Endocrine confusion pairs
15 Endocrine topics students commonly mix up on Step 2 CK, each with the fastest separator, a side-by-side comparison, and a free practice question.
Step 2 CK pairs are in open beta while clinical review finishes. Spot an issue? Tell us.
- Primary hyperparathyroidism vs Secondary hyperparathyroidismHigh calcium in the presence of elevated PTH is the immediate discriminator for primary disease.
- Primary hyperaldosteronism vs Renovascular hypertensionSuppressed renin with elevated aldosterone is the key discriminator for primary aldosteronism.
- Hyperparathyroidism (PTH-mediated) vs Malignancy hypercalcemia (PTHrP)Suppressed intact PTH in a hypercalcemic patient is the fastest discriminator for malignancy-driven hypercalcemia.
- Type 1 diabetes vs Type 2 diabetesLow C-peptide in a hyperglycemic patient is the fastest discriminator favoring type 1 diabetes.
- Cushing syndrome ACTH-dependent vs Cushing syndrome ACTH-independentACTH level after biochemical confirmation of hypercortisolism is the primary discriminator.
- Adrenal adenoma vs Adrenal hyperplasiaAdrenal venous sampling lateralization is the decisive discriminator between unilateral adenoma and bilateral hyperplasia.
- DKA vs HHSMarked anion gap acidosis with ketonemia is the key discriminator for DKA.
- Pheochromocytoma vs HyperthyroidismEpisodic adrenergic spells with severe BP surges favor pheochromocytoma, while sustained thyrotoxic symptoms with suppressed TSH favor…
- Hypoglycemia vs InsulinomaC-peptide level during hypoglycemia is the fastest branch point, because elevated C-peptide indicates endogenous insulin production.
- Primary adrenal insufficiency vs Secondary adrenal insufficiencyPotassium elevation from mineralocorticoid deficiency is the fastest discriminator for primary adrenal insufficiency.
- Thyroid storm vs Myxedema comaCore temperature direction at presentation, high fever versus hypothermia, separates the emergency state.
- Graves disease vs Subacute thyroiditisRadioactive iodine uptake pattern, diffusely high versus low, separates Graves from subacute thyroiditis.
- Diabetic neuropathy vs Diabetic nephropathyPersistent urine albumin-to-creatinine ratio at or above 30 mg/g identifies diabetic nephropathy.
- Acromegaly vs GigantismStatus of open versus closed epiphyseal growth plates is the key separator between gigantism and acromegaly.
- Hashimoto thyroiditis vs Atrophic thyroiditisPresence or absence of goiter on exam is the rapid discriminator between these autoimmune hypothyroid phenotypes.