MKSAP ENDOCRINOLOGY QUESTIONS
What are the expected side effects of panretinal laser photocoagulation therapy? -
Answers -Retained central vision but poorer peripheral and night vision. Q1
What is the prevalence of adrenal incidentalomas? - Answers -- >50 yo 2-3%
- >70 yo 7%. Q2
What questions must you ask about an adrenal mass in a young person? - Answers --
Primary or metastatic
- Benign or malignant
- Functioning or not. Q2
What percentage of adrenal incidentalomas are functioning? - Answers -10%. Not all
have signs or symptoms of functionality. Q2
Size matters in adrenal incidentalomas in terms of malignant potential. What are the
size cutoffs? - Answers -- 4 cm or less have <2% chance of being malignant
- 6 cm or more have >25% of being malignant. Surgical removal is necessitated for this
size. Q2
What is the major rate-limiting factor of tight glycemic control in T1DM? - Answers -
Hypoglycemic episodes. 48-72 hours after hypoglycemic episode occurs, the adrenergic
response is blunted to low glucose. Q19
What is an indication for alpha-lipoic acid? - Answers -Diabetic neuropathy. Q19
What is an indication for pramlintide? - Answers --Management of T1DM.
-Synthetic long-acting analog of amylin.
-Slows gastric emptying, decreases glucagon secretion , and promotes satiety. Q19
What percentage of thyroid nodules are malignant? - Answers -5-15%. Q20
What is the most accurate way to determine whether a thyroid nodule is benign or
malignant? - Answers -FNA. Q20
What percentage of healthy persons have a thyroid nodule? - Answers -30-50%. Q20
What is the recommended size for performing an FNA? - Answers -5mm. Q20
What differentiates thyrotoxicosis of the thyroid gland from central hyperthyriodism? -
Answers -A detectable TSH. Q28
, What would you expect the TSH and T3 and T4 to be in central hyperthyroidism? -
Answers -Detectable TSH in the setting of elevated T3 and T4. Q28
How do you diagnose central hyperthyroidism and how do you treat it? - Answers -
Pituitary MRI and neurosurgical resection. Q28
What are the classic symptoms of pheochromocytoma? - Answers -Hypertension,
palpitations, sweating, headaches. Q29
How do you diagnose pheochromocytoma? - Answers -- Plasma and urine
metanephrines and normetanephrines
- Urine catecholamines (epinephrine and norepinephrine)
- Urine vanillylmandelic acid. Q29
How do you preoperatively treat blood pressure in pheochromocytoma? - Answers -
Treat with short-acting alpha-blockers (prazosin, doxazosin, and terazosin) and then
beta-blockers. Q29
How do you diagnose Paget's disease of bone? - Answers -- Bone scan then plain
radiographs. Bone scan shows increased uptake and plain radiographs show
coarsened bony trabeculae (pathognomonic). Q30
What are the clinical signs and symptoms of Paget's disease of bone? - Answers --
Bone pain
- Traumatic and pathologic fractures
- Skeletal deformities
- CN impairment (VIII)- hearing. Q30
What lab test can you use to monitor response to therapy in Paget's disease of bone? -
Answers -Serum collagen type 1 cross-linked C-telopeptide (CTX). Q30
How do you convert Hgb A1C to serum glucose? - Answers -- A1C x 25 = serum
glucose
- A1C of 5% = 100 mg/dL. Then every 1% increase in A1C is 30 mg/dL of blood
glucose. Q31
When does NPH 70/30 insulin peak? - Answers -Between 6-8 hours. Q31
What is the dawn phenomenon in DM? - Answers -Elevation of early morning (4-8a)
blood glucose due to elevation of GH and cortisol. Q31
What is MEN1? - Answers -- Hyperparathyroidism
- Pituitary adenoma (prolactinoma)
- Pancreatic tumors (islet cell). Q32
How is MEN1 inherited? - Answers -Autosomal Dominant. Menin gene. Q32
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