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?
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Metformin- In what setting is metformin contraindicated due to lactic acidosis risk?
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Severe renal impairment (eGFR under about 30 mL/min/1.73m2)- What is the primary mechanism of action of metformin?
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It decreases hepatic gluconeogenesis- What is the mechanism of action of SGLT2 inhibitors?
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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?
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Less than 7 percent- Diabetic ketoacidosis is defined by hyperglycemia, an anion gap metabolic acidosis, and ____.
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ketosis- Compared with diabetic ketoacidosis, hyperosmolar hyperglycemic state typically presents with what glucose and ketone pattern?
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Much higher glucose levels with minimal or no ketosis- What is the first step in managing diabetic ketoacidosis, before starting an insulin drip?
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Aggressive IV isotonic fluid resuscitation- When treating DKA, why must potassium be checked and often repleted before or with insulin?
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Insulin drives potassium into cells and can precipitate life-threatening hypokalemia- What annual test screens for diabetic nephropathy?
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Urine albumin-to-creatinine ratio- How often should a patient with diabetes get a dilated eye exam to screen for retinopathy?
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Annually- What class of medications is first-line for painful diabetic peripheral neuropathy?
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Gabapentinoids (pregabalin, gabapentin) or the SNRI duloxetine- What causes the Somogyi phenomenon?
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Rebound morning hyperglycemia following unrecognized nocturnal hypoglycemia- What causes the Dawn phenomenon?
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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?
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Hashimoto thyroiditis
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