Endocrine Flashcards
lab values in hyperparathyroidism
high calcium, high PTH, low phosphate
lab values seen in hypoparathyroidism
decreased Calcium, Decreased PTH, decreased magnesium, elevated phosphate
labs in hypothyroidism
increased TSH, decreased T4
labs in hyperthyroidism
increased T4, decreased TSH
exophthalamous, pretibial myxedema, goiter, and lid lag are symptoms seen in …
Grave’s disease
treatment of hypothyroidism
levothyroxine
when starting someone on levothyroxine, when should you measure their TSH
every 6 weeks
most common type of thyroid cancer
papillary
cold nodule on thyroid scan is indicative of
thyroid cancer
labs found in addison’s disease
hyperkalemia, hyponatremia
excess of growth hormone from anterior pituitary - in adults
acromegaly
excess of growth hormone from anterior pituitary - in children
gigantism
primary adrenal cortical insufficiency
addison’s disease
most common cause of adrenal cortisol dysfunction
corticosteroid use
two physical exam findings that are only seen in addison’s disease and not secondary adrenal cortical insufficiency
hyperpigmentation of the skin, orthostatic hypotension
ACTH level in primary adrenal insufficiency
elevated
ACTH level in secondary adrenal insufficiency
decreased
test to differentiate between primary and secondary adrenal insufficiency
give a high dose of ACTH – if cortisol rises = secondary adrenal insufficiency, if cortisol level stays the same = primary (addison’s)
treatment of addison’s disease
hydrocortisone and flutacortisone
treatment of secondary adrenal insufficiency
hydrocortisone
most common cause of cushing syndrome
steroid use
PE findings of someone with cushing syndrome/disease
obesity, buffalo hump, striae, thin extremities, moon faces, HTN, acanthosis nigricans
initial screening test for cushings syndrome
24 hr free urine cortisol
test to differentiate between cushings syndrome and disease
high dose suppression test - if cortisol decreases = disease
polyuria, polydipsia, and polyphagia are sx of which disorder
diabetes
4 lab values that can DX DM
- Fasting blood glucose >126, on two occasions
- 2 hour glucose tolerance test >200
- A1C >6.5
- Random blood glucose >200 with symptoms
low blood sugar overnight with rebound high blood sugar in the morning
somogi phenomenon
BGL over 250, pH <7.3 and ketones in the urine
DKA
treatment for DKA
SIPS - saline, insulin, potassium, search for cause
BGL over 600 with a normal pH
HHS
MEN Type I cancers
pituitary, parathyroid, pancreatic
MEN Type IIA
medullary thyroid, pheochromocytoma, parathyroid
MEN Type IIB
medullary thyroid, mucosal neuroma, marfoid body habitus, pheochromocytoma
MEN disorders have what type of inheritance
Autosomal dominant
most common risk factor for thyroid cancer
radiation exposure
catecholamine secreting adrenal tumor, results in high BP and a headache
pheochromocytoma
Dx test for pheochromocytoma
24 hr catecholamines
what medications need to be given prior to having an adrenalectomy due to pheochromocytoma
alpha blocker and beta blocker
decreased serum osmolality and increased urine osmolality
SIADH
complication of correcting serum Na too quickly
central pontine myelinolysis
tap of facial nerve elicits cheek twitch
Chvostek’s sign – hypocalcemia
BP cuff inflation elicits carpal spasm
Trousseu’s sign – hypocalcemia
increased serum osmolality and decreased urine osmolality
diabetes insipidus
type of DI that has no ADH production
central DI
type of DI that has partial or complete insensitivity to ADH
nephrogenic DI
tx of central DI
desmopressin
tx of nephrogenic DI
decreased Na, remove drug causing, HCTZ
test to differentiate between central and nephrogenic DI
desmopression stimulation test, if urine output decreases it is central
treatment for dwarfism
growth hormone
low TSH, high T4
hyperthyroidism
most common cause of hyperthyroidism
grave’s diease
Increased TSH, low T4
hypothyroidism
most common cause of hypothyroidism
Hassimoto’s
test to confirm Grave’s disaese
anti-thyrotropin antiboties
test to confirm Hassimoto’s
anti-TPO antibodies
most common cause of thyroid pain
subacute thyroiditis
treatment of hyperthyroidism during pregnancy
PTU for first trimester, then metheimazole
treatment for hyperthyroidism
PTU, metheimazole, thryoidectomy
treatment for hypothyroidism
levothyroxine
