THREE High-Yield Endocrine Facts for the USMLE Step 2 CK Exam
1. Hormone Replacement Therapy increases the risk of forming blood clots. Thus, there is an increased risk of MI, venous thrombosis, breast cancer, and possibly dementia. The biggest indication for HRT are the prevention of osteoporosis and vasomotor spasms.
2. Patients on chronic steroids can get suppression of the hypothalamic-pituitary-adrenal axis which can lead to hypotension during acute infectious episodes. Hypotension will usually respond to a stress dose of glucocorticoids and hydration. * Dexamethasone is the drug of choice in this circumstance because it is the longest-lasting GC.
3. If a diabetic patient shows up in your office with sugar levels that AREN’T too high, always be sure to check for an anion gap, using the equation: [Na – (Cl + HCO3)]. Remember a normal anion gap is 12.
Causes of a high anion gap include:
– Renal Failure
– Lactic Acidosis
– Aspirin Intoxication
– Ethylene Glycol and Methanol Intoxication
– Metformin toxicity (DM 2 patients)