2-uWorld Flashcards
active form of vit D 1,25 dihydroxyvitD is AKA
calcitriol
why does sarcoid patient get renal stones?
hypercalciuria due to hypercalcemia which causes stones
steroids are beneficial in sarcoid due to ___ pathyphysiology
whereas bisphosphonate is NOT effective due to ___ pathyphys
they DECREASE calcitriol production
bisphosphonate decreases bone resportion which is NOT how serum calcium levels rise in sarcoidosis
cinacalcet is good for hypercalcemia due to _____ disease, and it works with this ____ moa
hyperparathyroidism
MOA: calcium mimetic so touches calcium receptors on parathyroid cells–>DECR production of PTH
** there is a patient with high TSH and normal T4, but very symptomatic, should you tx with levo?
YES
YES YES !!
** there is a patient with high TSH and normal T4, no symptoms but has + ab, should you tx with levo?
YESSSS !!!!!
a patient with subclinical hypothyroidism with TSH ____ NEEEDS treatment !!!!!!!!
> 10
adrenal ___ can co-occur in hypothyroidism
insufficiency
medullary thyroid cancer causes ___ over-release
calcitonin
(therefore PTH low and Ca low)
look for _____ mutation in medullary thyroid cancre
RET germline mutation
in amiodarone induced HYPOthroidism, you would tx ____
by continuing amio
AND
give levothyroxine
in type I amio-induced hyperthyroid, you would tx ____
by DISCONTINUE amio
tx with methimazole
may even remove thyroid
(hx of graves/TNG)
in Type II amio-induced hyerthyroid, you would tx ____
continue amio
(no prior thyroid-graves/TNG hx)
tx of choice prolactinoma
moa
cabergoline
bromocriptine
MOA: dopamine agonist
prolactin can do ___ to GnRH secretion, next ___ will happen
suppress gnrh
decr in LH FSH–> hypogonadism
gonadotropin suppression can occur from:
ie these can cause hypogonadism
Obesity (aromatase acivity incr->incr estrogen->decr GNrh)
exogenous androgens
DIABETES
Hyperprolactenemia (it suppresses gnrh)
***** the only real use of ordering thyroid peroxidase Abs is to diagnose _____ really
subclinical hypothyroidism
for triglyceride induced pancreatitis, give:
___ if Trig >500
___ if Trig > 1000 OR VERRy bad pancreatitis
insuilin drip
Apheresis/plasma exchange
in subacute de quervein thyroiditis, Tx with these med(s)
Steroid - first if severe pain
NSAID
Bblocker
you can have hypercalcemia due to ___ even in a case with High but NORMAL PTH level
primary hyperparathyroidism
