Endo Flashcards
Treatment for hyperthyroid in pregnancy (esp 1st trimester)
PTU
MEN2A syndrome
Medullary thyroid cancer
Pheochromocytoma
Primary hyperparathyroidism
(Test for pheo prior to thyroidectomy in patients with medullary thyroid cancer)
Indications for parathyroidectomy for primary hyperPTH
< 50 and asymptomatic
Gfr < 60
Nephrolithiasis
24h urine Ca > 400
Serum Ca > 1 over ULN
T score < -2.5
Post-surgical hypoPTH
Ca goal (serum and urine)
8 - 8.5
Urine < 300 /24hr
XR with bone overgrowth
Dx & Tx
Paget’s
Bisphosphonates
TSH in pregnant woman
HCG binds to TSH receptors and decreases serum TSH levels
If TSH > 2.5, increase synthroid
Hypercortisolism diagnosis - with am cortisol stim, urine cortisol and ACTH
What other test do we need
DEXA - risk for OP
Longstanding Hashimotos
Rapid onset goiter
Weight loss
Night sweats
Dx?
Primary thyroid lymphoma
Diagnose with biopsy
Tests to diagnose Cushing
Decamethasone 1 mg suppression
24 hr urine free cortisol
Evening salivary cortisol
No need for ACTH
8 mg suppression is to differentiate Cushing and ectopic ACTH
Incidental adrenal mass mgmt
Test for Cushing and pheo
Plasma metanepheine
Low dose dexameth suppression
If HTn, then check for hyperaldo with Aldo:renin ratio
New DM1
Tests to get?
GAD65
IA-2
72 hr fast
High or low C-peptide? With insulin use, oral glycemics, and insulinoma
Low
High
High
MEN1
HyperPTH
Pituitary neoplasm
Pancreatic NETs
Drug causes of hyperprolactinemia
Psychotropic TCAs Anti-seizure Metoclopramide Domperidone CCBs Methyldopa Opiates Protease Inhibitors
Reasons for surgery on pituitary adenomas
Secretion of GH, ACTH, or TSH Mass effect Visual changes Hypopituitarism Unresponsive to dopamine agonists (prolactinomas)
