Endo

Question 1

Indications of parathyroidectomy

Answer 1

1. Gfr or creative clearance less than 60, 24 hour urine Ca >400, or nephrolithiasis
2. T score of -2.5 or worse
3. Age 50 or younger in otherwise asx individual
4. Calcium increased by at least 1 above the upper limit of normal
5. Surveillance not possible

Question 2

Indications for thyroid FNA

Answer 2

• on US if >1cm
• High risk features on US and <1cm
• Cold nodule

Question 3

High risk features on US for thyroid nodule

Answer 3

• Tall > wide
• Microcalcifications
• Irregular shape
• Marked Hypoechoic
• increased vascularity

Question 4

Vitiligo Dx - other dx to screen for

Answer 4

Diabetes Mellitus Type 1

Thyroid

Question 5

Estrogen Supplement CI

Answer 5

VTE
CAD
Endometrial cancer
Breast Cancer
Active liver disease

relative CI: smoking

Question 6

Pagets disease Diagnosis and Treatment

Answer 6

Diagnosis:
- 60yo
- Elevated Alk Phos (isolated)
- May have neuro sx due to compression, may have fractures, may have high output heart failure
Dx with BONE SCAN
Dx with xrays: osteolytic lesions or sclerosis, cortical thickening

TX:

• only if symptomatic or hypercalcemic
• tx with bisphosphonates

Question 7

Osteoporosis risks for men

Answer 7

hypogonadism 
hyperthyroid
Vit D def (Gastrectomy, low vit D) 
Smoking, alcohol
previous fractures