergoline
The first D2-receptor agonist to b used in the treatment of hyperprolactinemia.
Bromocriptine
Cabergoline
Pergolide
Quinagolide
Bromocriptine
D2-receptor agonist frequently used in Europe and is dosed once daily.
Bromocriptine
Cabergoline
Pergolide
Quinagolide
Quinagolide
Which of the following drugs is used to treat hyperprolactinemia?
a) Bromocriptine
b) Digoxin
c) Warfarin
d) Metformin
Answer: a) Bromocriptine
Which of the following is a common adverse effect of bromocriptine?
a) Hypertension
b) Hypotension
c) Diarrhea
d) Nausea and vomiting
Answer: d) Nausea and vomiting
Which of the following is a long-acting dopamine agonist used to treat hyperprolactinemia?
a) Cabergoline
b) Levodopa
c) Carbidopa
d) Pramipexole
Answer: a) Cabergoline
Which of the following is a pituitary hormone that is inhibited by dopamine?
a) Growth hormone
b) Prolactin
c) Adrenocorticotropic hormone
d) Thyroid-stimulating hormone
Answer: b) Prolactin
Which of the following is a potential complication of untreated hyperprolactinemia in females?
a) Osteoporosis
b) Polycystic ovary syndrome
c) Hypothyroidism
d) Cushing’s syndrome
Answer: a) Osteoporosis
complete or partial loss of anterior and posterior pituitary function resulting in a complex disorder characterized by multiple pituitary hormone deficiencies.
Panyhypopituitarism
Which of the following is a risk factor for hyperprolactinemia?
a) Obesity
b) Smoking
c) Alcohol consumption
d) Physical inactivity
Answer: a) Obesity
Hyperprolactinemia is caused by:
a) Increased dopamine levels
b) Increased prolactin levels
c) Decreased dopamine levels
d) Decreased prolactin levels
Answer: c) Decreased dopamine levels
Which of the following is a nonpharmacological treatment option for hyperprolactinemia?
a) Surgery
b) Radiation therapy
c) Weight loss
d) Chemotherapy
Answer: c) Weight loss
The diagnosis of hyperprolactinemia is typically made by measuring:
a) Blood glucose levels
b) Thyroid hormone levels
c) Prolactin levels
d) Cortisol levels
Answer: c) Prolactin levels
Which of the following is a sign or symptom of hyperprolactinemia in females?
a) Erectile dysfunction
b) Infertility
c) Gynecomastia
d) Testicular atrophy
Answer: b) Infertility
Which of the following is a known risk factor for type 2 diabetes mellitus?
a) Being underweight
b) Smoking
c) Low-fat diet
d) Physical activity
Answer: b) Smoking
Which of the following is an essential component of the pathophysiology of type 1 diabetes mellitus?
a) Insulin resistance
b) Autoimmune destruction of pancreatic beta cells
c) Beta-cell hyperplasia
d) Overproduction of insulin
Answer: b) Autoimmune destruction of pancreatic beta cells
Which of the following nonpharmacological treatments is recommended for individuals with diabetes mellitus?
a) Smoking cessation
b) Limiting carbohydrate intake
c) Regular physical activity
d) All of the above
Answer: d) All of the above
Which of the following is a sign or symptom of diabetes mellitus?
a) Blurred vision
b) Chest pain
c) Shortness of breath
d) Joint pain
Answer: a) Blurred vision
Which of the following tests is used to diagnose diabetes mellitus?
a) Fasting plasma glucose test
b) Hemoglobin A1C test
c) Oral glucose tolerance test
d) All of the above
Answer: d) All of the above
Which of the following is a known risk factor for gestational diabetes mellitus?
a) Being underweight
b) Young maternal age
c) Previous pregnancy with a normal birthweight infant
d) Low-fat diet
Answer: b) Young maternal age
Which of the following medications is commonly used to manage type 2 diabetes mellitus?
a) Metformin
b) Insulin
c) Aspirin
d) Antibiotics
Answer: a) Metformin
Which of the following is a potential complication of uncontrolled diabetes mellitus?
a) Hypertension
b) Osteoporosis
c) Diarrhea
d) Diabetic retinopathy
Answer: d) Diabetic retinopathy
Which of the following lifestyle changes can help prevent the development of type 2 diabetes mellitus?
a) Quitting smoking
b) Following a low-carbohydrate diet
c) Engaging in regular physical activity
d) All of the above
Answer: d) All of the above
Which of the following symptoms is indicative of hypoglycemia in individuals with diabetes mellitus?
