What to Know about Endocrinology from ACP’s #IM2017 Conference ABIM Board Review Course

Knowmedge chief editor Dr Sunir Kumar (@DrSunir) delivered real-time updates from the American College of Physicians’ Internal Medicine conference. Using #IM2017, you can view those and other relevant tweets from this year’s gathering.

Below is a compilation of 22 Endocrinology pearls to help you with your board prep for ABIM, ABFM, and USMLE boards. In addition, these are useful in your daily clinical practice.

@knowmedge Latent autoimmune DM of adulthood usually occurs after age 40. Type 1 DM will usually be diagnosed <40 years of age. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge Latent autoimmune DM of adulthood will have + antibodies to glutamic acid decarboxylase (GAD). #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge Pre-diabetes: fasting glucose 100-125 mg/dL, 2 hour OGTT (140-199 mg/dL), or hgba1c of 5.7-6.4%. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge DM: Fasting glucose >or equal to 126 mg/dL, Random glucose>200 mg/dL, 2 hour OGTT>200 mg/dL, or hgba1c >or equal to 6.5%. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge New guideline: Metformin should be avoided if GFR <30 mL/minute. Now we don't use creatinine to not use Metformin. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge Type 1 DM eye exam: within 5 years of diagnosis, then annually. Type 2 DM: at time of diagnosis, then annually. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge ADA glucose goal in critically ill patients is 140-180 mg/dL. This typically requires IV insulin. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge Pts with TG level greater or equal to 500 mg/dL should be Rx with fibrates to prevent pancreatitis. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge Lithium (Hypo or hyperthyroidism). Other meds causing hypothyroidism: Interferon, IL-2, Amiodarone. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge If normal TSH with elevated Free T4, check MRI pituitary to rule out central hyperthyroidism. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge Graves–>Abs to TSH receptor. Diffuse, increased thyroid scan uptake (>30%). #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge Less than 5% uptake is decreased uptake. Thyroglobulin elevated–>thyroiditis. Thyroglobulin decreased–>exogenous use. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge Hypothyroid, pregnant patients will need their T4 dose increased by 25-50%. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge Prolactin levels <150 ng/mL are usually caused by drugs and other non-prolactinomas. If >150 ng/mL, think prolactinoma. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge Granulomatous dz (sarcoidosis or TB), B cell lymphoma: High 1,25 vitamin D, high Ca, high phosphorous, low PTH. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge About 50% patients with primary hyperparathyroidism will have low vitamin D level. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge 3 screening tests for Cushing: 1 mg Dexamethasone suppression test, 24 hr urine cortisol, late night salivary cortisol. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge 1 adrenal insufficiency: Decreased cortisol, decreased aldosterone, decreased adrenal androgens. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge 1 adrenal insufficiency: ACTH is increased,which will lead to hyperpigmentation. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge 2 Adrenal insufficiency: decreased cortisol, decreased ACTH (no hyperpigmentation), normal aldosterone (no high K). #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge Pheo associated with MEN 2, von-Hippel-Lindau, or type 2 Neurofibromatosis. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

@knowmedge Alpha blocker before BB for pheo. Usually Rx with alpha blocker 14 days prior to surgery. Phenoxybenzamine or Doxazosin. #IM2017
— Sunir Kumar (@SunirMD) March 29, 2017

Reference: American College of Physicians (ACP). Internal Medicine Maintenance of Certification (MOC) board review course.