En-do-crime Flashcards
Hashimoto
Auto
Lympho
Markers for hashimoto
Tug antibody
Tpo
Invasive fibrous thyroiditis
Wood thyroid
Riedel thyroditis
Post viral thyrioditis
Painful
De quervain ,sub acute
Goiter
Hyperthyroidism
Exopthalmus
Excess circulating thyroid hormones
Tsk -r or tsab -diagnostic
Graves’ disease
Inhibit t4-t3 peripheral conversion
PTU
Inhibit TPO function
Reduce antibody level
Enhance rates of remission
Ptu, methimazole
SSKI
Thyroid storm
Before surgery
Plummer’s dse. (Toxic adenoma)
Hyperthyroidism from a single hyper functioning nodule
Myxedema (gull disease)
Hypothyroidism in older or adult Slowing of physical and mental Cold intolerance Overweight Drop in symphathetic activity Constipation
Major cause -release of inflammatory cytokines
Low ft3,normal t4,and tsh
Low t4-poor prognosis
Routine acutely I’ll patients- no need
Sick euthyroid syndrome
Thyroid cancer risk factors associated with?
Head and neck irradiation
Iodine def.
Men 2
Papillary ca
Follicular ca
Medullary ca
Mc thyroid cancer
Psammoma bodies
Papillary thyroid cancer
Psammoma bodies
Papillary thyroid cancer
Meningioma
Cannot be diagnosed in FNAB along with hurtle cell carcinoma
IODINE DEFICIENCY
Follicular
Dx : vascular and capsular invasion
Production of calcitonin Local invasion is more common Para follicular cells FamiLial -MEN 2 Poor prognosis: older,male,higher mitotic act., small cell type
Medullary thyroid cancer
Lymphoma treatment
CHOP
- cyclophosphamide,vincristine, doxurubucin, prednisone
Regional radiation
Poor prognostic fix for FTC
Distant metastasis >50 >4cm Hurtle cell Marked vascular invasion
Complete or near total insulin deficiency
T1DM
Insulin resistant
Impaired insulin secretion
T2DM
Ketosis prone
T1DM
1a -autoimmune
1b - iodiopathic
GdM screening
24-8 weeks ago
Risk factors for Type 2
Fam hx
Obesity >25
Physical inactivity
Hx > kg/9 lbs Hba1c 5.7-6.4 Hpn PCOS -Stein leventhal syndrome Hx of heart disease Triglycerides >250
Criteria for diagnosis of DM
Symptoms PPP \+ Rbs = >200mg/dl or 11.1 mmol\l Fbs = > 126 mg/dl or 7 mmol/l HbA1c - >6.5 % 2-hr plasma glucose >200 mg/dl OGTT
Screening
Rbs
Fbs
OGTT
Confirmatory
OGTT
Monitoring
HbA1c
Fructosamine test \glycosylated albumin
Reflects glycemic status over the prior 2 weeks
Fructosamine essay
Hypoglycemia
Low plasma glucose
Relief of symptoms after giving glucose or sugars
Whipples triad
Inadequate insulin administration Pregnancy Infarction Drug-coccaine Infection
S/s Nausea,thirst Abdominal pain Sob Tachycardia Dehydration/phone Kussmauls breathing Acetone breath
Keto acidosis
MODY 123456
1 - HNF4@ 2- glucokinase gene 3 - HNF @1 4- IPF -1 5- HNF -1b 6 - neuroD1
Due to mutations in hepetonuclear Transcription factors
MODY 123
Thyroid hormone synthesis normally begins at about
about 11 weeks AOG
Thyroid size
12–20 g in size, highly vascular, soft in consistency
Thyroid glands develops during what AOG
3rd week
Thyroid medullary C cells
produce calcitonin
Wolff- chaikoff effects
Iodine induced hypothyroidism
Jod basedow effects
Iodine induced hyperthyroidism
Treatment for hypothyroidism
Goal of treatment ?
Levothyroxine
Normalization of tsh
Treatment recommended: pregnant/wishes to conceive, TSH
> 10 mIU/L
state of thyroid hormone excess and is not synonymous with hyperthyroidism which is the result of excessive thyroid function.
Thyrotoxicosis
Drug induced thyroiditis
Amiodarone