a) Nausea
b) Fatigue
c) Blurred vision
d) Sweating
Answer: d) Sweating
Which of the following is a commonly used medication to manage type 1 diabetes mellitus?
a) Metformin
b) Insulin
c) Glipizide
d) Pioglitazone
Answer: b) Insulin
Which of the following medications works by increasing insulin secretion from pancreatic beta cells?
a) Metformin
b) Insulin
c) Glipizide
d) Pioglitazone
Answer: c) Glipizide
Which of the following medications works by inhibiting the breakdown of incretin hormones?
a) Metformin
b) Insulin
c) Sitagliptin
d) Pioglitazone
Answer: c) Sitagliptin
Which of the following medications works by improving insulin sensitivity and reducing hepatic glucose production?
a) Metformin
b) Insulin
c) Glipizide
d) Pioglitazone
Answer: a) Metformin
Which of the following medication classes is associated with an increased risk of hypoglycemia in individuals with diabetes mellitus?
a) ACE inhibitors
b) Beta-blockers
c) Calcium channel blockers
d) Sulfonylureas
Answer: d) Sulfonylureas
Which of the following is a diagnostic criterion for diabetes mellitus according to the American Diabetes Association?
a) Fasting plasma glucose level ≥ 120 mg/dL
b) Random plasma glucose level ≥ 200 mg/dL
c) HbA1c level ≥ 6.5%
d) All of the above
Answer: d) All of the above
Which of the following tests is used to screen for gestational diabetes mellitus?
a) Fasting plasma glucose test
b) HbA1c test
c) Oral glucose tolerance test
d) Random plasma glucose test
Answer: c) Oral glucose tolerance test
Which of the following factors can affect the accuracy of HbA1c measurements?
a) Iron deficiency anemia
b) Chronic kidney disease
c) High altitude
d) All of the above
Answer: d) All of the above
Which of the following tests is recommended for screening for type 2 diabetes mellitus in asymptomatic individuals?
a) Fasting plasma glucose test
b) HbA1c test
c) Oral glucose tolerance test
d) Random plasma glucose test
Answer: b) HbA1c test
Which of the following tests is used to monitor blood glucose levels in individuals with diabetes mellitus?
a) Fasting plasma glucose test
b) HbA1c test
c) Oral glucose tolerance test
d) Random plasma glucose test
Answer: b) HbA1c test
Diabetes Association medication algorithm?
a) Metformin
b) Sulfonylureas
c) DPP-4 inhibitors
d) GLP-1 receptor agonists
Answer: a) Metformin
Which of the following medications should be added to metformin if the HbA1c target is not achieved?
a) Sulfonylureas
b) DPP-4 inhibitors
c) GLP-1 receptor agonists
d) All of the above
Answer: d) All of the above
Which of the following medications should be avoided in patients with heart failure according to the American Diabetes Association medication algorithm?
a) Metformin
b) Sulfonylureas
c) DPP-4 inhibitors
d) SGLT-2 inhibitors
Answer: b) Sulfonylureas
SGLT-2 inhibitors may be preferred in these patients due to their cardiovascular benefits.
Which of the following medications can cause weight loss in patients with diabetes mellitus?
a) Sulfonylureas
b) DPP-4 inhibitors
c) GLP-1 receptor agonists
d) None of the above
Answer: c) GLP-1 receptor agonists
Which of the following medications can cause weight loss in patients with diabetes mellitus?
a) Sulfonylureas
b) DPP-4 inhibitors
c) GLP-1 receptor agonists
d) None of the above
Answer: c) GLP-1 receptor agonists
Which of the following medications is contraindicated in patients with a history of pancreatitis or pancreatic cancer?
a) Metformin
b) Sulfonylureas
c) DPP-4 inhibitors
d) SGLT-2 inhibitors
Answer: d) SGLT-2 inhibitors
a group of metabolic disorders of fat, carbohydrate, and protein metabolism that results from defects in insulin secretion, sensitivity, or both.
Diabetes mellitus
3 criteria for diagnosis of diabetes:
- fasting plasma glucose ≥126 mg/dL,
- 2-hour value from a 75-g oral glucose tolerance test ≥200 mg/dL, or
- a casual plasma glucose level of ≥200 mg/dL
acute complication in Type 1 DM?
Diabetic ketoacidosis
acute complication in Type 2 DM?
Hyperosmolar hyperglycemic state
Which of the following medications is commonly used to treat ACTH insufficiency?
A. Aspirin
B. Levothyroxine
C. Insulin
D. Hydrocortisone
Answer: D. Hydrocortisone
Which of the following statements is true regarding hydrocortisone treatment for ACTH insufficiency?
