Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

543 > Endo > Flashcards

Endo Flashcards

1
Q

Metabolic syndrome

What is the major risk factor?

Other risk factors?

A

OBESITY major risk factor

  • overlaps with DM*
  • age
  • ethnicity: Indigenous, African, Hispanic, Asian, Pacific Islander
  • sedentary lifestyle
  • poor diet (high carb)
  • poverty
  • hx of HTN, dyslipidemia, impaired fasting glucose, PCOS, GDM, gout, OSA
  • Meds: atypical antipyschotics (esp clozapine)
  • family hx of DM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Metabolic syndrome increases risk for ____ and ______

What are some other obesity-related co-morbidities?

A

CVD
DM

  • NASH
  • Liver cancer
  • CKD
  • PCOS
  • gout
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Metabolic syndrome
Diagnostic criteria:
3 or more of the following:

A

WTHFB

  • waist circumference
  • high TG (1.7+ or above)
  • low HDL-C (<1.0 men <1.3 women or treated)
  • high FPG (5.6+ or treated)
  • high BP (130+/85+ or treated)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Metabolic syndrome

Diagnostic investigations

A

Labs: CBC, fasting glucose, A1C, eGFR/Cr, lipids, Lp(a), TSH, LFTs, urate

Sleep study if symptoms of OSA

Framingham Risk Calculator to determine 10-year CV risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Metabolic syndrome

What is the first line treatment?

A

Aggressive lifestyle interventions

  • weight management
  • physical activity

This will help with hyperglycemia and CV risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Metabolic syndrome

Weight loss: aim for ______ % loss, goal BMI _____

A

5-10% of initial weight

BMI <25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Metabolic syndrome

4 different diets to have shown improvement in weight and glycemic control

A
  • mediterranean
  • DASH (Na <2300 mg/day)
  • low glycemic index
  • high fibre (30+ g/day)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

OBESITY

Candidates for bariatric surgery:

A

BMI >40

or

BMI >35 plus risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

BMI

  • underweight:
  • healthy
  • overweight
  • obese
A

under: <18.5
healthy: 18.5-24.9
overweight: 25.0-29.9
obese: 30.0+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Obesity is defined as:

BMI:
in kids:

A

BMI 30.0+

in kids: 95% on WHO growth chart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Obesity

What categories of medications are risk factors for obesity?

A
  • antidepressants
  • antihistamines
  • anti-pyschotics
  • antidiabetics (insulin, SU)
  • anticonvulsants
  • hormones (estrogen, progesterone)
  • beta/alpha blockers
  • glucocorticoid steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Obesity

-linked to what types of cancer?

A

-colon, endometrial, lung, liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Obesity

Exercise recommendations

  • adults
  • kids
A

150 min mod intensity/week
weight training 2x/week

Kids: 60 min + mod exercise/day
155-180 min/week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ORLISTAT for obesity

  • route?
  • % weight loss at one year?
  • net weight loss at 4 years

common side effects?

A

ORLISTAT

  • po
  • 3% at 1 year
  • 2.8 kg at 4 years

side effects:

  • loose oily stools
  • flatus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

LIRAGLUTIDE for obesity

  • route?
  • drug class?
  • % weight loss at one year?
  • net weight loss at 3 years

common side effects?

contraindications?

A

LIRAGLUTIDE aka Victoza

  • sc
  • GLP-1
  • 5.4% at 1 year
  • 4.2% at 3 years
  • significant reduction in risk of developing T2DM

side effects:
-n/v/d/constipation

Contraindicated:

  • hx pancreatitis
  • personal or FHx of medullary thyroid cancer
  • pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

NALTREXONE-BUPROPION for Obesity

  • route?
  • % weight loss at 1 year?
  • effect on pre-DM?
  • effect on HTN?

common side effects?

Contraindications?

A

CONTRAVE

  • po
    4. 8% weight loss in 1 year
  • impact on pre-DM not studied
  • INCREASE in BP

side effects:

  • nausea, constipation, diarrhea, dry mouth
  • headache, dizziness

Contraindications:

  • uncontrolled HTN
  • any opioid use
  • hx or risk for seziures
  • severe liver/renal failure
  • pregnancy
  • MAOI
17
Q

