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Endocrinology Fellowship > Texas AACE > Flashcards

Texas AACE Flashcards

0
Q

Which part of LDL is arthrrogenic?

A

Cholesterol component

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1
Q

What is the most important component of metabolic syndrome?

A

Adipose tissue dysfunction.

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2
Q

How many groups that would benefit from statin therapy are identified in the new guidelines?

A

4

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3
Q

Does LDL(a) increase risk for cardiovascular disease?

A

Yes

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4
Q

What happens to ghrelin after gastric bypass surgery?

A

It decreases.

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5
Q

What syndrome is characterized by uncontrolled diabetes and glycogenic hepatopathy and…

  • Growth failure
  • Cushingoid appearance
  • Hepatomegaly
A

Mauriac syndrome

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6
Q

What happens to the Anti-Mullerian Hormone level in PCOS?

A

It is increased.

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7
Q

What is Anti-Mullerian Hormone a surrogate marker of?

A

Ovarian reserve

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8
Q

Is there any data to prove that testosterone prevents fractures?

A

No

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9
Q

Do different TSH goals make a difference in how patients feel?

A

Not really.

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10
Q

Should you order a free T3 when monitoring levothyroxine therapy?

A

No

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11
Q

What is the treatment of choice for adynamic bone disease in chronic kidney disease?

A

Teriparatide

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12
Q

Can cabergoline be used to treat Cushing’s diseass?

A

Yes.

Off label.

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13
Q

What does Mifepristone do to serum glucose?

A

Decreases it.

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14
Q

Has cabergoline been associated with valvular heart disease?

A

Yes

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15
Q

Which receptors are present on heart valves that may cause valvular thickening when cabergoline acts on them?

A

5HT-2B

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16
Q

Should you give Qsymia (phentermine and topiramate) to pregnant women?

A

No.

Contra-indicated in pregnancy and those who will not or can not comply with contraceptive guidance.

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17
Q

What is the dosing for starting Qysmia (phentermine and topiramate)?

Hint: 2 prescriptions

A

3.75 mg/23 mg - for 14 days
Then
7.5 mg/46 mg - for 30 days

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18
Q

What is the maximum dose for Qysmia (phentermine and topiramate) in patients with hepatic impairment or moderate/severe renal impairment?

A

7.5 mg/46 mg

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19
Q

Twelve weeks after starting Qysmia (phentermine and topiramate) the patient has lost less than 3% of their body weight.

What is the next step?

A

Stop Qysmia.

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20
Q

If patient has been on Qysmia (phentermine and topiramate) 7.5 mg/46 mg a day for 12 weeks and has lost 3% of his body weight…

What is the next step?

Hint: 2 prescriptions

A

Escalate dose:

11.25 mg/69 mg - 14 days
15 mg/92 mg - 30 days

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21
Q

A patient has been on Qysmia (phentermine and topiramate) 7.5 mg/46 mg a day for 12 weeks, followed by 15 mg/92 mg for another 12 weeks. They have lost less than 5% of their body weight.

Next step?

A

Stop Qysmia.

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22
Q

How should Qysmia (phentermine and topiramate) be discontinued?

A

Tapered.

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23
Q

What is the starting dose of mifepristone in the treatment of Cushing syndrome?

A

300 mg PO qDay

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24
What is the maximum dose of mifepristone in mild to moderate hepatic and/or renal impairment?
600 mg PO qDay
25
What is the maximum dose of mifepristone in the treatment of Cushing's Syndrome?
1200 mg PO qDay | Do not exceed 20 mg/kg
26
Which two statins are contraindicated with mifepristone?
Simvastatin | Lovastatin
27
What does mifepristone do to potassium?
Lowers it.
28
What happens to potassium in primary adrenal insufficiency?
Elevated.
29
What is the mechanism of action of mifepristone when treating Cushing's Syndrome?
Selective, competitive glucocorticoid-receptor antagonist. | Also a progesterone receptor antagonist
30
Mifepristone is contra-indicated in breast-feeding. True or false.
True.
31
Norditropin (somatropin) FlexPro Pens. What dosage and colors are they available in?
5 mg/1.5 mL - Yellow 10 mg/1.5 mL - Blue 15 mg/1.5 mL - Green 30 mg/1.5 mL - Purple
32
Up to what temperature can Norditropin (somatropin) FlexPro Pens be stored at?
77 •F
33
Use of somatropin in patients with acute critical illness following complications from surgery, trauma or acute respiratory failure. Good idea or not?
Not a good idea. | May lead to increased mortality.
34
What is in Oseni?
Alogliptin and pioglitazone.
35
What is the first and only FDA-approved EPA-only omega-3 fatty acid?
Vascepa (icosapent ethyl)
36
What is Vascepa (icosapent ethyl) indicated for?
Severe hypertriglyceridemia (triglycerides more than 500 mg/dL)
37
What baseline testing should be done before starting Somavert (Pegvisomant)?
LFTs (ALT, AST, total bilirubin and alkaline phosphatase).
38
What is the maximum indicated daily maintenance dose for Somavert (Pegvisomant)?
30 mg
39
What needs to be monitored (baseline and during therapy) when mipomerson is used?
LFTs Baseline: ALT, AST, alkaline phosphate, and total bilirubin. Maintenance: ALT and AST
40
What is the main risk when using mipomerson?
Hepatotoxicity
41
Is mipomerson recommended in patients with severe renal impairment, clinically significant proteinuria or on renal dialysis?
No
42
Is mipomerson contraindicated in moderate-severe (Child-Pugh B or C) or active liver disease?
Yes
43
Which hormone does pasireotide inhibit?
ACTH
44
What does pasireotide do to blood glucose?
Makes it higher.
45
Which cardiac test is recommended prior to dosing of pasireotide and during treatment and why?
EKG testing. | May lead to bradycardia and QT prolongation
46
Does pasireotide (Signifor) come in pill form or injection form?
Injection form.
47
Which laboratory tests should be done at baseline before starting pasireotide?
LFTs | ALT and AST
48
How often should LFTs be checked during treatment with pasireotide?
- Baseline, then - 1 - 2 weeks after starting treatment, then - monthly for 3 months, then - every 6 months.
49
Which drugs are first line pharmacologic therapy for patients with acromegaly?
Somatostatin analogs
50
Somatuline Depot (lanreotide) may reduce gallbladder motility and lead to gallstone formation. True or false?
True
51
Do somatostatin analogs reduce growth hormone levels?
Yes
52
Do growth hormone receptor antagonists reduce growth hormone levels?
No
53
What's the maximum dose of lanreotide?
120 mg every 4 weeks.
54
What inheritance pattern does MODY generally have?
Autosomal dominant.
55
MODY2 is linked to mutations in which enzyme?
Glucokinase
56
Mutations in glycolytic enzyme glucokinase are associated with which MODY?
MODY2
57
What is the management of MODY2?
Typically managed by diet and exercise.
58
Management of MODY 1,3 and 4.
Oral sulfonylureas
59
Which MODY progresses to requiring insulin?
MODY5
60
Which MODY requires replacement of endocrine and exocrine pancreatic functions?
MODY8
61
What is the estimated frequency of MODY?
2%

Endocrinology Fellowship (31 decks)

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