Term
| What value for a random glucose check fits DM criteria? |
|
Definition
| 200 or more mg/dL with symptoms |
|
|
Term
| What value for fasting glucose check fits DM criteria? |
|
Definition
| 126 or higher on two separate reads |
|
|
Term
| What is the glucose lvl criteria for DM after a 2-hr 75g oral glucose load? |
|
Definition
|
|
Term
| What are the three once-daily insulins? |
|
Definition
Lantus (glargine)
Levemir (detemir)
NPH |
|
|
Term
| What tests should be order for a pt in diabetic ketoacidosis? |
|
Definition
CBC
CMP
BUN/creatinine
ABG
serum ketones
CXR
blood culture
UA/cultures
EKG |
|
|
Term
| At what serum glucose lvls should a pt in DKA be switched to D5NS solution? Why? |
|
Definition
| once blood glucose lvls are below 250 mg/dL; to prevent hypoglycemia |
|
|
Term
| When should a pt previously in DKA be switched from IV insulin to IM insulin? |
|
Definition
| Once anion gap normalizes |
|
|
Term
| Which medication classes can cause a DM type 2 patient to slip into a hyperglycemic hyperosmolar nonketotic state? |
|
Definition
B-blockers
steroids
thiazides |
|
|
Term
| What are the diagnostic criteria for pts to be in a hyperglycemic hyperosmolar nonketotic state? |
|
Definition
serum gluc over 600
pH over 7.3
bicarb over 15
anion gap less than 14
osmolality over 310 |
|
|
Term
| What approach is acceptable in the management of both HHNS and DKA? |
|
Definition
|
|
Term
| What are the three most common microvascular complications of DM? |
|
Definition
retinopathy
nephropathy
neuropathy |
|
|
Term
| How is nonproliferative diabetic retinopathy differentiated from proliferative? |
|
Definition
Nonprolif: cotton wool spots, microaneurysms, blot hemorrhages
Prolif: neovascular |
|
|
Term
| In the initial management of hyperthyroidism what category of medications are most important? |
|
Definition
| b-blockers for rate control |
|
|
Term
| Why cardiac arrhythmia may by the initial presentation of hyperthyroidism? |
|
Definition
| A-fib (also look for increased pulse pressure) |
|
|
Term
| How is menstruation affected by hypothyroidism? |
|
Definition
|
|
Term
| How is menstruation affected hyperthyroidism? |
|
Definition
|
|
Term
| Which type of hyperthyroidism is more likely to cause arthralgias and myalgias? |
|
Definition
|
|
Term
| What treatment option is indicated in pregnant pts with hyperthyroidism? |
|
Definition
| surgical reduction of thyroid |
|
|
Term
| What immunoglobulins/antibodies are positive in pts with Grave's disease? |
|
Definition
thyroid-stimulating immunoglobulin
thyroglobulin antibody |
|
|
Term
| Which antibody test is positive in pts with Hashimoto's thyroiditis? |
|
Definition
|
|
Term
| Regardless of cause what treatment option is indicated in cases of hypercalcemia? |
|
Definition
| fluids and Lasix after volume correction (to excrete calcium from blood) |
|
|
Term
| What age groups should be screened for osteoporosis regardless of risk factors? |
|
Definition
|
|
Term
| What types of drugs/deficiences can cause secondary osteoporosis? |
|
Definition
| smoking, alcoholism, renal failure, hyperthyroidism, hyperparathyroidism, Vit D def, hypercortisolim, and chronic steroid use |
|
|
Term
| Why should hormone replacement therapy be avoided in osteoporotic pts? |
|
Definition
| inceased cardiovascular and breast cancer risk |
|
|
Term
| When should pts be treated for osteoporosis? |
|
Definition
Once T score is less than - 2
or
Once T score is less than -1.5 w/ risk factors for fractures |
|
|
Term
| What are the first line medications of choice for osteoporosis? |
|
Definition
| bisphosphonates (-dronates) |
|
|
Term
| How is Cushing's disease different from Cushing's syndrome? |
|
Definition
| Cushing's disease IS Cushing's syndrome caused by an adenoma of the pituitary gland |
|
|
Term
| What are the four primary etiologies of cushing's syndrome? |
|
Definition
1. adrenal (adenoma/carcinoma)
2. pituitary (adenoma)
3. ectopic lung cancer
4. exogenous (corticosteroid administration) |
|
|
Term
| Which three labs should be run to determine the underlying cause of Cushing's syndrome? |
|
Definition
1. plasma cortisol
2. urinary cortisol
3. serum ACTH |
|
|
Term
| What test, when positive, is pathomneumonic for Cushing's syndrome? |
|
Definition
| increase 24-hr urine cortisol |
|
|
Term
| What is Addison's disease? |
|
Definition
| primary failure of the adrenal glands (cortex) |
|
|
Term
| What are the signs/symptoms of Addison's disease? |
|
Definition
hyperpigmentation
dehydration
hyponatremia
hyperkalemia
salt craving |
|
|
Term
| How is adrenal insufficiency determined? |
|
Definition
| ACTH stimulation test with subsequent failure to produce appropriate cortisol levels |
|
|
Term
| What medication is the drug of choice in adrenal insufficiency? |
|
Definition
| mineral-/gluccocorticoids (hydrocortisone) |
|
|
Term
| What is the most common functional pituitary tumor? |
|
Definition
|
|
Term
| What two medications do pts in adrenal crisis need? |
|
Definition
| fluid resuscitation and IV hydrocortisone |
|
|
Term
| What are the affects of a prolactinoma on LH and FSH? |
|
Definition
|
|
Term
| Which class of drugs are used to inhibit the secretion of prolactinomas? |
|
Definition
|
|
Term
| What are the three Ps (characteristics) of Wermer's syndrome (MEN syndrome type I)? |
|
Definition
parathyroid hyperplasia
pancreatic islet cell tumor
pituitary adenoma |
|
|
Term
| What are the two common components of both MEN type IIa and IIb? |
|
Definition
thyroid medullary cancer
pheochromocytoma |
|
|
Term
| What are the three characteristics of MEN type IIa? |
|
Definition
Parathyroid hyperplasia
Thyromedullar cancer
Pheochromocytoma |
|
|
Term
| What are the five characteristics of MEN type IIb? |
|
Definition
Thyromedullar cancer
Pheochromocytoma
Mucocutaneous neuromas
Ganglioneuromatosis of colon
Marfan-like habitus |
|
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