Endocrine

Question 1

Best imaging for pituitary adenoma?

Answer 1

MRI.

Question 2

Key hormones to check?

Answer 2

FSH, LH, TSH, prolactin, GH, ACTH.

Question 3

Typical visual field defect?

Answer 3

Bitemporal hemianopsia.

Question 4

First-line medical therapy for prolactinoma?

Answer 4

Dopamine agonist (bromocriptine).

Question 5

Fasting glucose 6.7, next test?

Answer 5

75 g OGTT.

Question 6

Meds to prevent diabetes in impaired glucose tolerance?

Answer 6

Metformin, acarbose, thiazolidinedione.

Question 7

Long-term glucose control test?

Answer 7

HbA1c.

Question 8

Monitoring frequency for Type 1 Diabetes?

Answer 8

HbA1c q3mo, urine A/C yearly, cholesterol yearly, Cr q6mo.

Question 9

Complications of Type 1 Diabetes?

Answer 9

Retinopathy, nephropathy, neuropathy, CAD.

Question 10

Insulin regimen split for Type 1 Diabetes?

Answer 10

40–50% basal, 50–60% premeal bolus.

Question 11

Dietary advice for Type 1 Diabetes?

Answer 11

<30% fat (<10% sat), 55% carbs, protein 15–20%.

Question 12

Screening guideline for Type 2 Diabetes?

Answer 12

q3yrs after 40 (earlier if risk factors).

Question 13

Diagnostic criteria (CDA) for Type 2 Diabetes?

Answer 13

FBG ≥7.0, 2h OGTT ≥11.1, A1C ≥6.5%.

Question 14

Glycemic targets for Type 2 Diabetes?

Answer 14

A1C <7.0%, 2h post-prandial 5–10.

Question 15

First-line medication for Type 2 Diabetes?

Answer 15

Metformin (unless contraindicated).

Question 16

Yearly complication screening for Type 2 Diabetes?

Answer 16

Neuropathy (monofilament), nephropathy (ACR), retinopathy (eye exam), dyslipidemia, BP, CAD risk.

Question 17

Diagnostic T-score cutoffs for Osteoporosis?

Answer 17

Normal > –1, Osteopenia –1 to –2.5, Osteoporosis < –2.5.

Question 18

First-line non-pharm management for Osteoporosis?

Answer 18

Weight-bearing exercise, smoking/alcohol cessation, fall prevention.

Question 19

Calcium & Vitamin D requirements for Osteoporosis?

Answer 19

Calcium 1500 mg/day, Vit D 800 IU/day.

Question 20

First-line drug therapy for Osteoporosis?

Answer 20

Bisphosphonates (alendronate, risedronate).

Question 21

Bisphosphonate side effects?

Answer 21

GI upset, esophagitis, osteonecrosis of jaw.

Question 22

Red flags for thyroid cancer?

Answer 22

Male, <20 or >65, rapid growth, local invasion, radiation history, FHx.

Question 23

First-line diagnostic test for thyroid nodule?

Answer 23

U/S guided FNA.

Question 24

Hyperthyroidism Rx?

Answer 24

Thionamides (PTU, methimazole), β-blocker, radioiodine, surgery.

Question 25

Hypothyroidism Rx?

Answer 25

Levothyroxine; recheck TSH in 6 weeks.

Question 26

Key complication of hypothyroidism?

Answer 26

Myxedema coma.

Question 27

Common drug causes of gynecomastia?

Answer 27

Spironolactone, cimetidine, verapamil, nifedipine, ketoconazole, TCAs, digoxin, HAART, narcotics.

Question 28

Physiological ages for gynecomastia?

Answer 28

Newborns, adolescence, older men.

Question 29

Classic triad of symptoms for DKA?

Answer 29

Polyuria, polydipsia, polyphagia.

Question 30

Typical labs for DKA?

Answer 30

High glucose, ketones, acidosis, ↑AG, low K⁺ (after correction).

Question 31

Treatment for DKA?

Answer 31

IV fluids, insulin, K⁺ replacement.

Question 32

PCOS diagnostic clue?

Answer 32

LH:FSH >2.

Question 33

Sudden severe hirsutism + virilization — think?

Answer 33

Androgen-secreting ovarian/adrenal tumor.

Question 34

Late-onset CAH screen?

Answer 34

↑17-OHP.

Question 35

Common drug causes of hirsutism?

Answer 35

Dilantin, steroids, metoclopramide, methyldopa.

Question 36

First-line lifestyle management for hirsutism?

Answer 36

Healthy eating, exercise, weight loss (esp. PCOS).

Question 37

Hair removal options for hirsutism?

Answer 37

Depilatories, waxing, laser, electrolysis.

Question 38

PCOS-specific treatments?

Answer 38

Weight loss, OCP, provera (for withdrawal bleed), clomiphene for fertility.

Question 39

Anti-androgen therapies for hirsutism?

Answer 39

Spironolactone, flutamide, finasteride, Diane-35.

Question 40

Other hormonal options for hirsutism?

Answer 40

OCP, GnRH agonists, insulin-sensitizers.

Question 41

Why induce withdrawal bleed in amenorrhea?

Answer 41

To prevent endometrial hyperplasia or cancer.