Diabetes Mellitus. 1. Know the laboratory criteria for the diagnosis of diabetes 5. Define “diabetes insipidus” and identify how it would be recognized. …
AM2 Endocrinology
I Thyroid Gland Disorders
1 Identify iodine as necessary for the synthesis of thyroid
hormones
2 Identify TRH and TSH and describe their role in regulating
thyroid hormone levels
3 Identify thyroxine T4 and triiodothyronine T3 as the two
major thyroid hormones
4 Describe the difference between free vs protein-bound thyroid
hormone TBG
5 Identify and describe the role of each of the following
diagnostic tests in evaluating thyroid disease
T4 RAI
Free T4
T3 resin uptake
T3 RAI total serum T3
free thyroid index FTI
TSH
antithyroid antibodies
thyroglobulin
thyroid radioiodine uptake RAI uptake
thyroid scanning
thyroid ultrasound
fine needle aspiration and cytology
6 Identify autoimmune processess and treatment for hyperthyroidism
as the most common causes of hypothyroidism in the USA; identify
iodine deficiency as the most common
cause worldwide
7 Identify Hashimotos thyroiditis as an autoimmune disease that
often results in hypothyroidism with goiter
8 Define cretinism Identify the relationship between thyroid
hormone deficiency at birth and mental retardation
9 Describe the typical signs and symptoms of hypothyroidism
10 Describe the clinical picture of severe hypothyroidism with
myxedema
11 Describe basic principles of thyroid replacement therapy for
hypothyroidism choice of drug, schedule for increasing dosages,
cautions in elderly or cardiac patients
12 Identify Graves disease as the most common cause of
hyperthyroidism; distinguish between Graves disease and other
forms of hyperthyroidism
13 Identify or describe the classic signs and symptoms of
hyperthyroidism; identify infiltrative ophthalmopathy as
specific for Graves disease
14 Briefly describe the pros and cons of treating hyperthyroidism
with:
antithyroid drugs eg, propylthiouracil and
methimazole,
radioactive iodine,
surgery
15 Describe the syndrome of toxic multinodular goiter
16 Describe the syndrome of subacute thyroiditis
17 Describe the syndrome of thyroid storm
18 Describe the workup for a patient with a solitary thyroid
nodule
19 Describe the difference between, and clinical significance of,
hot nodules versus cold nodules on radioisotope scanning
II Diabetes Mellitus
1 Know the laboratory criteria for the diagnosis of diabetes
mellitus in adults
2 Describe the differences between type 1 and type 2 diabetes
mellitus
3 Recognize the typical symptoms of hyperglycemia which may cause
the patient to present to the primary care practitioner
4 Briefly describe the role that each of the following plays in
the causation of diabetes mellitus:
autoimmune processes,
genetic inheritance,
insulin resistance
5 Identify diabetic ketoacidosis DKA and nonketotic
hyperglycemic-hyperosmolar coma as the two major consequences of
uncontrolled diabetes
6 Recognize the signs and symptoms of
DKA
7 Recognize the signs and symptoms of nonketotic hyperglycemic-
hyperosmolar coma
8 Describe the symptoms of hypoglycemia that may be caused by
insulin or sulfonylureas
9 List or recognize the major chronic complications of diabetes
mellitus, especially increased atherosclerosis CAD, CVA, PVD,
diabetic retinopathy, nephropathy, neuropathy, and foot ulcers
10 Describe the characteristic clinical findings of diabetic
retinopathy
11 Describe the role that each of the following plays in management
of diabetes
diet
weight reduction for obesity
exercise
insulin
oral agents
self-monitoring of blood glucose
glycosylated hemoglobin assay Hb A1c
Note: we will leave details of the insulins and oral agents to the
Patient Management course You should at least have an idea of
which insulins are short-, intermediate-, or long-acting for this
course
12 Describe the management issues for each of the following special
cases
in diabetes mellitus
adolescents
elderly
pregnant patients
III Endocrine Roundup:
A Parathyroid Disorders
1 Describe the role of each of the following in calcium
homeostasis
parathyroid hormone PTH
vitamin D
calcitonin
2 Identify the problems caused in the body by hypercalcemia
3 Identify hyperparathyroidism and malignancy as the two major
causes of hypercalcemia
4 Identify common causes of hypocalcemia
5 Identify the problems caused in the body by hypocalcemia
6 Describe the following signs associated with hypocalcemia
Chvosteks sign
Trousseaus sign
tetany
B Pituitary Gland Disorders
1 Describe the relationship between the hypothalamus and the
anterior pituitary gland
2 Recognize each of the following as anterior pituitary hormones,
and state briefly what each of them does in the body
adrenocorticotropic hormone ACTH
growth hormone GH
prolactin
thyroid stimulating hormone TSH
follicle stimulating hormone FSH
ltteinizing hormone LH
3 Recognize bilateral temporal field loss homonymous hemianopsia
as a classic presenting sign in pituitary tumors
4 Identify arginine vasopressin AVP, also known as antidiuretic
hormone ADH, as a hormone produced by the posterior pituitary
gland
5 Define diabetes insipidus and identify how it would be
recognized
6 Identify dwarfism, gigantism, and acromegaly as consequences of
either under- or over-secretion of growth hormone
7 Recognize the association of galactorrhea and amenorrhea in
women with excessive prolactin secretion hyperprolactinemia
C Adrenal Gland Disorders
1 Identify cortisol, aldosterone, and androgens as adrenal
hormones
2 Describe the negative feedback relationship of ACTH secretion
and cortisol levels
3 Describe the clinical presentation of primary adrenal
insufficiency Addisons disease
4 Describe the clinical presentation of
adrenocortical
hyperfunction Cushings syndrome Distinguish between
Cushings syndrome and Cushings disease
5 Identify primary hyperaldosteronism as a cause of secondary
hypertension; recognize the association with spontaneous
hypokalemia
6 Describe the clinical features of pheochromocytoma
D Osteoporosis
1 Identify risk factors for development of osteoporosis
2 Describe the clinical findings of osteoporosis
3 Describe prevention and treatment measures for osteoporosis
Note: details of the pharmacologic treatment options will be
tested in the
Patient Management course
Source:cdc.gov
