INTERNAL MEDICINE BOARD REVIEW FLASHCARDS

Endocrinology & Metabolism

Includes 50 Flashcards for Board Exam prep

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KNOWMEDGE

INTERNAL MEDICINE BOARD REVIEW FLASHCARDS

Endocrinology & Metabolism

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Question 1

What are the three main types of

autoimmune polyendocrine syndrome
(APS)?

Answer 1

APS Type I, APS Type II, and X-linked

polyendocrinopathy, immunodeficiency
and diarrhea-syndrome (XPID)

Question 2
What autoimmune polyendocrine
syndrome is characterized by the
occurrence of Addison's disease along
with autoimmune thyroid disease and/or
type I diabetes mellitus?

Answer 2

Autoimmune polyendocrine syndrome

(APS) Type II

Question 3
Patients with autoimmune
polyendocrine syndrome (APS) Type I
generally have two of three possible
conditions. What are the three
conditions?

Answer 3
APS type I is characterized by at least
two of the following three conditions:
hypoparathyroidism, mucocutaneous
candidiasis, Addison's disease (adrenal
insufficiency)

Question 4

What is the most common type of

autoimmune polyendocrine syndrome
(APS)?

Answer 4

Autoimmune polyendocrine syndrome

(APS) Type II

Question 5

What are the hormones produced in the

neurohypophysis (posterior pituitary
gland)?

Answer 5

Antidiuretic hormone (ADH) and

Oxytocin

Question 6

What hormone in excess can lead to

Cushing's syndrome?

Answer 6

Adrenocorticotropic hormone (ACTH)

Question 7

The screening test for excess of what

hormone is insulin growth factor-1 (IGF1)?

Answer 7

Growth hormone (GH)

Question 8

What hormone is inhibited by dopamine

from the hypothalamus?

Answer 8

Prolactin

Question 9

Paraplegia, high calcium, deafness and

high output congestive heart failure are
seen in what condition?

Answer 9

Osteosarcoma

Question 10

What is the T score range on DEXA scan

for a diagnosis of osteoporosis?

Answer 10

T-score between -1 and -2.5

Question 11

What common chronic condition can

cause a discrepancy between the T score
of the spine and the hip?

Answer 11

Osteoarthritis of the spine

Question 12

In the workup of amenorrhea, follicle

stimulating hormone (FSH) level 35 U/L
suggests what likely diagnosis?

Answer 12

Primary ovarian failure

Question 13

In the workup of amenorrhea, follicle

stimulating hormone (FSH) 20U/L - 35
U/L suggests what likely diagnosis?

Answer 13

Low ovarian reserve

Question 14

What is a normal follicle stimulating

hormone (FSH) level?

Answer 14

<20 U/L

Question 15

What is another term for subclinical

hypothyroidism?

Answer 15

Mild thyroid failure

Question 16

What value (TSH or free T4) determines

if subclinical hypothyroidism should be
treated?

Answer 16

TSH. Treat if greater than 10U/mL

Question 17
Of the lab changes associated with
treating subclinical hypothyroidism,
what most corresponds to a decrease in
the chances of developing coronary
artery disease?

Answer 17

Lower LDL

Question 18

What is the time cut-off after which an

elevated PSA in the context of
testosterone use warrants biopsy?

Answer 18

6 months

Question 19

What effect does testosterone use have

on hemoglobin?

Answer 19

Increased hemoglobin

Question 20

Polycystic ovarian syndrome features

elevated testosterone and LH:FSH ratio
greater than or equal to what value?

Answer 20

LH:FSH ratio greater than or equal to 3:1

Question 21

In what conditions causing hirsutism

would we expect the DHEA (17-OH
ketosteroid) levels to be elevated?

Answer 21

Cushings disease, Adrenal carcinoma, or

Congenital adrenal hyperplasia.

Question 22

Congenital adrenal hyperplasia (CAH) is

caused by what enzyme deficiency?

Answer 22

21-beta hydroxylase

Question 23

What are the two thyroid-related

emergencies?

Answer 23

Thyroid storm and Myxedema coma

Question 24

What are the two most common

symptoms in myxedema coma?

