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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
Q

What is the maximum dose of mifepristone in mild to moderate hepatic and/or renal impairment?

A

600 mg PO qDay

25
Q

What is the maximum dose of mifepristone in the treatment of Cushing’s Syndrome?

A

1200 mg PO qDay

Do not exceed 20 mg/kg

26
Q

Which two statins are contraindicated with mifepristone?

A

Simvastatin

Lovastatin

27
Q

What does mifepristone do to potassium?

A

Lowers it.

28
Q

What happens to potassium in primary adrenal insufficiency?

29
Q

What is the mechanism of action of mifepristone when treating Cushing’s Syndrome?

A

Selective, competitive glucocorticoid-receptor antagonist.

Also a progesterone receptor antagonist

30
Q

Mifepristone is contra-indicated in breast-feeding.

True or false.

31
Q

Norditropin (somatropin) FlexPro Pens.

What dosage and colors are they available in?

A

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
Q

Up to what temperature can Norditropin (somatropin) FlexPro Pens be stored at?

33
Q

Use of somatropin in patients with acute critical illness following complications from surgery, trauma or acute respiratory failure.

Good idea or not?

A

Not a good idea.

May lead to increased mortality.

34
Q

What is in Oseni?

A

Alogliptin and pioglitazone.

35
Q

What is the first and only FDA-approved EPA-only omega-3 fatty acid?

A

Vascepa (icosapent ethyl)

36
Q

What is Vascepa (icosapent ethyl) indicated for?

A

Severe hypertriglyceridemia (triglycerides more than 500 mg/dL)

37
Q

What baseline testing should be done before starting Somavert (Pegvisomant)?

A

LFTs (ALT, AST, total bilirubin and alkaline phosphatase).

38
Q

What is the maximum indicated daily maintenance dose for Somavert (Pegvisomant)?

39
Q

What needs to be monitored (baseline and during therapy) when mipomerson is used?

A

LFTs
Baseline: ALT, AST, alkaline phosphate, and total bilirubin.
Maintenance: ALT and AST

40
Q

What is the main risk when using mipomerson?

A

Hepatotoxicity

41
Q

Is mipomerson recommended in patients with severe renal impairment, clinically significant proteinuria or on renal dialysis?

42
Q

Is mipomerson contraindicated in moderate-severe (Child-Pugh B or C) or active liver disease?

43
Q

Which hormone does pasireotide inhibit?

44
Q

What does pasireotide do to blood glucose?

A

Makes it higher.

45
Q

Which cardiac test is recommended prior to dosing of pasireotide and during treatment and why?

A

EKG testing.

May lead to bradycardia and QT prolongation

46
Q

Does pasireotide (Signifor) come in pill form or injection form?

A

Injection form.

47
Q

Which laboratory tests should be done at baseline before starting pasireotide?

A

LFTs

ALT and AST

48
Q

How often should LFTs be checked during treatment with pasireotide?

A
  • Baseline, then
  • 1 - 2 weeks after starting treatment, then
  • monthly for 3 months, then
  • every 6 months.
49
Q

Which drugs are first line pharmacologic therapy for patients with acromegaly?

A

Somatostatin analogs

50
Q

Somatuline Depot (lanreotide) may reduce gallbladder motility and lead to gallstone formation.

True or false?

51
Q

Do somatostatin analogs reduce growth hormone levels?

52
Q

Do growth hormone receptor antagonists reduce growth hormone levels?

53
Q

What’s the maximum dose of lanreotide?

A

120 mg every 4 weeks.

54
Q

What inheritance pattern does MODY generally have?

A

Autosomal dominant.

55
Q

MODY2 is linked to mutations in which enzyme?

A

Glucokinase

56
Q

Mutations in glycolytic enzyme glucokinase are associated with which MODY?

57
Q

What is the management of MODY2?

A

Typically managed by diet and exercise.

58
Q

Management of MODY 1,3 and 4.

A

Oral sulfonylureas

59
Q

Which MODY progresses to requiring insulin?

60
Q

Which MODY requires replacement of endocrine and exocrine pancreatic functions?

61
Q

What is the estimated frequency of MODY?

Endocrinology Fellowship (30 decks)

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