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Endocrinology
STEP 2 Rx notes
| Question | Answer |
|---|---|
| Which hormonal level is seen elevated in Vitamin D-dependent rickets? | Hyperparathyroidism |
| What is the cause of Vitamin D-dependent rickets type I? | Mutation in gene coding for 1α-hydroxylation enzyme in the kidney |
| What is the HbA1c goal range? | 6.5-7% |
| What is the diagnostic fasting plasma for DMII? | Fasting glucose >126 |
| What is the amount of glucose given to perform a 2-hr plasma glucose test in a non-pregnant patient? | 75 g |
| What condition is predisposed by hyperglycemia causing Median nerve compression? | Carpal Tunnel syndrome |
| What is a fatal complication of severe thyrotoxicosis? | Thyroid storm |
| What is the pharmacologic treatment regimen of thyroid storm? | 1. ß-blocker --> ↓ adrenergic tone 2. Thioamide --> block new TH synthesis 3. Iodine solution --> block release of TH 4. Glucocorticoids --> ↓ peripheral convertion of T4 --> T3 |
| What is the reason to use Thionamide in treatment of Thyroid storm? | Block new TH synthesis |
| What is the purpose of using glucocorticoids in treating Thyroid storm? | ↓↓ peripheral conversion of T4 into T3(active) |
| What is the MCC of Adrenal crisis? | Acute, severe glucocorticoid deficiency |
| What exogenic form of steroid is given in treating Adrenal crisis? | Hydrocortisone |
| What steroid mimics the most closely a glucocorticoid? | Hydrocortisone |
| What steroid mimics the most a mineralocorticoid? | Fludrocortisone |
| Fludrocortisone is supposed to mimic or mask the deficiency of: | Aldosterone |
| Hydrocortisone is supposed to mask the deficiency of: | Cortisol |
| What serum calcium level indicates a Hypercalcemic crisis? | Above 14 mg/dL |
| In addition to serum Ca2+ > 14, what are accompanying S/S of Hypercalcemic crisis? | Neuropsychiatric S/S (AMS, somnolence) and dehydration due to ADH resistance |
| What is the treatment for Hypercalcemic crisis? | Aggressive IV saline fluid resuscitation and loop diuretics ---> Calcitonin or bisphosphonates |
| What are the MC S/S of Primary HyperPTH? | Recurrent nephrolithiasis and joint pain |
| How are levels of Calcium, phosphate, and PTH in primary hyperPTH? | ↑↑Calcium, ↑PTH, but ↓ phosphate |
| What are the MCC of primary hyperPTH? | PTH-adenomas or hyperplasia |
| What is the best treatment option for primary HyperPTH? | Parathyroidectomy in symptomatic patients |
| S/S of thyrotoxicosis + painless nodular goiter + low TSH. Dx? | Primary hyperthyroidism |
| What are the radionuclide findings for Toxic Multinodular goiter? | 1. ↑↑↑ RAIU 2. Multiple foci radiotracer distribution |
| ↓↓ RAIU + no radiotracer distribution. Dx? | Non-toxic Multinodular goiter |
| Which type of MNG has elevated levels or RAIU? | Toxic MNG |
| What is the consequence of autonomous secretion of Aldosterone in primary hyperaldosteronism on the kidneys? | 1. ↑↑↑ renal Na+ REABSORPTION 2. ↑↑ K+ and H+ urinary excretion |
| What is the result of the compensatory mechanisms due to excessive Aldosterone secretion? | Hypernatremia, hypokalemia, and metabolic alkalosis |
| Muscle weakness + (+) Trousseau sign. Labs severe Calcium deficiency, low PTH, and ↑phosphate. Dx? | Hypoparathyroidism |
| Euglycemic DKA is associated in what patients? | DM type 2 on SGLT2-inhibitors |
| Glucose level near normal, anion gap metabolic acidosis, and (+) ketones. Dx? | Euglycemic DKA |
| How are the RAIU values in symptomatic patients on Amiodarone? | Low RAIU |
| What is the 1st line of treatment for Subacute Granulomatous thyroiditis? | Anti-inflammatory therapy with NSAIDs |
| What is the best treatment option of Klebsiella-CAP? | 2nd or 3rd generation cephalosporin |
| What is the associated Na+ level in Adrenal insufficiency? | Hyponatremia |
| How is Graves disease treated in 1st trimester of pregnancy? | PTU |
| What medication is used for GD in 2nd and 3rd trimesters? | Methimazole |
| On which type of hyperparathyroidism, is phosphate reduced or low? | Only in Primary hyperparathyroidism |
| Which type of hyperparathyroidism is Calcium low in blood? | Secondary Hyperparathyroidism |
| At what age should any person, regardless of comorbidities or risk factors should be screen for DM2? | 35 years old or older |
| What is the term given to a person with a fasting blood glucose of 110? | Prediabetic |
| Which is more fatal, HHS or DKA? | HHS |
| Hyperglycemia (>600), volume deficit, and (-) ketones. Dx? | HHS |
| What is the initial best step in treating HHS? | Aggressive hydration |
| What type and route of insulin is given in DKA management? | IV regular insulin |
| At what K+ level, in DKA, is K+ given prior to insulin? | <3.3 |
| What is the range for microalbuminuria? | 30-299 mcg/mg |
Created by:
rakomi
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