ROSH REVIEW- ENDOCRINE QUESTIONS
AND CORRECT ANSWERS
WhatA2diabetesA2drugA2classA2isA2atA2riskA2forA2hypoglycemia?
HowA2canA2thisA2beA2treated?A2-A2Ans--Sulfonylureas!A2
Glimepiride
CanA2alsoA2causeA2weightA2gain
TX:
Octreotide
WhatA2isA2MOAA2forA2Metformin?A2-A2Ans--BiguanideA2drugA2class
DecreasesA2hepaticA2glucogenesis
DiarrheaA2isA2sideA2effect
Don'tA2useA2inA2renalA2failure
WhatA2testA2canA2helpA2toA2determineA2ifA2aA2patientA2isA2surreptitiouslyA2self-
administeringA2insulin?A2-A2Ans--CA2peptideA2level:
Low
InsulinA2level:
A2
High
A2 isA2diagnosticA2forA2factitiousA2hypoglycemia!
WhatA2medicationsA2areA2bestA2forA2loweringA2triglyercides?
WhatA2medicationsA2areA2bestA2forA2loweringA2LDL?
WhatA2medicationsA2areA2bestA2forA2increasingA2HDL?
GoalsA2forA2allA2ofA2these?A2-A2Ans--Triglycerides:
BestA2loweredA2viaA2FIBRATES
LDL:
BestA2loweredA2viaA2STATINS
HDL:
,BestA2increasedA2viaA2NIACINA2(Flushing,A2PruritisA2SE)
ExerciseA2alsoA2increasesA2HDL
Goals:
Triglycerides-->A2<150
LDL-->A2<70
HDLA2-->A2>40
WhatA2isA2theA2criteriaA2forA2diagnosingA2DiabetesA2I?
MOA?
Tx?A2-A2Ans--FastingA2Glucose:
A2>126A2onA22A2separateA2occasionsA2
RandomA2Glucose:
>200
GlucoseA2ChallengeA275A2mg:
>200A22A2hoursA2postA2challenge
AlC:
>6.5%
MOA:
AutoimmuneA2DestructionA2ofA2PancreaticA2ß-cellsA2(isletsA2ofA2LangerhansA2beta-
cells)A2causingA2decreasedA2insulinA2+A2increasedA2glucose
Tx:
Insulin
WhatA2isA2preA2diabetesA2Alc?A2-A2Ans--5.7-6.4%
WhichA2ofA2theA2followingA2isA2theA2recommendedA2treatmentA2forA2aA2pituitaryA2adenoma
A2>1A2cmA2inA2size?A2-A2Ans-->A21cmA2orA2compressingA2opticA2chiasmA2PituitaryA2tumors:
SurgicalA2transphenoidalA2(hardy)A2resectionA2isA2treatmentA2ofA2choice!
RadiationA2therapy:
UsedA2inA2olderA2adultsA2thatA2cannotA2haveA2surgery
DopamineA2Agonists:
UsedA2inA2microA2tumorsA2orA2prolactinomasA2toA2reduceA2size/symptoms
WhatA2structureA2isA2commonlyA2compressedA2andA2affectsA2visionA2inA2thoseA2withA2aA2p
ituitaryA2adenoma?A2-A2Ans--OpticA2Chiasm!
, WhatA2presentsA2withA2bitemporalA2hemianopia?
Tx?A2-A2Ans--PituitaryA2tumorA2compressingA2OpticA2Chiasm!
Tx:
TranssphenoidalA2surgicalA2resection
WhatA2presentsA2withA2amenorrhea,A2galactorrhea,A2infertility?
Tx?A2-A2Ans--Prolactinoma
MostA2commonA2PituitaryA2Tumor!
Tx:
DopamineA2AgonistsA2
Bromocriptine,A2Cabergoline
WhatA2presentsA2withA2GigantismA2inA2childrenA2andA2AcromegalyA2inA2adults?A2-A2Ans--
PituitaryA2tumorA2hyperA2secretingA2GH!
WhatA2isA2mostA2commonA2complicationA2seenA2withA2pituitaryA2tumors?A2-A2Ans--
BitemporalA2Hemianopia
Meaning:
PartialA2BlindnessA2whereA2visionA2isA2MissingA2inA2theA2OuterA2HalfA2ofA2BothA2theA2Right
A2andA2LeftA2VisualA2Field.
WhatA2labsA2areA2expectedA2withA2TSHA2producingA2pituitaryA2adenoma?A2-A2Ans--
ElevatedA2TSH,A2HighA2T3A2andA2HighA2T4
ALLA2elevated!
WhatA2thyroidA2disorderA2isA2definedA2byA2alteredA2mentalA2statusA2andA2decompensated
A2metabolicA2state?A2-A2Ans--MyxedemaA2Coma!
MostA2severeA2manifestationA2ofA2Hypothyroidism
WhatA2presentsA2withA2generalizedA2weakness,A2fatigue,A2facialA2swelling,A2constipation,
A2coldA2intolerance,A2weightA2gain,A2periorbitalA2edema,A2dryA2skinA2withA2coarse/
brittleA2hair,A2delayedA2DTR?
ExpectedA2labs?
MostA2commonA2manifestation?
