Diabetes Type 2

It will be difficult to properly review diabetes here.  You already have all the information you need. There are certain basic themes that recur in internal medicine exams that frequently “trip up” test-takers. The most common is the ever-moving-target of diagnosing diabetes.    Diagnostic criteria: A fasting plasma glucose level of 126 mg/dL (7.0 mmol/L) or higher,… Read more »

Empty sella syndrome

Empty sella syndrome is where the suprasellar subarachnoidal space herniates through an incomplete diaphragm of sella, so that sella is filled partially with CSF. The pituitary is flattened and pushed to one side, but tends to function normally. The two specific types are discussed below.  MRI is the best way to demonstrate CSF in the sella. Most… Read more »


Osteoporosis is a skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility, and therefore an increased risk of fracture. In osteoporosis, the bone mineral density is reduced, bone microarchitecture deteriorates, and the amount and variety of proteins in bone are altered. Diagnosis Osteoporosis is defined as a… Read more »


Multiple endocrine neoplasia type 1 (MEN1) is a hereditary condition associated with tumors of the endocrine glands. Originally known as Wermer syndrome, the most common tumors seen involve the parathyroid gland, islet cells of the pancreas, and pituitary glands. Other endocrine tumors seen in MEN1 include adrenal cortical tumors and carcinoid tumors, as well as tumors in other parts of the… Read more »


The most common sign of multiple endocrine neoplasia type 2 is medullary thyroid carcinomas. Multiple endocrine neoplasia type 2 is divided into three subtypes: type 2A, type 2B (formerly called type 3), and familial medullary thyroid carcinoma. These subtypes differ in their characteristic signs and symptoms and risk of specific tumors; for example, hyperparathyroidism occurs… Read more »

Hashimoto’s Thyroiditis

Hashimoto thyroiditis is part of the spectrum of autoimmune thyroid diseases and is characterized by the destruction of thyroid cells by various cell- and antibody-mediated immune processes. This condition is the most common cause of hypothyroidism in the United States in individuals older than 6 years. It is the most common form of goiter and… Read more »


The jury is still out on a number of issues related to hypertriglyceridemia, so any questions on the exam will focus on what is confirmed, and actively avoid any controversies. Hypertriglyceridemia is correlated with an increased risk of cardiovascular disease in the presence of: low HDL cholesterol levels elevated LDL cholesterol levels. You shouldn’t get… Read more »

Noonan’s syndrome

The cardinal features of Noonan syndrome include unusual facies (ie, hypertelorism, down-slanting eyes, webbed neck), congenital heart disease (in 50%), short stature, and chest deformity. Approximately 25% of individuals with Noonan syndrome have mental retardation. Bleeding diathesis is present in as many as half of all patients with Noonan syndrome. Typically presents as a male patient with… Read more »


Consists of – medullary thyroid carcinoma, – pheochromocytoma, and – mucosal and gastrointestinal neuromas Associated feature: – Marfanoid features


Hyponatremia is the most frequent electrolyte disorder encountered in our clinical practices. 25% of the hospital population and 5% of our out-patients.  Severity of hyponatremia prognosticates adverse outcomes, especially when hyponatremia develops in the hospital. Hyponatremia is defined as a serum sodium level of less than 135 mEq/L and is considered severe when the serum… Read more »