Rapid Style Questions

Question 1

Can hypothyroidism be associated with abnormal lipid panels?

Answer 1

Yes, due to lower LDL receptors causing high lipids in the serum

Can also see mild hypertension

Question 2

What is facial plethora?

What diagnosis is it associated with?

Answer 2

a clinical sign that’s characterized by facial swelling and puffiness, and is caused by excessive blood flow to the face

Cushing Syndrome

Question 3

What is Cushing’s Disease?

Answer 3

Cushing disease is a specific type of Cushing syndrome caused by a pituitary tumor - leading to ACTH overproduction

Question 4

Is hypertension a common physical exam finding in a patient with Cushing’s Syndrome/Disease?

Answer 4

Yes

Question 5

What are the three screening tests available for Cushing’s?

Answer 5

1. 24-hour urinary free cortisol (most specific)
2. Nighttime (11pm) salivary cortisol
3. Low-dose (1mg) overnight dexamethasone suppression test

Question 6

What findings with a low-dose overnight dexamethasone suppression test are consistent with Cushing’s Syndrome?

Answer 6

Elevated cortisol or no suppression with low-dose dexamethasone

Question 7

How can you prevent the Somogyi phenomenon in Type I Diabetes patients?

Answer 7

Prevent hypoglycemia with either:
* Decreasing nighttime NPH dose
* Move the evening NPH earlier
* Give a bedtime snack

Somogyi Phenomenon is nocutrnal hypoglycemia followed by rebound hyperglycemia. Diagnosed with 3am BG level.

Question 8

What is the most common cause of hyperosmolar hyperglycemic state (HHS) in Type II Diabetics?

Answer 8

Infection (typically pneumonia or UTI)

Illness leading to reduced fluid intake leads to profound dehydration, increased osmolarity, hyperglycemia, and total body potassium deficit.

Question 9

What is the first-line treatment for a pituitary adenoma?

Answer 9

Dopamine agonists (Cabergoline or Bromocriptine)

Cabergoline is better tolerated