13 JAN 2017 0706 IM

Question 1

GLP-1 agonists are associated with what adverse event?

Answer 1

Acute pancreatitis

Question 2

What is the treatment for cryptococcal meningitis?

Answer 2

Amphotericin B and flucytosine followed by fluconazole for consolidation (8 weeks)

Question 3

What are the treatment options for chronic prostatitis / chronic pelvic pain syndrome?

Answer 3

• Antibiotics
• Alpha blockers
• 5-a-reductase inhibitors

Question 4

Why don’t patients with primary hyperaldosteronism have edema or clinically significant hypernatremia?

Answer 4

Aldosterone escape
moa = hydrostatic pressure opposes aldosterone mediated Na reabsorption leading to ultimate excretion. Note that K will still be low due to the hyperaldosterone.

Question 5

How does ursodeoxycholic acid work as treatment for primary biliary cholangitis?

Answer 5

• It is a hydrophilic bile acid that decreases biliary injury by the more hydrophobic endogenous bile acids
• Increases biliary secretion and may have additional anti-inflammatory and immunomodulatory effects

Question 6

What is the most common extraskeletal complaint of ankylosing spondylosis?

Answer 6

Anterior uveitis

Question 7

Why does starting oral estrogen therapy increase the requirement for levothyroxine in patients with hypothyroidism?

Answer 7

• Oral estrogen formulations decrease clearance of thyroxine-binding globulin (TBG), leading to TBG levels
• TBG is synthesized and sialylated in the liver; transdermal estrogen bypasses the liver and does not affect TBG levels
• Hypothyroidism patients re dependent on exogenous thyroid replacement and cannot compensate

Question 8

What is the Uthoff phenomenon?

Answer 8

Flare up of MS after moving to a much warmer climate