A. Hydrocortisone is only available as an oral medication.
B. The dosage of hydrocortisone should be gradually increased over time.
C. Hydrocortisone can cause hyperglycemia and hypertension.
D. Hydrocortisone treatment is not effective in treating ACTH insufficiency.
Answer: B. The dosage of hydrocortisone should be gradually increased over time.
Which of the following laboratory tests is used to diagnose ACTH insufficiency?
A. Thyroid function tests
B. Serum electrolytes
C. Cosyntropin stimulation test
D. Lipid panel
Answer: C. Cosyntropin stimulation test
Which of the following is a risk factor for developing ACTH insufficiency?
A. Family history of type 2 diabetes
B. Long-term use of corticosteroids
C. Active smoking
D. Regular physical activity
Answer: B. Long-term use of corticosteroids
What is the primary pathophysiological mechanism of ACTH insufficiency?
A. Impaired insulin secretion
B. Decreased production of cortisol and other adrenal hormones
C. Autoimmune destruction of pancreatic beta cells
D. Overproduction of growth hormone
Answer: B. Decreased production of cortisol and other adrenal hormones
Which of the following is a common sign of ACTH insufficiency?
A. Hyperpigmentation of the skin
B. Hypertension
C. Weight gain
D. Tachycardia
Answer: A. Hyperpigmentation of the skin
Which of the following is the first-line medication for the treatment of ACTH insufficiency?
A. Levothyroxine
B. Insulin
C. Metformin
D. Hydrocortisone
Answer: D. Hydrocortisone
Which of the following is a non-pharmacological treatment option for managing ACTH insufficiency?
A. Regular exercise
B. Dietary modification
C. Transplantation of a healthy pituitary gland
D. Psychotherapy
Answer: B. Dietary modification
the drug of choice in bilateral adrenal hyperplasia (BAH)-dependent hyperaldosteronism.
Spironolactone, a competitive inhibitor of aldosterone
Which of the following drugs is the first-line treatment for acute gout attacks?
a. Allopurinol
b. Colchicine
c. Febuxostat
d. Probenecid
Answer: b. Colchicine
Which of the following drugs is a xanthine oxidase inhibitor used to treat chronic gout?
a. Allopurinol
b. Colchicine
c. Febuxostat
d. Probenecid
Answer: a. Allopurinol
Which of the following drugs is used to treat chronic gout by increasing the excretion of uric acid?
a. Allopurinol
b. Colchicine
c. Febuxostat
d. Probenecid
Answer: d. Probenecid
Which of the following is the primary underlying cause of gout?
a. Decreased renal excretion of uric acid
b. Increased production of uric acid
c. Autoimmune dysfunction
d. Vascular damage
Answer: b. Increased production of uric acid
What is the mechanism by which uric acid crystals cause inflammation in gout?
a. Activation of complement system
b. Stimulation of mast cells
c. Recruitment of neutrophils
d. Upregulation of cytokine production
Answer: c. Recruitment of neutrophils
Which of the following medical conditions is commonly associated with the development of gout?
a. Hypothyroidism
b. Hyperthyroidism
c. Diabetes mellitus
d. Hypertension
Answer: d. Hypertension
Which of the following is a known risk factor for the development of gout?
a. Vegetarian diet
b. Low alcohol consumption
c. Obesity
d. Regular exercise
Answer: c. Obesity
Which of the following is a common symptom of acute gout?
a. Joint stiffness
b. Fever
c. Muscle weakness
d. Sudden onset of severe joint pain
Answer: d. Sudden onset of severe joint pain
Which of the following is a potential complication of chronic gout?
a. Hypertension
b. Liver failure
c. Kidney stones
d. Pneumonia
Answer: c. Kidney stones
Which of the following is the recommended serum urate level for patients with gout?
a. Less than 4 mg/dL
b. Less than 6 mg/dL
c. Less than 8 mg/dL
d. Less than 10 mg/dL
Answer: b. Less than 6 mg/dL
Which of the following is gold standard for the diagnosis of gout?
a. X-ray of the affected joint
b. Ultrasound of the affected joint
c. Blood test for uric acid levels
d. Joint aspiration and analysis of synovial fluid
Answer: d. Joint aspiration and analysis of synovial fluid
Which of the following medications is not recommended for the treatment of gout?
a. Allopurinol
b. Colchicine
c. Probenecid
d. Aspirin
Answer: d. Aspirin
Which of the following medications is used for the long-term management of gout?
