Diabetes and thyroid management scenarios plus rheumatologic disease workups tested on USMLE Step 2 CK.
41 cards · basic cards · AI-written, checked twice. Edit anything.
- What is the first-line pharmacologic agent for newly diagnosed type 2 diabetes mellitus?
- Metformin
- In what setting is metformin contraindicated due to lactic acidosis risk?
- Severe renal impairment (eGFR under about 30 mL/min/1.73m2)
- What is the primary mechanism of action of metformin?
- It decreases hepatic gluconeogenesis
- What is the mechanism of action of SGLT2 inhibitors?
- They block glucose reabsorption in the proximal renal tubule, increasing urinary glucose excretion
- What is the general HbA1c target for most nonpregnant adults with type 2 diabetes?
- Less than 7 percent
- Diabetic ketoacidosis is defined by hyperglycemia, an anion gap metabolic acidosis, and ____.
- ketosis
- Compared with diabetic ketoacidosis, hyperosmolar hyperglycemic state typically presents with what glucose and ketone pattern?
- Much higher glucose levels with minimal or no ketosis
- What is the first step in managing diabetic ketoacidosis, before starting an insulin drip?
- Aggressive IV isotonic fluid resuscitation
- When treating DKA, why must potassium be checked and often repleted before or with insulin?
- Insulin drives potassium into cells and can precipitate life-threatening hypokalemia
- What annual test screens for diabetic nephropathy?
- Urine albumin-to-creatinine ratio
- How often should a patient with diabetes get a dilated eye exam to screen for retinopathy?
- Annually
- What class of medications is first-line for painful diabetic peripheral neuropathy?
- Gabapentinoids (pregabalin, gabapentin) or the SNRI duloxetine
- What causes the Somogyi phenomenon?
- Rebound morning hyperglycemia following unrecognized nocturnal hypoglycemia
- What causes the Dawn phenomenon?
- Early morning hyperglycemia from a normal nocturnal surge in growth hormone and cortisol
- What is the most common cause of hypothyroidism in iodine-sufficient regions?
- Hashimoto thyroiditis