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Question 1

Syndrome caused by overproduction of growth hormone (GH); Usually affecting pts in their 40s; MC etiology is from a pituitary tumor*

Answer 1

Acromegaly

Question 2

Pts may present w/ symptoms of tumor compression (HA, double vision, or visual field defects); Presentation is from soft tissue overgrowth; enlarged jaw, hands, and feet with coarsening of the facial features; HTN, cardiomegaly, insulin resistance & colonic polyps/cancer;

Answer 2

Acromegaly

Question 3

MC reason for increased mortality is from cardiovascular disease

Answer 3

Acromegaly

Question 4

First initial test is an insulin-like growth factor (IGF-1)-increased! MRI of pituitary

Answer 4

Acromegaly

Question 5

Adrenal insufficiency; MC cause is from autoimmune destruction

Answer 5

Addisons Disease

Question 6

Pts present with fatigue, weakness, anorexia, nausea, weight loss; Hyperpigmentation occurs from long-standing elevated ACTH levels; pt will also have hypotension, hyponatremia, hypoglycemia, hyperkalemia, and metabolic acidosis

Answer 6

Addison’s DIsease

Question 7

Dx is confirmed with ACTH stimulation test (cosyntropin)-if cortisol levels DO NOT rise, adrenal insufficiency is confirmed

Answer 7

Addisons Disease

Question 8

Tx of choice is Fludrocortisone (mineralocorticoid)

Answer 8

Addison’s Disease

Question 9

Increased cortisol levels from any source=

Answer 9

Cushing’s Syndrome

Question 10

Increased cortisol levels from a pituitary adenoma=

Answer 10

Cushing’s Disease

Question 11

Pts present with central obesity, facial plethora, proximal weakness, striae, moon face, buffalo hump, HTN, diabetes, supraclavicular fat pads, and atrophy of the skin;

Answer 11

Cushing’s

Question 12

Screen with 24H urine free cortisol, low dose dexamethasone test, or late night salivary test

Answer 12

Cushing’s

Question 13

Autoimmune destruction of the pancreatic beta cells; will result in insulin dependence; can lead to DKA

Answer 13

T1DM

Question 14

Characterized by insulin resistance related to obesity

Answer 14

T2DM

Question 15

May present with obesity or acanthosis nigricans; consider dx in pts with prolonged or recurrent fungal infections

Answer 15

T2DM

Question 16

Dx: Two fasting glucose levels >126; Once glucose level >200 with symptoms; HbA1C 6.5%; Positive 2hour or 3hour OGTT

Answer 16

Diabetes Mellitus

Question 17

Postive antibodies, low c-peptide, low insulin, and an elevated glucose

Answer 17

T1DM

Question 18

No antibodies, normal to increased c-peptide, normal to increased insulin, and an elevated glucose

Answer 18

T2DM

Question 19

Insulin is mainstay of tx; Pts should receive a basal insulin (Glargine) followed by a pre meal rapid acting insulin (Lispro)

Answer 19

T1DM

Question 20

Increases insulin sensitivity and blocks gluconeogensis from the liver; does not cause weight gain or hypoglycemia

Answer 20

Metformin

Question 21

Second line tx of DM in addition to Metformin OR first line if there are c/i to Metformin (elevated creatinine)

Answer 21

Sulfonylureas

Question 22

Triad: hyperglycemia, anion gap metabolic acidosis, and serum ketones; MC cause is secondary to infection and misuse of insulin

Answer 22

DKA

Question 23

MC cause is Grave’s disease-an autoimmune disease that leads to TSH receptor antibodies

Answer 23

Hyperthyroidism

Question 24

Present with heat intolerance, weight loss, palpitations, hyperdefecation, anxiety, and tachycardia

Answer 24

Hyperthyroidism

Question 25

Presents with eye (proptosis, chemosis, lid retraction, etc), and skin abnormalities (pretibial myxedema)

Answer 25

Grave’s Disease

Question 26

All will have suppressed TSH and an elevated FT4, except for pituitary adenoma which will have both an elevated TSH and FT4-NEED MRI

Answer 26

hyperthyroidism

Question 27

Radioactive iodine uptake will show a deceased uptake in all forms except Grave’s disease (will have elevated uptake)

Answer 27

hyperthyroidism

Question 28

Tx= 1. Beta blockers used for adrenergic symptoms; 2. PTU or methimazole (first line) to stabilize; 3. Definitive tx is radioactive iodine; 4. Steroids used to tx ophthalmopathy; 5. Pregnant pts are treated with PTU for the first trimester, then switched to methimazole after first trimester

Answer 28

Hyperthyroidism

Question 29

Is usually a direct result of having neck surgery; very common to have post-surgery for thyroid cancer; second MC cause is autoimmune

Answer 29

Hypoparathyroid

Question 30

Pt presents with muscle spasms; paresthesias; Chvosteks sign (tapping in front of triages will cause facial twitching) & Trousseau sign (inflating a BP cuff on arm will cause tetany)

Answer 30

Hypoparathyroid

Question 31

EKG will demonstrate a prolonged QT interval; check Mg levels, as pts may have hypomagnesemia; Decreased PTH, decreased serum calcium, increase phosphorus

Answer 31

Hypoparathyroid

Question 32

MC etiology is Hashimoto’s thyroiditis-autoimmune disease

Answer 32

Hypothyroidism

Question 33

Worldwide, the MC cause is iodine deficiency

Answer 33

hypothyroidism

Question 34

Pts will present with constipation, weight gain, fatigue, decreased reflexes, cold intolerance, and hair loss

Answer 34

Hypothyroidism

Question 35

Elevated TSH and a decreased FT$

Answer 35

hypothyroidism

Question 36

Very important to take this 4 hours before taking iron or calcium supplements (otherwise will cause inadequate absorption)

Answer 36

Levothyroxine

Question 37

Regulates calcium homeostasis

Answer 37

PTH

Question 38

“stones, bones, abdominal moans, and psychic groans”

Answer 38

hyperparathyroidism

Question 39

elevated PTH, elevated serum calcium, decreased phosphate; EKG shows shortened QT interval

Answer 39

Hyperparathyroidism