second-MKSAP

Question 1

Adverse reaction of testosterone therapy

Answer 1

prostate enlarge
prostate cancer

can cause OSA

thrombophilia->DVT

erythrocytosis

Question 2

what PSA level prompts investigation of prostate cancer after testosterone initiation

Answer 2

> .4 at 6mo
or
1.4 at 1y

after initiation^^^^

Question 3

how to dose hydrocortisone and fludrocortisone in adrenal insufficiency

Answer 3

hydrocortisone BID or TID
- to mimic circadian rhtyhm
- 10/15mg in AM, then 5mg in afternoon/evening

Fludrocortisone QD

Question 4

ideally, PO bisphosphonate should be initiated ____ time after completing anabolic

Answer 4

6mo

Question 5

patient has abnormal thyroid function, which supplement should you feel suspicious of?

Answer 5

biotin, recheck thyroid function tests after discontinueing biotin

(mimics thyrotoxicosis)

Question 6

after total thyroidectomy in a patient diagnosed with thyroid cancer, what is the next step in terms of surveillence?

what kind of cancers should this next step be used for?

Answer 6

post op radioactive iodine
- purpose is to detect PERSISTENCE or RE-OCCURENCE of disease

use for follicular or papillary cancer bcs they mets

Question 7

Patient is started on levothyroxine after thyroidectomy post thyroid cancer, what is the lab values to look for?

Answer 7

treatment goal:

TSH <.5

(bcs thyroid cancer cells VERY receptive to TSH so goal to keep TSH below normal levels)

Question 8

osteoporosis drug of choice for post menopausal women

Answer 8

Denosumab
raloxifene

Question 9

____ drug should be started ____time after discontinuing denosumab otherwise ____ can happen

Answer 9

Antiresorptive like Bisphosphonate

6mo

rebound bone turnover

Question 10

hot thyroid nodule diagnostic test

Answer 10

RAIU

Question 11

For patients with gestational diabetes, the recommended glucose targets are a fasting plasma glucose level less than ____ mg/dL and a 2-hour postprandial glucose level less than ___

___ is Tx

Answer 11

<95

<120

Tx with insulin basal bolus

Question 12

Thyroid nodule found, next step

Answer 12

TSH

Question 13

Found a thyroid nodule, you u/s and FNA it and it was benign pathology, what is the next step in f/u?

Answer 13

repeat u/S in

-12 mo if HIGH suspicion nodule
-24mo if LOW suspicion nodule

Question 14

3 settings where measuring T3 is approriate

Answer 14

-thyrotoxicosis (is it an isolated T3 secretion perhaps?)

-severity of hyperthyroidism and response to treatment/meds

-differentiate hyperthryoidism vs desctructive thyroiditis