Endocrine

Question 1

What is the best screening test for thyroid disease?

Answer 1

Thyroid stimulating hormone

(TSH)

TSH levels help determine the presence of hypothyroidism or hyperthyroidism.

Question 2

What lab values indicate hyperthyroidism?

Answer 2

• Decreased TSH
• Elevated T4
• Elevated T3

Question 3

What is the most common cause of hyperthyroidism?

Answer 3

Grave’s Disease

Question 4

Which condition is characterized by symptoms such as tachycardia, high fevers, and CNS dysfunction?

Answer 4

Thyroid storm

Question 5

What is the first-line treatment for hypothyroidism?

Answer 5

Synthetic T4 (levothyroxine)

Levothyroxine is used to replace deficient thyroid hormones.

Question 6

What is the most common cause of hypothyroidism in the US?

Answer 6

Hashimoto’s Disease

Hashimoto’s Disease is an autoimmune disorder affecting the thyroid.

Question 7

Fill in the blank:

In areas of the Western Pacific, South East Asia, and Africa, the most common cause of hypothyroidism is ______.

Answer 7

iodine deficiency

Question 8

What are the normal lab values for fasting plasma glucose?

Answer 8

<100 mg/dL

Normal fasting plasma glucose levels help rule out diabetes.

Question 9

What A1C level is diagnostic for diabetes?

Answer 9

6.5% or greater

Question 10

Which diabetes type is characterized by insulin resistance?

Answer 10

Type 2 diabetes

Question 11

What is the initial pharmacological treatment for type 2 diabetes?

Answer 11

Metformin

Metformin is preferred due to its efficacy and safety profile.

Question 12

What is a common side effect of Metformin?

Answer 12

Diarrhea

Question 13

True or False:

Metformin is contraindicated in patients with severe renal dysfunction.

Answer 13

True

Question 14

Which class of medications is preferred for type 2 diabetes patients with established cardiac disease?

Answer 14

Glucagon-like peptide receptor agonist

(GLP1)

Question 15

When is insulin indicated for diabetes management?

Answer 15

• A1C >9%
• Symptomatic, hyperglycemic, and ketonuria present

GLP-1 may be a reasonable alternative to insulin.

Question 16

What is the initial dosing for basal insulin?

Answer 16

0.2 units per kg a day

Question 17

What should be done if a patient experiences hypoglycemia while on insulin?

Answer 17

Decrease the bedtime dose by either 4 units or 10% (whichever is greater)

Question 18

True or False:

The endocrine system functions as a negative feedback system.

Answer 18

True

The body adjusts hormone production based on current levels to maintain balance.

Question 19

Fill in the blank:

In hyperthyroidism, TSH is ______.

Answer 19

decreased

Hyperthyroidism is characterized by decreased TSH and elevated T4 and T3 levels.

Question 20

True or False:

Thyroid storm is a common condition.

Answer 20

False

Thyroid storm is a rare, life-threatening condition resulting from untreated hyperthyroidism.

Question 21

Fill in the blank:

In type 1 diabetes, patients are ______ deficient.

Answer 21

Insulin

Type 1 diabetes is characterized by a lack of insulin production.

Question 22

What are the risk factors for type 2 diabetes?

Answer 22

• Obesity
• Genetic susceptibility
• Lifestyle choices (alcohol and smoking)
• Sedentary lifestyle
• History of gestational diabetes
• PCOS
• Metabolic syndrome

These factors contribute to insulin resistance, leading to type 2 diabetes.

Question 23

What is the recommended A1C target for most adults with diabetes?

Answer 23

7% or less

A1C targets help manage long-term glucose control in diabetic patients.

Question 24

What is the Somogyi effect?

Answer 24

High blood sugar in the morning caused by a rebound effect.

The Somogyi effect is more common in type 1 diabetes.

Question 25

What is the **primary treatment** for Addison’s disease?

Answer 25

* Hydrocortisone, prednisone, or methylprednisolone to replace cortisol deficiency * Fludrocortisone acetate to replace aldosterone deficiency ## Footnote Addison’s disease is treated with lifelong hormone replacement therapy to restore both glucocorticoid and mineralocorticoid balance. Hydrocortisone is most commonly used because it mimics the body’s natural cortisol rhythm.

Question 26

What are the **symptoms** of an adrenal crisis?

Answer 26

* Shock or hypotension * Abdominal, flank, back, or lower chest pain * Nausea and vomiting * Fatigue * Unexplained fever * Unexplained hypoglycemia * Hyperpigmentation or vitiligo * Confusion or coma ## Footnote Adrenal crisis is a medical emergency requiring immediate treatment.

Question 27

What is a **common cause** of Cushing’s disease?

Answer 27

Taking high doses of oral or injectable corticosteroids over time. ## Footnote Cushing’s disease can also result from tumors causing overproduction of cortisol.

Question 28

What is the **primary diagnostic test** for Cushing’s disease?

Answer 28

24-hour urinary cortisol excretion test. ## Footnote This test measures cortisol levels to diagnose Cushing’s disease.

Question 29

# Fill in the blank: The normal fasting glucose range is \_\_\_\_\_\_.

Answer 29

70–99 mg/dL