Clin Med Endo Exam #2 UPDATED
ACTUAL Exam Questions and CORRECT
Answers
For type II DM to occur, what must exist? - CORRECT ANSWER - Insulin resistance and
inadequate insulin secretion
What are the preprandial and postprandial plasma glucose target levels for patients with type I
DM? - CORRECT ANSWER - Fasting: 80-130
Peak postprandial: <180
What is the first indicator of diabetic nephropathy? - CORRECT ANSWER -
Microalbuminuria
What specialists should a type I Diabetic be referred to? - CORRECT ANSWER - Endo,
nutritionist, nephro, podiatrist and ophthamologist
What might hypoglycemia result from? - CORRECT ANSWER - -Change in insulin dose,
a small or missed meal or strenuous exercise
Somogyi effect - CORRECT ANSWER - hypoglycemia followed by rebound
hyperglycemia
If low at 2-3am, suspect somogyi.
Causes: Excess or ill-timed insulin, missed meals or snacks, and inadvertent insulin
administration
Radioactive Iodine tests and possible diagnosis - CORRECT ANSWER - If diffuse uptake,
graves disease or pituitary adenoma
If decreased uptake, thyroiditis
If a hot nodule, toxic adenoma
, If cold nodule, suspect malignancy
What are the clinical features of hashimoto's - CORRECT ANSWER - Asymptomatic firm
diffuse goiter and often hypothyroid at time of diagnosis
Pain and tenderness not usually present
Often progresses to permanent hypothyroidism
What is the treatment of thyroid storm? - CORRECT ANSWER - Beta blockers are initial
Tx of choice.
Methimazole, PTU
IV fluids, glucocorticoids
Who is at the highest risk for myxedema coma and when does it more commonly occur? -
CORRECT ANSWER - -Elderly women w/ poorly controlled hypothyroidism are at the
highest risk
-Occurs more commonly in winter months
T/F, T3 possesses about 4x the hormone "strength" as T4. - CORRECT ANSWER - True
A low T4 and high TSH would indicate: - CORRECT ANSWER - Primary
hypothyroidism
A high T4 and low TSH would indicate - CORRECT ANSWER - primary hyperthyroidism
What is the most reliable test to differentiate the "cold" nodule that is cancer versus benign? -
CORRECT ANSWER - A thyroid needle biopsy
What is the first line diagnostic test for hypothyroidism? - CORRECT ANSWER - TSH
ACTUAL Exam Questions and CORRECT
Answers
For type II DM to occur, what must exist? - CORRECT ANSWER - Insulin resistance and
inadequate insulin secretion
What are the preprandial and postprandial plasma glucose target levels for patients with type I
DM? - CORRECT ANSWER - Fasting: 80-130
Peak postprandial: <180
What is the first indicator of diabetic nephropathy? - CORRECT ANSWER -
Microalbuminuria
What specialists should a type I Diabetic be referred to? - CORRECT ANSWER - Endo,
nutritionist, nephro, podiatrist and ophthamologist
What might hypoglycemia result from? - CORRECT ANSWER - -Change in insulin dose,
a small or missed meal or strenuous exercise
Somogyi effect - CORRECT ANSWER - hypoglycemia followed by rebound
hyperglycemia
If low at 2-3am, suspect somogyi.
Causes: Excess or ill-timed insulin, missed meals or snacks, and inadvertent insulin
administration
Radioactive Iodine tests and possible diagnosis - CORRECT ANSWER - If diffuse uptake,
graves disease or pituitary adenoma
If decreased uptake, thyroiditis
If a hot nodule, toxic adenoma
, If cold nodule, suspect malignancy
What are the clinical features of hashimoto's - CORRECT ANSWER - Asymptomatic firm
diffuse goiter and often hypothyroid at time of diagnosis
Pain and tenderness not usually present
Often progresses to permanent hypothyroidism
What is the treatment of thyroid storm? - CORRECT ANSWER - Beta blockers are initial
Tx of choice.
Methimazole, PTU
IV fluids, glucocorticoids
Who is at the highest risk for myxedema coma and when does it more commonly occur? -
CORRECT ANSWER - -Elderly women w/ poorly controlled hypothyroidism are at the
highest risk
-Occurs more commonly in winter months
T/F, T3 possesses about 4x the hormone "strength" as T4. - CORRECT ANSWER - True
A low T4 and high TSH would indicate: - CORRECT ANSWER - Primary
hypothyroidism
A high T4 and low TSH would indicate - CORRECT ANSWER - primary hyperthyroidism
What is the most reliable test to differentiate the "cold" nodule that is cancer versus benign? -
CORRECT ANSWER - A thyroid needle biopsy
What is the first line diagnostic test for hypothyroidism? - CORRECT ANSWER - TSH
