Endo Flashcards
Initial levothyroxine dose for hypothyroidism
1.6ug/kg/day
Reduce to 25-50ug/day if patient is old and has cardiovascular disease
Chronic use of opioid or methadone can cause secondary hypogonadism and increased prolactin level
Sglt2 inhibitor should be cautious in patient with
Previous amputation, severe peripheral neuropathy, severe peripheral vascular disease or active diabetic foot ulcer or soft tissue infections.
When will we do screening pheo in incidental adrenal mass
When density of the mass more than 10 hounsfield
Which antibodies in Hashimoto thyroiditis
Thyroid peroxidase antibodies
Urine calcium-creatinine ratio determination is used to diagnosed
Familial hypocalciuric hypercalcemia
PTH level is elevated
Test in graves disease
Thyroid stimulating immunoglobulin and thyrotropin receptor antibodies
Glp1 receptor antagonist just reduce risk of atherosclerotic cardiovascular disease and diabetic kidney disease. Contraindicated in history of pancreatitis and not reduce risk of heart failure related hospitalization
Side effect of teriparatide
Increase in bone osteosarcoma
Inferior petrosal sinus sampling used to diagnose cushing disease by checking acth level in the inferior petrosal sinus with periphery after administration of corticotropin releasing hormone
Progestin can cause bone loss when use alone. If combine with estrogen will decrease bone loss
Virilization symptom
Voice deepening, clitoromegaly, male patterm baldness, severe acne
Hirsutism
Thick coarse dark hair in upper lip, chin, and side of the face
Active warming can cause ???
Vasodilation and can cause hypotension
When treating myxedema, if a random cortisol is more than… do not need to give hydrocortisone
18
Marker for monitoring papillary thyroid cancer
Serum thyroglobulin and thyroglobulin antibody
Treat type 2 amiodarone induce thyrotoxicosis and symptomatic thyroid tenderness from thyroiditis
Prednisone
Teprotumumab is a monoclonal antibody to insulin like growth factor 1 receptor, uses to treat
Moderate to severe graves ophthalmopathy
Treatment of primary hyperparathyroidism and concurrent osteoporosis, unable to undergo surgery
Alendronate
Pituitary infiltrative disorder caused by sarcoidosis and Langerhans cell histiocytosis
Can cause deficiency of anterior pituitary hormones and arginine vasopressin deficiency
How many types of amiodarone induce thyroiditis and how to differentiate
Type 1 AIT on graves and thyroid nodules, treat with methimazole
Type 2 AIT called destructive thyroiditis treated with glucocorticoid
Differentiate by ultrasound. Increase vascularity is type 1, decrease vascularity is type 2
Which circumstances to check free t3
1: evaluation of thyrotoxicosis to identify isolated t3 toxicosis
2: assess the severity of hyperthyroidism and response to therapy
3: to potentially differentiate hyperthyroidism from destructive thyroiditis
Contrandication of raloxifen
High risk for fracture and history of cardiovascular disease
Contraindication of romosozumab: mixed anabolic and antiresorptive effect
History of cardiocascular disease
Teriparatide is an anabolic agent used for postmenopausal women at high risk osteoporotic fracture. If start subsequent to denosumab discontinuation, it will stimulate the bone resorption associated with denosumab
Positive plasma aldosterone concentration/plasma renin activity in primary aldosteronism
Ratio greater than 20 with plasma aldosterone concentration of at least 15 ng/dl
When do we consider pheochromocytoma
When nodule density is more than 10 hounsfield units
How is plasma renin activity on patient uses acei and arb
Plasma renin activity is elevated. If pra is low, suspect primary hyperaldosteronism
Confirmatory test for primary hyperaldosteronism
Aldosteron measurement after oral sodium loading or saline suppression test. Aldosteron level need to be suppressed after loading with sodium
How to distinguish renal and extrarenal of potassium loss
Check 24-hour potassium creatinine ratio or spot urine potassium creatinine ratio. If less than 13 meq/g it is extrarenal.
In acromegaly, if IGF-1 is elevated, what to do next
Oral glucose tolerance test to confirm the diagnosis
How high is GH after oral glucose tolerance test to diagnose
Normal is less than 0.2 ng/ml
Diagnostic is more than 1 ng/ml
Aldosterone also has direct inflammatory and fibrotic effects
