Endocrine Flashcards
At what percentile BMI should kids be screened for DM2
95th
ADA recommends DM2 screening if overweight &
2 of folllowing
- family hx of type 2
- signs of insulin resistance ( (acantha, pcos, HTN, dyslipidemia)
- black or brown
- gestational diabetes baby
At what A1C should child be put on insulin with type 2 diabetes
9
how does methimazole work? use?
blocks iodines ability to combine with tyrosine to for t4 and t3. Drug of choice for pediatric hyperthyroid
How long does methimazole take to see full effect? how long should it be taken
4-8 weeks to see full reduction. can take indefinately if working. can stop after 1 year of euthyroid
tx for thyroid storm
Antithyroid (methimazole) + iodine (SSKI) + steroids
b-blocker for symptoms
cause of myxedema coma? tx?
untreated hypothyroid. tx is IV levothyroxine
graves disease thyroid hormone levels
t4 - high
TSH - low
primary hyperthyroid = problem is actually in the thyroid
symptoms of thyroid storm
increased HR, very high temperature, tachypnea, dehydration, altered mental status (some say AMS is needed for diagnosis)
what drugs can cause hypothyroid
lithium and interferon
When is SSKI used
BEFORE surgery 7-10 days to lower thyroid hormone and reduce blood flow and blood loss.
AFTER radioactive iodine because ablation is slow
AE of methimazole
agranulocytosis
baseline monitoring of methimazole
WBC (agranulocytosis) and LFTs
When should methimazole be abruptly stopped
fever or infection - check WBC to make sure its not blood stuff (per uptodate)
Drugs that can cause SIADH
carbazmazepine, oxcarb, SSRIs, Chlorpromazine, opioids… lots more
