Endo Flashcards
Normal TSH
0.5-5
What is go to screening test for suspected thyroid issues?
TSH
If abnormal go to thyroid panel.
Elevated TSH and low T3/T4
Hypothyroidism
First line med for hypothyroidism?
Synthroid
Biggest concern with synthroid?
Cardiac issues
How often should we recheck TSH after starting synthroid?
4-6 weeks
Decreased TSH and increased T3/T4
Hyperthyroidism
Medication for hyperthyroidism during the first trimester?
PTU
Medication for hyperthyroidism during the second trimester?
Tapazole
What does the parathyroid do?
Releases parathyroid hormone which keeps calcium and phosphorus in check.
Calcium and phosphorus have a ___ relationship?
Inverse
High calcium and low phosphorus?
Hyperparathyroidism
If a type 1 diabetic is ill do we continue insulin?
yes
Somogyi and dawn effect both:
result in an elevated blood glucose level upon awakening
With this there is a DIP in BG in the middle of the night before it rises in the AM?
Somogyi
What do we do if the somogyi effect is occurring?
Cut back on nighttime insulin
With this the BG steadily rises all night?
Dawn effect
What causes the dawn effect?
Increase in growth hormone
Type 2 diabetes is diagnosed with an HbA1c of?
6.5 or higher
Max dose of Metformin?
2550mg/day
What can long-term use of metformin lead to?
B12 deficiency
What do we monitor with metformin?
Renal function
When the GFR is less than 49 what do we do with the metformin?
Cut dose in half
When the GFR is less than 30 what do we do with the metformin?
Stop
Which oral type 2 diabetes medication are cardio-protective?
SGLT2 inhibitors (end in -flosin)
At what HbA1c do we initiate insulin?
Greater than 9
What PE finding may occur due to insulin resistance?
Acanthosis nigricans
Do type 2 diabetes patients need to take ASA?
Yes, especially if they are at risk of heart disease
What diabetic med causes hypoglycemia?
Sulfonylureas (glipizide)
Long-acting insulin:
Lantus
Levemir
What does metabolic syndrome entail?
Increased abdominal obesity
HTN
HLD
What are patients at risk of with metabolic syndrome?
Heart disease, stroke, and diabetes
What medications should we not give to those with metabolic syndrome?
CCB and thiazides
With Cushing disease we have ___ ____ cortisol?
Too much
Patients with Cushing’s will present:
With moon face, purple striae, and truck obesity
With Addison’s disease the patient will have:
Too little cortisol
With Addison’s disease the potassium level will be low or high?
High
With Cushing’s disease the potassium level will be low or high?
Low
