Endocrinology Flashcards
6 cards from real ABIM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Endocrinology flashcards as text
A 50-year-old man presents with hypertension, hypokalemia, and metabolic alkalosis. Plasma aldosterone-to-renin ratio is markedly elevated. What is the most appropriate next step?
Answer: CT scan of the adrenal glands
Once primary aldosteronism is confirmed biochemically, CT scan of the adrenal glands is the first imaging step to identify an adenoma versus bilateral hyperplasia.
A 55-year-old woman with Cushing disease undergoes transsphenoidal surgery but has persistent hypercortisolism. What is the next treatment option?
Answer: Repeat transsphenoidal surgery or radiotherapy
For persistent Cushing disease after failed transsphenoidal surgery, repeat surgery or pituitary radiation is the preferred next step before bilateral adrenalectomy.
A patient with type 1 diabetes presents with DKA: glucose 520 mg/dL, pH 7.18, bicarbonate 10 mEq/L, potassium 5.8 mEq/L. When should insulin be started?
Answer: After fluid resuscitation and potassium is ≥3.5 mEq/L
Insulin infusion should not be started until potassium is ≥3.5 mEq/L, because insulin drives potassium intracellularly and can precipitate life-threatening hypokalemia.
A 40-year-old man has an incidentally found 2.5 cm adrenal mass. It appears lipid-rich on CT (HU < 10). He is normotensive with normal electrolytes. What should be done?
Answer: Biochemical evaluation for hormonal hypersecretion
All adrenal incidentalomas require biochemical evaluation for pheochromocytoma, subclinical Cushing syndrome, and primary aldosteronism, regardless of imaging characteristics.
A patient with Graves disease is planning pregnancy. Which treatment is preferred in the first trimester?
Answer: Propylthiouracil (PTU)
PTU is preferred over methimazole in the first trimester of pregnancy because methimazole is associated with aplasia cutis and choanal atresia in the fetus.
A 65-year-old woman with type 2 diabetes develops peripheral neuropathy with burning pain. Her HbA1c is well controlled at 7.1%. What is the first-line pharmacotherapy for her neuropathic pain?
Answer: Gabapentin or pregabalin
Gabapentin, pregabalin, and duloxetine are first-line agents for painful diabetic peripheral neuropathy based on efficacy evidence and guideline recommendations.