Answer 24

Hypothermia (temp less than 35C) and

Obtunded state

Question 25

What are the main treatments for

myxedema coma?

Answer 25

Intravenous levothyroxine, Intravenous

steroids and Antibiotics

Question 26

What is the enzyme that converts 17-OH

progesterone to cortisol?

Answer 26

21-beta hydroxylase

Question 27

What type of inheritance pattern does

congenital adrenal hyperplasia (CAH)
follow?

Answer 27

Autosomal recessive

Question 28

What condition is associated with

antibodies to post-synaptic acetylcholine
receptors?

Answer 28

Myasthenia gravis

Question 29

What condition is associated with

antibodies to pre-synaptic acetylcholine
receptors?

Answer 29

Eaton-Lambert syndrome

Question 30

What lab value is expected to be

elevated in the context of a strong family
history of heart disease and low HDL?

Answer 30

Lipoprotein(a)

Question 31

In what 3 main deficiencies can

homocysteine levels be elevated?

Answer 31

Vitamin B12, Folate, or Vitamin B6

deficiency

Question 32

Impaired fasting glucose is diagnosed

when the blood glucose is in what
range?

Answer 32

100-125mg/dL

Question 33

What is the antibody most clinically

useful for diagnosing type 1 diabetes
mellitus?

Answer 33

Anti-glutamic acid decarboxylase

Question 34

What 3 main ophthalmologic findings

can be seen in proliferative diabetic
retinopathy?

Answer 34

Cotton-wool spots, Neovascularization,

or Macular edema

Question 35

What is the definition of prediabetes

based on hemoglobin A1c?

Answer 35

A1c between 6.0 and 6.5%

Question 36

What type of bone lesions are seen in

multiple myeloma?

Answer 36

Lytic bone lesions

Question 37

In which calcium abnormality (hyper- or

hypo-) does tapping of the facial nerve
cause contraction of the facial muscle?

Answer 37

Hypocalcemia. Finding is known as

Chvostek sign.

Question 38

Is pancreatitis associated with hypo or

hypercalcemia?

Answer 38

Hypercalcemia

Question 39

Is hypercalcemia more commonly

associated with constipation or
diarrhea?

Answer 39

Constipation

Question 40
Which combination is at greater risk of
developing osteoporosis: Active lifestyle
& High BMI or Sedentary lifestyle & Low
BMI

Answer 40

Sedentary lifestyle & Low BMI

Question 41

What is the T score range on DEXA scan

for a diagnosis of osteoporosis?

Answer 41

Less than -2.5

Question 42

What injectable medication may be

given for osteoporosis?

Answer 42

Teriparatide

Question 43
True or False: Plicamycin is an effective,
commonly used treatment for patients
with hypercalcemia associated
sarcoidosis.

Answer 43

False; Plicamycin is not used often

because of its potential renal, liver, and
bone marrow side effects.

Question 44

What medication is used to decrease

calcium levels in primary and tertiary
hyperparathyroidism?

Answer 44

Cinacalcet, a calcimimetic agent

Question 45

What is the main side effect limiting the

use of calcitonin?

Answer 45

Tachyphylaxis, which is a sudden

decrease in the effectiveness of the drug

Question 46
In addition to aggressive IV fluids, what is
the best medication to provide a
sustained calcium-lowering effect in
malignancy?

Answer 46

IV Zoledronate

Question 47

What are the three Ps associated with

Multiple Endocrine Neoplasia (MEN) 1?

Answer 47

Parathyroid hyperplasia, Pancreas islet

cell tumor, Pituitary tumor

Question 48

What is the age cut-off indication for

parathyroidectomy in patients with
primary hyperparathyroidism?

Answer 48

Age less than 50 years

Question 49

What is the calcium cut-off indication for

parathyroidectomy in patients with
primary hyperparathyroidism?

Answer 49

Calcium greater than 1mg/dL above

normal (>12 mg/dL)

Question 50

What form of vitamin D is elevated in

patients with sarcoidosis?

Answer 50

1,25-dihydroxyvitamin D

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