MKSAP Qbank Flashcards

1
Q

Three first line tests to establish hypercortisolism

A
  1. Late night salivary cortisol
  2. 24 hour urinary free cortisol
  3. Overnight DMT suppression test
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2
Q

How many tests are needed to establish hypercortisolism

A

2/3 first line tests

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3
Q

Monoclonal antibody for osteoporosis

A

Denosumab

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4
Q

Which medication should be started before stopping denosumab

A

Bisphosphonates

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5
Q

One lab diagnostic of myxedema coma?

A

Low free T4. Not TSH

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6
Q

Commonly administered in myxedema coma with levothyroxine

A

Empiric steroids for adrenal insufficiency

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7
Q

Lab to monitor levothyroxine dosage after pituitary resection

A

T4

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8
Q

Target FT4 for levithyroxine supplementation after pitutary resection

A

Mid to upper range of normal

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9
Q

Does alendronate improve BMD?

A

No

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10
Q

Nesidoblastosis

A

Post gastric bypass hypoglycemia

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11
Q

Clinically significant hypoglycemia

A

55

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12
Q

Relative hypoglycemia

A

Rapid correction of BG in a patient with persistently high BG

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13
Q

Hypoglycemia unawareness

A

Lack of autonomic response to low BG

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14
Q

Whipple’s triad

A

Hypoglycemia triad

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15
Q

4 tests for fasting hypoglycemia

A
  1. Insulin
  2. C peptide
  3. Pro insulin
  4. Beta hydroxy butyrate
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16
Q

Frequency of lab draws for fasting hypoglycemia

A

Every 6 hours

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17
Q

Frequency of plasma glucose measurement for PP hypoglycemia

A

Every 30 minutes * 5 hours after meal

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18
Q

Fasting BG for metabolic syndrome

A

100

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19
Q

TG for metabolic syndrome

A

150

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20
Q

DBP for metabolic syndrome

A

85

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21
Q

Waist circumference for metabolic syndrome

A

35 F and 40 M

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22
Q

Weight loss goal for DM

A

7% in 6 months

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23
Q

When should you not target a HbA1c

A

Life expectancy <10 years

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24
Q

Side effect of thiazolidinediones

A

CHF

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25
Q

Fournier gangrene is a SE of which hypoglycemic agent

A

SGLT-2

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26
Q

2 lab abnormalities seen with Metformin

A
  1. Lactic acidosis
  2. B12 deficiency
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27
Q

Insulin dose in T2DM

A

0.1-0.5

28
Q

Insulin in type 1 DM

A

0.4-1unit/kg

29
Q

Most incidentally discovered adenomas are ——-

A

Benign

30
Q

What are the two ways to classify a pitutary adenoma

A
  1. Micro and macro
  2. Functioning and non functioning
31
Q

Duration for denosumab

A

10 years

32
Q

What is MACE

A

Mild autonomous cortisol excess; adrenal ACTH independent production of cortisol without features of fishing’s

33
Q

Three drugs for neuropathic pain

A
  1. Pregablin
  2. Gabapentin
  3. Cymbalta
34
Q

Common pain medication causing hypogonadism

A

Opiates by suppressing GnRH

35
Q

Medications causing hyperprolactenemia

A

Anti psychotics and metoclopropamide

36
Q

Rx of med related hyper prolactinemia

A
  1. Stop if possible
  2. If cannot be stopped —> put Stuart MRI to evaluate for adenoma
  3. Hormone replacement to Rx symptoms
  4. DO NOT GIVE CABERGOLINE DUR TO WORSENING OF PSYCH SYMPTOMS
37
Q

When to Re image pitutary adenoma after starting therapy

A

3 months and then every 6-12 months

38
Q

Asymptomatic pitutary micro adenoma Rx

A

None

39
Q

Mainstay Rx or acromegaly

A

Surgery

40
Q

Drug Rx of acromegaly

A

Pegvisomant

41
Q

Difference between Cushing disease and syndrome

A

Disease: pitutary source
Syndrome: any source

42
Q

Diagnosis DI

A
  1. High serum osmolarity and Na
  2. Low urine osmolarity
  3. Water deprivation
43
Q

Diff central from nephrogenic DI

A

Desmopressin supression

44
Q

2 medications causing hyperCa

A
  1. Lithium
  2. Thiazides
45
Q

What is tertiary huperPTH

A

CKD patients with chronic secondary hyperPTH develop PTH hyperplasia leading to autonomous PTH production

46
Q

Familial hypocalciuric hupocalcemia gene mutation

A

Calcium sensing R gene

47
Q

2 other endocrine disorders causing high Ca

A

Throtoxicosis and Addison crisis

48
Q

When should rheum screen for osteoporosis

A

Steroids for >6 months
1. <40 yr + risk factors
2. >40 yr

49
Q

Common side effect of zolendronic acid

A

First insulin fever and myalgia —> does not recur

50
Q

Contraindication for bisphosphonate

A

GFR <35

51
Q

Recombinant PTH for osteoporosis

A

Teri pertained and abaloparatide

52
Q

Max duration for recombinant PTH in osteoporosis

A

2 years

53
Q

Sclerotin inhibitor

A

Romosuzumab

54
Q

Contraindication of romosuzumab

A

CVD

55
Q

Which hormone levels should be tested in all patients with adrenal incidentaloma

A

Cortisol levels

56
Q

When should pheo testing be done for incedentaloma

A

> 10 hounsfield unit on CT abdomen

57
Q

What are the characteristics of benign adrenal incedentaloma

A
  1. Size <4 cm
  2. Hounsfield units <10
  3. Contrast washout >60% in 10 minutes
58
Q

Which anti thyroid medication is used acutely and which is maintainance

A

PTU - promote recovery
Methimazole - maintain

59
Q

Endocrine abnormalities progression after pitutary resection

A

DI post op —> SIADH in 7-10 days —> DI permanent

60
Q

Which two drugs lead to false results on RAIU scan?

A

Lithium and Amiodarone

61
Q

Proxy for HBA1c in patients with hemolytic anemia

A

Frustosamine

62
Q

Remember situations when HBA1c is not useful

A
  1. Hemolytic anemia
  2. Blood transfusion
  3. Hemoglobinopathies
63
Q

Contraindications for GLP-1

A
  1. Pancreatic CA/pancreatitis
  2. MEN syndrome
64
Q

Predominant hormone regulating PO4

A

FGF-23

65
Q

Which electrolyte deficiency can lead to low PTH secretion

A

Mg