a. Colchicine
b. Indomethacin
c. Allopurinol
d. Prednisone
Answer: c. Allopurinol
Which of the following medications can cause a serious hypersensitivity reaction in patients with gout?
a. Colchicine
b. Allopurinol
c. Probenecid
d. Prednisone
Answer: b. Allopurinol
Which of the following medications can be used to treat both acute gout attacks and hyperuricemia in patients with gout?
a. Colchicine
b. Allopurinol
c. Probenecid
d. Febuxostat
Answer: d. Febuxostat
Which of the following medications is contraindicated in patients with severe renal impairment?
a. Colchicine
b. Allopurinol
c. Probenecid
d. Prednisone
Answer: b. Allopurinol
Which of the following is considered first-line therapy for osteoarthritis?
A. Acetaminophen
B. Non-steroidal anti-inflammatory drugs (NSAIDs)
C. Glucosamine and chondroitin
D. Intra-articular corticosteroid injections
Answer: A. Acetaminophen
Which of the following is a potential side effect of long-term NSAID use for osteoarthritis?
A. Hypotension
B. Gastrointestinal bleeding
C. Hyperkalemia
D. Hepatotoxicity
Answer: B. Gastrointestinal bleeding
Which of the following medications is not recommended for the treatment of osteoarthritis?
A. Celecoxib
B. Naproxen
C. Diclofenac
D. Codeine
Answer: D. Codeine
Which of the following drugs is the most effective for the long-term management of osteoarthritis?
A. Acetaminophen
B. Naproxen
C. Celecoxib
D. Glucosamine
Answer: C. Celecoxib
Which of the following is a potential side effect of long-term use of COX-2 inhibitors for osteoarthritis?
A. Renal impairment
B. Gastrointestinal bleeding
C. Hyperkalemia
D. Hepatotoxicity
Answer: A. Renal impairment
Which of the following drugs is not recommended for the treatment of osteoarthritis in older adults?
A. Acetaminophen
B. NSAIDs
C. Tramadol
D. Opioids
Answer: D. Opioids
Which of the following is a common risk factor for the development of osteoarthritis?
A. Obesity
B. Hypertension
C. Hyperthyroidism
D. Asthma
Answer: A. Obesity
Which of the following is a common sign of osteoarthritis?
A. Joint swelling
B. Joint redness
C. Joint warmth
D. Joint stiffness
Answer: D. Joint stiffness
Which of the following is a common symptom of osteoarthritis?
A. Fatigue
B. Headache
C. Fever
D. Joint pain
Answer: D. Joint pain
Which of the following is a key pathophysiological feature of osteoarthritis?
A. Synovial inflammation
B. Synovial hypertrophy
C. Articular cartilage destruction
D. Pannus formation
Answer: C. Articular cartilage destruction
Which of the following nonpharmacological treatments is recommended for patients with osteoarthritis?
A. Weight loss
B. High-impact exercise
C. Prolonged bed rest
D. Inactivity
Answer: A. Weight loss
Which of the following nonpharmacological treatments has been shown to be effective in reducing joint pain and improving function in patients with osteoarthritis?
A. Acupuncture
B. Chiropractic manipulation
C. Physical therapy
D. Herbal supplements
Answer: C. Physical therapy
What is the gold standard for the diagnosis of osteoarthritis?
A. MRI
B. X-ray
C. CT scan
D. Ultrasound
Answer: B. X-ray
Which of the following drugs should be avoided in patients with osteoarthritis who are taking warfarin?
a. Acetaminophen
b. Celecoxib
c. Codeine
d. Naproxen
Answer: b. Celecoxib
Which of the following drugs should be avoided in patients with osteoarthritis who are taking lithium?
a. Acetaminophen
b. Celecoxib
c. Ibuprofen
d. Tramadol
Answer: c. Ibuprofen
Which of the following medications is a first-line treatment for osteoarthritis pain?
a. Methotrexate
b. Celecoxib
c. Acetaminophen
d. Prednisone
Answer: c. Acetaminophen
Which of the following medications is a disease-modifying agent for osteoarthritis?
a. Celecoxib
b. Glucosamine
c. Codeine
d. Naproxen
Answer: b. Glucosamine
Rationale: Glucosamine is a disease-modifying agent that can slow the progression of osteoarthritis by promoting cartilage regeneration. Celecoxib, codeine, and naproxen are all used to manage osteoarthritis symptoms but are not disease-modifying agents.
Which of the following medications can cause hepatotoxicity in patients with osteoarthritis?
a. Methotrexate
b. Celecoxib
c. Acetaminophen
d. Prednisone
Answer: a. Methotrexate