Tx?A2-A2Ans--Hypothyroidism!
AND CORRECT ANSWERS
WhatA2diabetesA2drugA2classA2isA2atA2riskA2forA2hypoglycemia?
HowA2canA2thisA2beA2treated?A2-A2Ans--Sulfonylureas!A2
Glimepiride
CanA2alsoA2causeA2weightA2gain
TX:
Octreotide
WhatA2isA2MOAA2forA2Metformin?A2-A2Ans--BiguanideA2drugA2class
DecreasesA2hepaticA2glucogenesis
DiarrheaA2isA2sideA2effect
Don'tA2useA2inA2renalA2failure
WhatA2testA2canA2helpA2toA2determineA2ifA2aA2patientA2isA2surreptitiouslyA2self-
administeringA2insulin?A2-A2Ans--CA2peptideA2level:
Low
InsulinA2level:
A2
High
A2 isA2diagnosticA2forA2factitiousA2hypoglycemia!
WhatA2medicationsA2areA2bestA2forA2loweringA2triglyercides?
WhatA2medicationsA2areA2bestA2forA2loweringA2LDL?
WhatA2medicationsA2areA2bestA2forA2increasingA2HDL?
GoalsA2forA2allA2ofA2these?A2-A2Ans--Triglycerides:
BestA2loweredA2viaA2FIBRATES
LDL:
BestA2loweredA2viaA2STATINS
HDL:
,BestA2increasedA2viaA2NIACINA2(Flushing,A2PruritisA2SE)
ExerciseA2alsoA2increasesA2HDL
Goals:
Triglycerides-->A2<150
LDL-->A2<70
HDLA2-->A2>40
WhatA2isA2theA2criteriaA2forA2diagnosingA2DiabetesA2I?
MOA?
Tx?A2-A2Ans--FastingA2Glucose:
A2>126A2onA22A2separateA2occasionsA2
RandomA2Glucose:
>200
GlucoseA2ChallengeA275A2mg:
>200A22A2hoursA2postA2challenge
AlC:
>6.5%
MOA:
AutoimmuneA2DestructionA2ofA2PancreaticA2ß-cellsA2(isletsA2ofA2LangerhansA2beta-
cells)A2causingA2decreasedA2insulinA2+A2increasedA2glucose
Tx:
Insulin
WhatA2isA2preA2diabetesA2Alc?A2-A2Ans--5.7-6.4%
WhichA2ofA2theA2followingA2isA2theA2recommendedA2treatmentA2forA2aA2pituitaryA2adenoma
A2>1A2cmA2inA2size?A2-A2Ans-->A21cmA2orA2compressingA2opticA2chiasmA2PituitaryA2tumors:
SurgicalA2transphenoidalA2(hardy)A2resectionA2isA2treatmentA2ofA2choice!
RadiationA2therapy:
UsedA2inA2olderA2adultsA2thatA2cannotA2haveA2surgery
DopamineA2Agonists:
UsedA2inA2microA2tumorsA2orA2prolactinomasA2toA2reduceA2size/symptoms
WhatA2structureA2isA2commonlyA2compressedA2andA2affectsA2visionA2inA2thoseA2withA2aA2p
ituitaryA2adenoma?A2-A2Ans--OpticA2Chiasm!
, WhatA2presentsA2withA2bitemporalA2hemianopia?
Tx?A2-A2Ans--PituitaryA2tumorA2compressingA2OpticA2Chiasm!
Tx:
TranssphenoidalA2surgicalA2resection
WhatA2presentsA2withA2amenorrhea,A2galactorrhea,A2infertility?
Tx?A2-A2Ans--Prolactinoma
MostA2commonA2PituitaryA2Tumor!
Tx:
DopamineA2AgonistsA2
Bromocriptine,A2Cabergoline
WhatA2presentsA2withA2GigantismA2inA2childrenA2andA2AcromegalyA2inA2adults?A2-A2Ans--
PituitaryA2tumorA2hyperA2secretingA2GH!
WhatA2isA2mostA2commonA2complicationA2seenA2withA2pituitaryA2tumors?A2-A2Ans--
BitemporalA2Hemianopia
Meaning:
PartialA2BlindnessA2whereA2visionA2isA2MissingA2inA2theA2OuterA2HalfA2ofA2BothA2theA2Right
A2andA2LeftA2VisualA2Field.
WhatA2labsA2areA2expectedA2withA2TSHA2producingA2pituitaryA2adenoma?A2-A2Ans--
ElevatedA2TSH,A2HighA2T3A2andA2HighA2T4
ALLA2elevated!
WhatA2thyroidA2disorderA2isA2definedA2byA2alteredA2mentalA2statusA2andA2decompensated
A2metabolicA2state?A2-A2Ans--MyxedemaA2Coma!
MostA2severeA2manifestationA2ofA2Hypothyroidism
WhatA2presentsA2withA2generalizedA2weakness,A2fatigue,A2facialA2swelling,A2constipation,
A2coldA2intolerance,A2weightA2gain,A2periorbitalA2edema,A2dryA2skinA2withA2coarse/
brittleA2hair,A2delayedA2DTR?
ExpectedA2labs?
MostA2commonA2manifestation?
Tx?A2-A2Ans--Hypothyroidism!