Endocrinology & Diabetes — Flashcards

Flashcard 591: An _____ can be used to differentiate between Cushing's syndrome and pseudo-cushings

Answer: insulin stress test

Flashcard 592: Patients with symptoms of type 2 diabetes can be diagnosed if: • HbA1c is _____ OR • Fasting glucose is ≥7 mmol/L OR • Random glucose/OGTT is ≥11.1 mmol/L

Answer: ≥48 mmol/mol

Flashcard 593: Most patients with De Quervain's Thyroiditis _____ require treatment

Answer: will not

Flashcard 594: Ectopic ACTH production is characteristically associated with _____ to cause Cushing's Syndrome.

Answer: small cell lung cancers

Extra: Small cell lung cancer (SCLC) is the most common cause of ectopic ACTH production (paraneoplastic Cushing's syndrome). Other causes include bronchial carcinoids, medullary thyroid cancer, and pheochromocytoma.

Flashcard 595: Children with Cushing's disease may experience _____ due to suppression of GH secretion and pseudoprecocity (virilization) due to increased adrenal androgens.

Answer: stunted growth

Extra: In pediatric Cushing's, the combination of weight gain with a decrease in linear growth velocity is a classic presentation. While adrenal androgens cause signs like pubic hair and acne (pseudoprecocity/virilization), the underlying hypercortisolism typically inhibits the gonadotropic axis, leading to delayed true puberty.

Flashcard 596: What is the next step in management for Type 2 Diabetes Mellitus (T2DM) when glycemic targets are not met on dual therapy?

Answer: Add a 3rd oral agent (e.g., DPP-4 inhibitor, SGLT2 inhibitor, or TZD) or GLP-1 receptor agonist or Insulin.

Extra: According to ADA/EASD guidelines, if HbA1c remains above target despite dual therapy, triple therapy is indicated. The choice of the 3rd agent depends on patient-specific factors such as ASCVD, CKD, heart failure, or the need to minimize hypoglycemia/weight gain.

Flashcard 597: In **asymptomatic** patients, a diagnosis of Type 2 Diabetes requires _____ abnormal test results (HbA1c or Plasma Glucose) obtained on separate occasions.

Answer: two

Flashcard 598: Cushing's disease causes _____ obesity as well as redistribution of adipose tissue causing moon face and buffalo hump

Answer: central

Flashcard 599: Patients with cushing's syndrome _____ have their morning cortisol spike suppressed upon overnight (low-dose) dexamethasone suppression test Patients with cushing's disease will not have their morning cortisol spike suppressed upon overnight (low-dose) dexamethasone suppression test

Answer: will not

Flashcard 600: HbA1c should be checked in patients with T2DM every _____ until stable and then 6 monthly

Answer: 3-6 months