Endo

Question 1

What are the 3 Ps associated with MEN1?

Answer 1

parathyroid, anterior pituitary and pancreatic islet cells

Question 2

What is another name for Graves Disease?

Answer 2

toxic diffuse goiter

Question 3

What is the triad associated with a pheochromocytoma?

Answer 3

episodic headache
diaphoresis
tachycardia with HTN

Question 4

What SEs? do you need to warn patients about when prescribing thiazide diuretics to diabetic pts?

Answer 4

hyperglycemia

Question 5

What are the two types of cells that make up the thyroid, and what are their functions?

Answer 5

Follicular cells, which secrete thyroid hormones T3 and T4

parafollicular cells (also known as C cells), which secrete calcitonin.

Question 6

What DM med is CI in pts with hx of pancreatitis?

Answer 6

GLP-1

Question 7

Define euthyroid sick syndrome

Answer 7

can be described as abnormal findings on thyroid function tests that occur in the setting of a nonthyroidal illness, without preexisting hypothalamic-pituitary and thyroid gland dysfunction. This is most commonly diagnosed in a hospitalized patient and after recovery from the underlying illness

Question 8

_______ should be monitored to evaluate for medullary thyroid cancer recurrence?

Answer 8

serum calcitonin

Question 9

What is the first line medication to treat pituitary adenomas? What is the MOA?

Answer 9

Cabergoline and bromocriptine

cabergoline is preferred

these meds stimulate pituitary dopamine receptors

Question 10

What lab test would you order to dx growth hormone deficiency or excess?

Answer 10

serum insulin-like growth factor 1

an insulin tolerance test,

macimorelin stimulation test

Question 11

What are the symptoms of growth hormone deficiency in adults?

Answer 11

decreased muscle mass, weakness, poor exercise tolerance, decreased bone density, increased subcutaneous fat and weight gain, poor cognition, mental fatigue, and memory impairment

Question 12

What diabetes drug class MOA works through the incretin system?

Answer 12

dipeptidyl peptidase 4 (DPP-4) inhibitor

sitagliptin and saxagliptin

Question 13

What is the incretin effect?

Answer 13

The incretin effect is the increase in insulin secretion after gastrointestinal absorption of glucose compared to the amount of insulin secreted in response to glucose infused intravenously.

Question 14

What result would you expect from the 24 hour urine free cortisol test in a pts with Cushings? (Increased/decreased) baseline ACTH levels, (with/without) cortisol suppression noted

Answer 14

increased baseline ACTH level WITH cortisol suppression noted

Question 15

What is the underlying cause of why you see jaundice and heart failure in thyroid storm?

Answer 15

Heart failure in thyroid storm is the result of increased oxygen demand by the tissues and the heart’s inability to keep up with such a high demand (high-output heart failure). Likewise, jaundice is the result of hepatic tissue hypoxia due to increased peripheral consumption of oxygen and unmet oxygen needs of the hepatocytes.

Question 16

The initial lab to determine the presence of acromegaly is ______

Answer 16

IGF-1

insulin-like growth factor 1

Question 17

How does the dosing differ compared with younger adults when prescribing levothyroxine for an older adult with hypothyroidism?

Answer 17

older adults need LOWER dosages of levo than younger adults

Question 18

What type of thyroid cancer has an elevated serum calcitonin level as its tumor marker?

Answer 18

medullary thyroid cancer

Question 19

What lab abnormalities would you expect to find in a pt with primary adrenal insufficiency (addison dz)?

Answer 19

hyponatremia

Question 20

What are the two of the main risks of over-replacement hyperthyroidism?
aka taking too much levothyroxine

Answer 20

Two of the main risks of over-replacement hyperthyroidism are atrial fibrillation and decreased bone mineral density,

Question 21

What is the MC trigger for a thyroid storm?

Answer 21

infection

Question 22

What medication should you give to a pt with prolactinoma? What drug class?

Answer 22

cabergoline

dopamine agonist

Question 23

What is the rapid onset of action, peak effect and duration of action for regular insulin? (short acting)

Answer 23

rapid onset of action, typically beginning within 30 minutes

The peak effect occurs between 2 and 4 hours

duration of action is approximately 5 to 8 hours.

Question 24

What is the most immediate life-threatening complication of pituitary apoplexy?

Answer 24

adrenal insufficiency

Question 25

What is the correct order of medications for tx for a thyroid storm?

Answer 25

propranolol, PTU, iodide, hydrocortisone