Term
| risk fx for stress hyperglycemia? |
|
Definition
ICU admission, fever, severe illness, sepsis, CNS infxn.
Give Insulin |
|
|
Term
|
Definition
A1c= 6.5%
Random BG= >200 OR Sx
Fasting BG= >126 x 2 |
|
|
Term
fatigue, wt loss, myalgias, incr'd pigmentation, and decr'd axillary/pubic hair.
How to confirm this dx? |
|
Definition
Chronic Adrenal insufficiency
confirm with low morning plasma cortisol/ACTH |
|
|
Term
decr TSH with other normal hormones
what to do if TSH persistently <0.1? |
|
Definition
Subclinical thyrotoxicosis
consider meds or radio iodine |
|
|
Term
| causes of subclinical thyrotoxicosis? |
|
Definition
| exogenous hormones, Graves, nodular thyroid dz |
|
|
Term
| necrolytic migratroy erythema rash assoc? |
|
Definition
|
|
Term
| Thyrotoxicosis manifestations in Elderly? |
|
Definition
Afib
apathy, confusion, prox musc wasting
proptosis and lid lag
decr appetite and constipation |
|
|
Term
| subclinical hypothyroidism assoc> |
|
Definition
incr'd risk of recurrent miscarriages
severe preeclampsia
preterm labor, abruptio |
|
|
Term
| hyperthyroid complications |
|
Definition
| Arrhtyhmias, CM, Osteoporosis |
|
|
Term
| Major diff btw NPH and Glargine |
|
Definition
| Glargine has lesser risk of hypoglycemia |
|
|
Term
|
Definition
|
|
Term
| sequelae of Lithium on thyroid |
|
Definition
| HYPOthyroidism. Don't stop it, just add Levo |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
U/S of neck and cervical LN
- <1cm = Papillary Lobectomy
- >1cm = Total thyroidectomy |
|
|
Term
| in DKA, when do you consider decr Insulin infusion and add Dextros? |
|
Definition
When Glucose <200 and AG still elevated
done to decr chance of hypoglycemia |
|
|
Term
| Sulfonylurea poisoning tx |
|
Definition
Dextrose given first
Give Octreotide |
|
|
Term
| Insulin and early morning exercise |
|
Definition
decr short acting insulin w/i 1-3 hrs prior
if it's really early, consider a change to basal insulin |
|
|
Term
| when to give bisphosphonate tx |
|
Definition
Osteoporosis (T score <-2.5)
Osteopenia (T score -1 and -2.5) with 10 yr prob >20% major OR >3% hip frac |
|
|
Term
| HTN, hyperglycemia, osteoporosis, mood swings, low K |
|
Definition
|
|
Term
| how to dx pheo after pos blood studies |
|
Definition
CT/MRI abdomen
pos= surgery, a/b blockers prior
neg= Oct scan, MIBG, PET |
|
|
Term
| These drugs increase TBG and decr T4 requiring incr in thyroid tx |
|
Definition
| Estrogen, Tamoxifen, Raloxifene, Methadone, heroin |
|
|
Term
| these drugs decr TBG and reducing Levo need |
|
Definition
| Steroids, Androgens, danazol |
|
|
Term
| these drugs decr Levo resorption |
|
Definition
cholestyramine
Iron, Calcium, PPI, Carafate |
|
|
Term
| drugs that increase thyroid metabolism |
|
Definition
| Rifampin, phenytoin, carbamazepine |
|
|
Term
|
Definition
| diet hx, analysis of psychosocial stressors |
|
|
Term
| hyperthyroid in pregn w/non tender Goiter |
|
Definition
Post-partum thyroidism.
-consistent with TPO ab's
similar to Silent thyroidits also. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Tender glad with hx of recent viral illness |
|
Definition
Dequiervan's (subacute)
tx is NSAID and BB |
|
|
Term
| Exercised induced amenorrhea pathophys |
|
Definition
| decr LH --> decr Estrogen-->infertility, osteopenia |
|
|
Term
|
Definition
24-28 wks
1. 50g Glu load
-<140 NO DM and no further testing
->140 100g 3hr |
|
|
Term
| Gestational DM target levels |
|
Definition
Fasting <95
1 hr post prand <140
2 hr post prand <120 |
|
|
Term
|
Definition
first line- diet
second line Insulin |
|
|
Term
| Suspected Hyperthyroid w/u (incr TSH and T3/4) |
|
Definition
|
|
Term
| normal Hyper PTH w/u AND sx's of Graves |
|
Definition
|
|
Term
|
Definition
1. RAIU
-High nodular-->Adenoma/multi goiter
-High Diffuse--> Graves
-Low RAIU-->TBG
-High TBG- Thyroiditis/Iodine exposure |
|
|
Term
|
Definition
1. TSH/US
Cancer suspicion--> FNA
No ca suspicion-->Low TSH
-run I scitigraphy
-cold-->FNA |
|
|
Term
|
Definition
pre treat with Methimazole.
consider ablation or surgery |
|
|
Term
| hemochromatosis Endo issues |
|
Definition
| Hypogonadism and Infertility |
|
|
Term
|
Definition
|
|
Term
abd pain (groans), bone pain, and psych overtone
-incr PTH with elevated urine Ca |
|
Definition
|
|
Term
| indications for a parathyroidectomy |
|
Definition
Age <50
SYMPTOMATIC hyper Ca
Urinary Ca >4k a day |
|
|
Term
| Amiodarone effect on Thyroid |
|
Definition
decr peripheral conversion of T4-->3
borderline incr TSH, INCR T4 and low T3
abnx will go away in 3-6 mos. |
|
|
Term
nml TSH, T4, and LOW T3
what causes this? |
|
Definition
Euthyroid sick syndrome
cortisol, TNF, starvation, GC's Amiodarone |
|
|
Term
|
Definition
IVF, Insulin, Potassium
IVF--> high flow NS; add D5 when <200
Insulin--> IV infusion decrease when able to eat Glu <200, AG <12 and HCO3 >15
Potassium--> add IV if <5.2meq/Hold Insulin <3.3 |
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