CEA PREP QUESTIONS ENDOCRINE
QUESTIONS AND ANSWERS UPDATED .
An,adult,patient,presents,with,tachycardia,and,nervousness.,The,patient,is,currently,taking,levothyroxine,
(Synthroid),,75,mcg,daily.,The,nurse,practitioner,orders,a,thyroid-
stimulating,hormone,(TSH),and,anticipates,having,to:,,ANS,-lower,the,dose,to,50,mcg,daily.
Rationale:,The,patient,is,presenting,with,symptoms,of,hyperthyroidism,,and,since,they,are,being,supplem
ented,with,levothyroxine,for,hypothyroidism,,it's,suggestive,that,they,are,overdosing,and,their,dose,shoul
d,be,decreased.,The,only,option,that,is,appropriate,is,to,lower,the,dose,to,50,mcg,daily,,and,although,addi
ng,a,50,mg,daily,dose,of,propranolol,may,be,helpful,to,manage,symptoms,for,a,hyperthyroid,patient,,this,
hyperthyroid,presentation,is,related,to,overmedication.,To,evaluate,this,more,directly,,the,patient,should
,have,a,TSH,and,T3/T4,level,drawn,and,it,is,likely,we,would,find,the,TSH,is,low,,T3,and,T4,are,elevated.
Which,of,the,following,is,produced,in,the,pancreas,and,counteracts,hypoglycemia?,,ANS,-Glucagon
Rationale:,Glucagon,is,made,in,the,pancreas,and,stimulates,glycogen,release,from,the,liver's,glycogen,stor
es,which,increases,blood,sugar,in,contrast,to,insulin,which,lowers,blood,sugar,by,increasing,permeability,
of,the,cell,membrane,to,glucose,thereby,increasing,intracellular,levels,of,glucose.
An,adult,male,who,has,managed,type,2,diabetes,mellitus,well,for,many,years,presents,for,a,6-
month,follow,up.,His,Hgb,A1c,has,risen,from,7%,to,9%,over,the,interval.,All,other,laboratory,values,are,no
rmal,and,his,BMI,is,still,25.,His,psychiatrist,recently,added,olanzapine,(Zypreza),to,the,medical,regimen.,T
he,nurse,practitioner,will,most,likely:,,ANS,-
Begin,to,increase,the,patient's,diabetes,medications,incrementally
Rationale:,A,common,side,effect,of,initiation,of,onanzapine,(Zyprexa),is,increased,appetite,and,it,is,eviden
ced,by,this,by,the,patient,having,their,A1c,increase,from,7,to,9%.,The,patient,should,have,their,diabetic,m
ediation,dose,increased,to,help,counteract,this,phemonemon,,however,a,long-
term,strategy,may,include,consult,the,psychiatrist,about,decreasing,the,dose,or,altering,the,medication,a
s,this,represents,a,considerable,health,risk,to,the,patient.,As,that,specifically,was,not,an,option,,the,best,o
ption,would,be,to,augment,the,anti-
diabetic,medication,regimen.,Stopping,the,olanzapine,without,discussing,it,with,the,psychiatrist,would,po
tentially,cause,the,patient,to,experience,discontinuation,syndrome.
A,60-year-old,woman,presents,for,a,routine,check-
up.,She,has,a,history,of,hypertension,,type,2,diabetes,mellitus,,and,hyperlipidemia.,She,is,currently,on,lisi
nopril,,metformin,,and,atorvastatin.,She,has,no,new,complaints.,On,examination,,her,blood,pressure,is,13
5/80,mmHg,,heart,rate,is,72,beats,per,minute,,and,BMI,is,32,kg/m².,Recent,laboratory,tests,reveal,HbA1c,
QUESTIONS AND ANSWERS UPDATED .
An,adult,patient,presents,with,tachycardia,and,nervousness.,The,patient,is,currently,taking,levothyroxine,
(Synthroid),,75,mcg,daily.,The,nurse,practitioner,orders,a,thyroid-
stimulating,hormone,(TSH),and,anticipates,having,to:,,ANS,-lower,the,dose,to,50,mcg,daily.
Rationale:,The,patient,is,presenting,with,symptoms,of,hyperthyroidism,,and,since,they,are,being,supplem
ented,with,levothyroxine,for,hypothyroidism,,it's,suggestive,that,they,are,overdosing,and,their,dose,shoul
d,be,decreased.,The,only,option,that,is,appropriate,is,to,lower,the,dose,to,50,mcg,daily,,and,although,addi
ng,a,50,mg,daily,dose,of,propranolol,may,be,helpful,to,manage,symptoms,for,a,hyperthyroid,patient,,this,
hyperthyroid,presentation,is,related,to,overmedication.,To,evaluate,this,more,directly,,the,patient,should
,have,a,TSH,and,T3/T4,level,drawn,and,it,is,likely,we,would,find,the,TSH,is,low,,T3,and,T4,are,elevated.
Which,of,the,following,is,produced,in,the,pancreas,and,counteracts,hypoglycemia?,,ANS,-Glucagon
Rationale:,Glucagon,is,made,in,the,pancreas,and,stimulates,glycogen,release,from,the,liver's,glycogen,stor
es,which,increases,blood,sugar,in,contrast,to,insulin,which,lowers,blood,sugar,by,increasing,permeability,
of,the,cell,membrane,to,glucose,thereby,increasing,intracellular,levels,of,glucose.
An,adult,male,who,has,managed,type,2,diabetes,mellitus,well,for,many,years,presents,for,a,6-
month,follow,up.,His,Hgb,A1c,has,risen,from,7%,to,9%,over,the,interval.,All,other,laboratory,values,are,no
rmal,and,his,BMI,is,still,25.,His,psychiatrist,recently,added,olanzapine,(Zypreza),to,the,medical,regimen.,T
he,nurse,practitioner,will,most,likely:,,ANS,-
Begin,to,increase,the,patient's,diabetes,medications,incrementally
Rationale:,A,common,side,effect,of,initiation,of,onanzapine,(Zyprexa),is,increased,appetite,and,it,is,eviden
ced,by,this,by,the,patient,having,their,A1c,increase,from,7,to,9%.,The,patient,should,have,their,diabetic,m
ediation,dose,increased,to,help,counteract,this,phemonemon,,however,a,long-
term,strategy,may,include,consult,the,psychiatrist,about,decreasing,the,dose,or,altering,the,medication,a
s,this,represents,a,considerable,health,risk,to,the,patient.,As,that,specifically,was,not,an,option,,the,best,o
ption,would,be,to,augment,the,anti-
diabetic,medication,regimen.,Stopping,the,olanzapine,without,discussing,it,with,the,psychiatrist,would,po
tentially,cause,the,patient,to,experience,discontinuation,syndrome.
A,60-year-old,woman,presents,for,a,routine,check-
up.,She,has,a,history,of,hypertension,,type,2,diabetes,mellitus,,and,hyperlipidemia.,She,is,currently,on,lisi
nopril,,metformin,,and,atorvastatin.,She,has,no,new,complaints.,On,examination,,her,blood,pressure,is,13
5/80,mmHg,,heart,rate,is,72,beats,per,minute,,and,BMI,is,32,kg/m².,Recent,laboratory,tests,reveal,HbA1c,
