Week 3 – Endocrinology
A 20-year-old female patient with tachycardia and weight loss but no optic symptoms has the following
laboratory values: decreased TSH, increased T3, and increased T4 and free T4. A pregnancy test is
negative. What is the initial treatment for this patient?
Beta blocker medications
A patient who is obese has recurrent urinary tract infections and reports feeling tired most of the time.
What initial diagnostic test will the provider order in the clinic at this visit?
C-peptide level
Hemoglobin A1C
Random serum
glucose Thyroid
studies
In order to determine how much T4 replacement of patient needs to reestablish a euthyroid state, the
nurse practitioner considers:
Patient's body weight
Replacement as based on body weight and is usually calculated in kilograms. Body weight is
multiplied by 1.6 to determine replacement needed in one day. This is the amount that
should be prescribed in otherwise healthy, less than 50 years old, no evidence of underlying
cardiac disease patients
Which findings are part of the 2009 diagnostic criteria for metabolic syndrome? (Select all that apply.)
Triglycerides ≧150 mg/dL
HDL cholesterol </= 40 mg/dL
Elevated waist circumference
Fasting plasma glucose ≧100 mg/dL
Decreased plasminogen activator inhibitor 1 levels
A patient recently diagnosed with type 1 diabetes mellitus is in clinic for a follow-up evaluation. The
provider notes that the patient appears confused and irritable and is sweating and shaking. What
intervention will the provider expect to perform once the point of care blood glucose level is known?
Giving a rapid-acting carbohydrate
, A 38-year-old male patient presents for his annual exam. He reports nervousness and weight loss, but
denies any changes in his dietary intake or exercise level. Based on these findings and the following lab
values, more what is the most likely diagnosis?
TSH 0.01 (normal 0.4-3.8)
Free T4 6 (normal 0.8-2.8)
Free T3 205 (normal 70-205)
Hyperthyroidism
TSH is low and T4 is high indicating hyperthyroidism
Excessive thirst and volume of dilute urine may be a symptom of:
Diabetes insipidus
Diabetes insipidus is a condition in which the kidneys are unable to conserve water, often
because there is insufficient antidiuretic hormone (ADH) or the kidneys are unable to respond
to ADH. Although diabetes mellitus may present with similar symptoms, the disorders are
different. Diabetes insipidus does not involve hyperglycemia.
Which findings are symptoms of hyperparathyroidism? (Select all that apply.)
Cognitive impairment
Chvostek’s sign
Renal calculi
Lef t ventricular hypertrophy
Perioral paresthesias
Which thyroid stimulating hormone (TSH) level indicates hyperthyroidism?
2.4 uIU/L
0.4 uIU/L
0.2 uIU/L
4.2 uIU/L
Some of the hallmark characteristics of hyperosmolar hyperglycemic state are:
Blood glucose over 1000 mg/dL
Slow onset (over days)
Higher prevalence in type 1
diabetics Negative ketones
A 20-year-old female patient with tachycardia and weight loss but no optic symptoms has the following
laboratory values: decreased TSH, increased T3, and increased T4 and free T4. A pregnancy test is
negative. What is the initial treatment for this patient?
Beta blocker medications
A patient who is obese has recurrent urinary tract infections and reports feeling tired most of the time.
What initial diagnostic test will the provider order in the clinic at this visit?
C-peptide level
Hemoglobin A1C
Random serum
glucose Thyroid
studies
In order to determine how much T4 replacement of patient needs to reestablish a euthyroid state, the
nurse practitioner considers:
Patient's body weight
Replacement as based on body weight and is usually calculated in kilograms. Body weight is
multiplied by 1.6 to determine replacement needed in one day. This is the amount that
should be prescribed in otherwise healthy, less than 50 years old, no evidence of underlying
cardiac disease patients
Which findings are part of the 2009 diagnostic criteria for metabolic syndrome? (Select all that apply.)
Triglycerides ≧150 mg/dL
HDL cholesterol </= 40 mg/dL
Elevated waist circumference
Fasting plasma glucose ≧100 mg/dL
Decreased plasminogen activator inhibitor 1 levels
A patient recently diagnosed with type 1 diabetes mellitus is in clinic for a follow-up evaluation. The
provider notes that the patient appears confused and irritable and is sweating and shaking. What
intervention will the provider expect to perform once the point of care blood glucose level is known?
Giving a rapid-acting carbohydrate
, A 38-year-old male patient presents for his annual exam. He reports nervousness and weight loss, but
denies any changes in his dietary intake or exercise level. Based on these findings and the following lab
values, more what is the most likely diagnosis?
TSH 0.01 (normal 0.4-3.8)
Free T4 6 (normal 0.8-2.8)
Free T3 205 (normal 70-205)
Hyperthyroidism
TSH is low and T4 is high indicating hyperthyroidism
Excessive thirst and volume of dilute urine may be a symptom of:
Diabetes insipidus
Diabetes insipidus is a condition in which the kidneys are unable to conserve water, often
because there is insufficient antidiuretic hormone (ADH) or the kidneys are unable to respond
to ADH. Although diabetes mellitus may present with similar symptoms, the disorders are
different. Diabetes insipidus does not involve hyperglycemia.
Which findings are symptoms of hyperparathyroidism? (Select all that apply.)
Cognitive impairment
Chvostek’s sign
Renal calculi
Lef t ventricular hypertrophy
Perioral paresthesias
Which thyroid stimulating hormone (TSH) level indicates hyperthyroidism?
2.4 uIU/L
0.4 uIU/L
0.2 uIU/L
4.2 uIU/L
Some of the hallmark characteristics of hyperosmolar hyperglycemic state are:
Blood glucose over 1000 mg/dL
Slow onset (over days)
Higher prevalence in type 1
diabetics Negative ketones
