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PANCE Endocrinology

Diabetes, thyroid, and adrenal disorder presentations and management decisions tested on the PANCE.

35 cards · basic cards · AI-written, checked twice. Edit anything.

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What is the underlying pathophysiology of type 1 diabetes mellitus?
Autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency.
What is the underlying pathophysiology of type 2 diabetes mellitus?
Insulin resistance combined with a relative insulin deficiency.
What fasting plasma glucose level meets the diagnostic criteria for diabetes mellitus?
126 mg/dL or higher, confirmed on a separate occasion.
What HbA1c value meets the diagnostic criteria for diabetes mellitus?
6.5% or higher.
What 2 hour plasma glucose value on an oral glucose tolerance test is diagnostic for diabetes mellitus?
200 mg/dL or higher.
For most patients with newly diagnosed type 2 diabetes mellitus, ____ is the first-line pharmacologic agent.
metformin
Why should metformin be avoided in patients with significant renal impairment?
It increases the risk of lactic acidosis.
What three findings define the hallmark lab picture of diabetic ketoacidosis?
Hyperglycemia, an anion gap metabolic acidosis, and ketosis.
What distinguishes hyperosmolar hyperglycemic state (HHS) from diabetic ketoacidosis?
HHS has markedly higher glucose with minimal or no ketosis, and occurs mainly in type 2 diabetes.
In the management of diabetic ketoacidosis, ____ is started before insulin therapy.
IV fluid resuscitation
What causes the dawn phenomenon in diabetic patients?
Early morning hyperglycemia from a normal surge of counterregulatory hormones such as growth hormone and cortisol.
What urine test screens for early diabetic nephropathy?
Urine microalbumin (albumin to creatinine ratio).
What is the most common cause of hyperthyroidism?
Graves disease.
What antibody is responsible for the hyperthyroidism seen in Graves disease?
Thyroid stimulating immunoglobulin (TSI), which activates the TSH receptor.
What two exam findings are specific to Graves disease and not seen in other causes of hyperthyroidism?
Exophthalmos and pretibial myxedema.

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