Hypothyroidism signs and symptoms

  • Neuropsychiatric:
  • Neuromuscular:
  • Physical appearance/Voice:
  • Cardiovascular:
  • Thyroid Gland:
  • Thermoregulation:
  • Gastrointestinal:
  • Pituitary Function:
A
  • Neuropsychiatric: depression, decreased mental function
  • Neuromuscular: Physical tiredness, paresthesia, hypokinesis, hyporeflexia
  • Physical appearance/Voice: weight gain, coarse, dry skin, periorbital edema, non-pitting edema, hoarseness
  • Cardiovascular: Bradycardia, Isolated diastolic hypertension
  • Thyroid Gland: Goiter
  • Thermoregulation: diminished sweating, Cold intolerance
  • Gastrointestinal: Constipation
  • Pituitary Function: Menorrhagia
18
Q

Hyperthyroidism signs and symptoms

  • Neuropsychiatric:
  • Neuromuscular:
  • Physical appearance/voice:
  • Cardiovascular:
  • Thyroid Gland:
  • Thermoregulation:
  • Ophthalmologic:
  • Gastrointestinal:
  • Pituitary function:
A
  • Neuropsychiatric: Anxiety, irritability, restlessness, Fatigue, increase appetite, decrease attention span
  • Neuromuscular: Tremors, proximal muscle weakness, hyperreflexia
  • Physical appearance/voice: Weight loss, hair loss
  • Cardiovascular: Palpitations, tachycardia, A-fib, Isolated systolic hypertension
  • Thyroid Gland: Goiter
  • Thermoregulation: Increase sweating, heat intolerance
  • Ophthalmologic: Blurred or double vision, dry eyes, conjunctivitis, proptosis or dysconjugated gaze.
  • Gastrointestinal: Increase frequency of stools
  • Pituitary function: Amenorrhea/oligomenorrhea
19
Q

When is anti-TPO measured?

A
  • not generally checked

- may help determine if autoimmune thyroiditis if pt has goitre or mildly elevated TSH

20
Q

What are the risk factors for thyroid disease?

  • sex and age?
  • personal or family hx?
  • hx of?
  • meds?
  • diet?
  • genetics?
A

men 60+
women 50+

personal/family hx thyroid disease
hx of autoimmune, neck irradiation, thyroidectomy or radioactive iodine ablation

meds: lithium and amiodarone
diet: iodine excess/deficieicny
- Turner, Down syndrome

21
Q

Hypothyroidism and TSH

  • when to check after starting/changing dose?
  • when to check TSH if normalized on treatment?
  • when to check if on lithium and amiodarone?
A
  • 6 weeks after starting or changing dose
  • check annually unless new indication
  • if on Li/amiodarone: check q3-6 months
22
Q

Thyroid

TSH is high, fT4 low
diagnosis of ____________

A

HYPOthyroidism

23
Q

Thyroid

TSH high, fT4 normal
diagnosis of _________

A

subclinical hypothyroidism
*usually asymptomatic

*treat if TSH >10 mU/L for subclinical

24
Q

Thyroid

TSH low, fT4 high
diagnosis of _________

A

HYPERthyroidism

  • overcorrected on synthroid
  • Grave’s
  • painless/postpartum thyroiditis
  • toxic multinodular goitre
25
Q

Thyroid

TSH low, fT4 normal, fT3 normal
diagnosis of __________

A

subclinical hyperthyroidism

*treat if TSH <0.1 mU/L

26
Q

Overtreatment of hypothyroidism can result in ________ (esp in elderly) and _______ in postmenopausal women

A

afib in elderly

bone loss in postmenopausal women

27
Q

Under what condition is TSH useful as measure of thyroid disease?

A
  • only if hypothalamic pituitary thyroid is INTACT

* if not, rely on fT4 measurement

28
Q

Hyperthyroidism

-how often to check TSH?

A

one month or longer

*initial treatment should be based on fT4 (pituitary secretion of TSH can be suppressed)

29
Q

if subclinical hypothryoidism is NOT treated, how often should you check TSH?

A

at 6-12 months

-sooner if clinical situation changes

30
Q

Pts with afib or osteoporosis should be checked for ___________

A

hyperthyroidism

31
Q

What additional risk factors would you consider in testing for thyroid disease in women who are pregnant/planning pregnancy?

A

age >30
>2 previous pregnancies
hx of preg loss, preterm delivery, infertility
DM type 1 and other autoimmune conditions
morbid obesity (BMI >40

32
Q

Postpartum thyroiditis

if a women is TPO Ab positive, when should TSH be done?

How does PP thyroiditis present?

A

3 and 6 months postpartum
annual TSH for all pts with hx of PP thyroiditis

hyperthryoid –> hypothyroid –> recovery to normal
*some woman stay hypothyroid

10-50% of women with PP thyroiditis end up with permanent hypothyroidism

543 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions