AG-ACNP Endocrine Questions and
Answers
What is a concern when lowering Na levels Correct Ans-be careful of lowering too fast, can
cause cerebral edema
What is pheochromocytoma? Correct Ans-RARE
results from excess catecholamine relese characterized by paroxysmal or sustained hypertension;
almost always due to a tumor of the adrenal medulla
What catecholamines are released in phyochromocytoma? Correct Ans-norepinephrine and
epinephrine
What are s/s of phyochromocytoma? Correct Ans-HTN(labile)
diaphoresis
hyperglycemia
severe h/a
palpitations
tremors
tachycardia
wt loss
postural hotn
,What is the first lab test you would run in suspected pheo pt? and why? Correct Ans-TSH, to
r/o hyperthyroid
A patient with DM and HTN should be on which classification of medication and why?
Correct Ans-ACE Inhibitors - to reduce proteinuria and the resulting diabetic nephropathy
30 yo. D with PMH of DM Type II is scheduled for a cardiac cath within the next 7 days. Home
medications include Metformin (Glucophage) 500 mg TID. What instructions would you give
her regarding her medications? Correct Ans-Instruct the patient to stop Metformin
(Glucophage) at least 3 days before procedure. The use of Metformin (Glucophage) and contrast
dye could cause ARF.
Identify the post-surgical complications associated with correction of a pheochromocytoma.
Correct Ans-Hypotension - depleted catecholimines
Adrenal Insufficiency
Hemorrhage
Define the treatment of choice of a pheochromocytoma. Correct Ans-Surgical removal of the
adrenal medulla tumor
Pheochromocytoma is most often associated with what hallmark symptom? Correct Ans-
Labile HTN and orthostatic hypotension
What are the four components of the urine assay that is diagnostic for a pheochromocytoma?
Correct Ans-Urine catecholimines
, Metanephrines
Vanillylmandelic acid (VMA)
Creatinine
What diagnostic confirms a pheochromocytoma? Correct Ans-CT scan of adrenals to confirm
and localize tumor
Define the criteria for diagnosing Metabolic Syndrome. Correct Ans-Any of the 3:
- Waist circumference: M > 40 in, F > 35 in
- BP > 130/85
- Triglycerides > 150
- FGB > 100
- HDL: M <40, F < 50
40 yo. F presented to ED with complaints of four UTIs in the past 6 months and chronic skin
infection, with increasing pruritus. What is most likely differential? Correct Ans-DM Type II.
Women present with reoccuring vaginitis and chronic skin infections.
Identify the three Insulin Analogs. Correct Ans-Aspart (NovoLog)
Glargine (Lantus) - prolonged duration
Lispro (Humalog) - rapid onset
Answers
What is a concern when lowering Na levels Correct Ans-be careful of lowering too fast, can
cause cerebral edema
What is pheochromocytoma? Correct Ans-RARE
results from excess catecholamine relese characterized by paroxysmal or sustained hypertension;
almost always due to a tumor of the adrenal medulla
What catecholamines are released in phyochromocytoma? Correct Ans-norepinephrine and
epinephrine
What are s/s of phyochromocytoma? Correct Ans-HTN(labile)
diaphoresis
hyperglycemia
severe h/a
palpitations
tremors
tachycardia
wt loss
postural hotn
,What is the first lab test you would run in suspected pheo pt? and why? Correct Ans-TSH, to
r/o hyperthyroid
A patient with DM and HTN should be on which classification of medication and why?
Correct Ans-ACE Inhibitors - to reduce proteinuria and the resulting diabetic nephropathy
30 yo. D with PMH of DM Type II is scheduled for a cardiac cath within the next 7 days. Home
medications include Metformin (Glucophage) 500 mg TID. What instructions would you give
her regarding her medications? Correct Ans-Instruct the patient to stop Metformin
(Glucophage) at least 3 days before procedure. The use of Metformin (Glucophage) and contrast
dye could cause ARF.
Identify the post-surgical complications associated with correction of a pheochromocytoma.
Correct Ans-Hypotension - depleted catecholimines
Adrenal Insufficiency
Hemorrhage
Define the treatment of choice of a pheochromocytoma. Correct Ans-Surgical removal of the
adrenal medulla tumor
Pheochromocytoma is most often associated with what hallmark symptom? Correct Ans-
Labile HTN and orthostatic hypotension
What are the four components of the urine assay that is diagnostic for a pheochromocytoma?
Correct Ans-Urine catecholimines
, Metanephrines
Vanillylmandelic acid (VMA)
Creatinine
What diagnostic confirms a pheochromocytoma? Correct Ans-CT scan of adrenals to confirm
and localize tumor
Define the criteria for diagnosing Metabolic Syndrome. Correct Ans-Any of the 3:
- Waist circumference: M > 40 in, F > 35 in
- BP > 130/85
- Triglycerides > 150
- FGB > 100
- HDL: M <40, F < 50
40 yo. F presented to ED with complaints of four UTIs in the past 6 months and chronic skin
infection, with increasing pruritus. What is most likely differential? Correct Ans-DM Type II.
Women present with reoccuring vaginitis and chronic skin infections.
Identify the three Insulin Analogs. Correct Ans-Aspart (NovoLog)
Glargine (Lantus) - prolonged duration
Lispro (Humalog) - rapid onset
