Adrenal Disorders
This is the first‑line treatment for suspected adrenal crisis and must be given immediately, even before labs return.
What is IV hydrocortisone?
This obesity medication is contraindicated in patients with a personal history of medullary thyroid carcinoma or MEN2, even if they have no symptoms.
What is a GLP‑1 receptor agonist (e.g., semaglutide, liraglutide)?
Drugs used for hyperthyroidism (list at least one correct one)
Propylthiouracil (PTU)
•Methimazole (Tapazole)
•Potassium iodide and iodine solution (Lugol’s Solution)
•Saturated solution of potassium iodide (SSKI, ThyroSafe)
Name the DM medications most likely to cause hypoglycemia
What is insulin, Sulfonylureas, meglitinides, pramlinitide
Name the two agents that are progestins used when a patient is treating VMS for menopause
What are prometrium and provera?
Oral Progestins
Micronized oral progesterone (Prometrium)
Medroxyprogesterone acetate (Provera)
This medication treats Cushing’s syndrome by inhibiting 11‑beta‑hydroxylase, reducing cortisol synthesis, and is known for causing hirsutism and hypertension due to increased androgen production.
What is metyrapone?
This medication is preferred for a patient with obesity and uncontrolled hypertension, because it does NOT increase blood pressure and may even lower it.
What is orlistat or a GLP‑1 receptor agonist?
Remember, we are not to use any phentermine such as Adipex-P, Lomaira, or Qsymia
Levothyroxine is often preferred for patients with hypothyroidism- explain what you expect with the labs T4 and TSH
Elevated TSH and Low T4
62 year old with prior MI needs improved glycemic control, A1C 8.4%, which therapy is preferred
SGLT2i or GLP-1RA
POPs and IUDs contain this active ingredient and are recommended for breastfeeding patients and migraines with aura
Progestin only contraceptive
Levonorgestrel
Estrogen reduces milk supply and increases VTE risk in early postpartum. Estrogen‑containing contraceptives are contraindicated in migraine with aura due to ↑ stroke risk. POPs, IUDs, and implants are safe.
Patients with primary adrenal insufficiency (Addison’s disease) require both glucocorticoid replacement and this mineralocorticoid to maintain sodium balance and blood pressure.
What is fludrocortisone
A patient on this obesity medication develops insomnia, anxiety, and increased heart rate. These effects are most consistent with the medication’s sympathomimetic properties.
What is phentermine (or phentermine/topiramate)?
This population requires a lower starting dose of levothyroxine (e.g., 12.5–25 mcg/day) due to risk of precipitating angina or arrhythmias.
Who are older adults or patients with cardiovascular disease?
A patient uses NPH 30 units BID. What is the correct conversion to glargine?
48 units daily
NPH BID → glargine = 80% of total daily NPH.
Total NPH = 60 units → glargine = 48 units.
Transdermal menopause therapy are preferred for patients with these comorbidities
Transdermal options include estradiol patches, estradiol gels, and estradiol spray. These are your three route categories—everything else (oral, vaginal, implant) is non‑transdermal.
What is migraine with aura, gallbladder disease, hypertriglyceridemia, and VTE risk.
This glucocorticoid has no mineralocorticoid activity, making it preferred in conditions where fluid retention must be avoided, such as cerebral edema or increased intracranial pressure.
What is dexamethasone?
This obesity medication is preferred in a patient with obesity and type 2 diabetes because it provides the largest A1c reduction and the greatest average weight loss among FDA‑approved agents.
What is semaglutide 2.4mg or tirzepatide 15mg once weekly
This common OTC product can bind levothyroxine in the gut, requiring separation by at least 4 hours to avoid reduced absorption.
What is calcium or iron?
Which patient should avoid pioglitazone?
A. A1c 9.2%
B. eGFR 40
C. NYHA Class III HF
D. Mild anemia
TZDs cause fluid retention → contraindicated in NYHA III/IV HF
A 39‑year‑old woman smokes 20 cigarettes/day. Which is contraindicated?
A. Combined oral contraceptive
B. Progestin‑only pill
C. Levonorgestrel IUD
D. Etonogestrel implant
Age ≥35 + heavy smoking = absolute contraindication to estrogen.
Which counseling is key for Incretin based obesity treatment?
Eat smaller more frequent meals throughout the day
Avoid high-fat and greasy foods
most common during dose escalations
symptoms improve over time
This antiarrhythmic medication can cause both hypo‑ and hyperthyroidism due to its high iodine content and direct effects on thyroid hormone synthesis.
What is amiodarone?
Which medication would be best for an obese HFpEF patient?
Hint: choose the agent with most weight loss efficacy
Mounjaro (tizepatide)