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Adult Cardiac > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What is the time interval between changing thyroid medications and re-checking labs to evaluate effectiveness?

A

8 weeks

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2
Q

What two betablockers are effective in treating thyroid toxicosis?

A

Propranolol & Nadolol

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3
Q

Methimazole and PTU can cause damage to what organ?

A

Liver (Liver failure)

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4
Q

How is it best to take levothyroxine?

A

Empty stomach with a glass of water

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5
Q

What is the percent risk that a thyroid nodule is malignant?

A

5%

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6
Q

Thyroxine is abbreviated as?

A

T4

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7
Q

How do you dose thyroid medication in a patient who is overweight?

A

Dose them at their ideal body weight

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8
Q

Menorrhagia is caused by hypo or hyper thyroid?

A

Hypothyroidism

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9
Q

Amiodarone and Interferon can cause which endocrine dysfunction?

A

Hypothyroidism

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10
Q

A normal DTR value is what?

A

2+

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11
Q

What is the goal TSH for a patient receiving treatment for hypothyroidism?

A

0.5-2

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12
Q

A patient on levothyroxine treatment for hypothyroidism returns with a TSH of <0.5. What do I do?

A

Decrease the dose by 12.5-25ug/d

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13
Q

A patient on levothyroxine returns with a TSH of >4. What do I do?

A

Increase the dose by 12.5-25ug/d

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14
Q

Diabetes and Hypothyroidism often go hand in hand because they are both considered what type of disorders?

A

autoimmune

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15
Q

A Normal TSH ranges between what values?

A

0.4-4

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16
Q

Free T4 ranges between what?

A

10-27

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17
Q

TPO should be below what?

A

35

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18
Q

When should we treat subclinical hypothyroidism?

A

Infertility, considering pregnancy, pregnancy. those who are symptomatic, with a goiter, or TPO antibodies

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19
Q

If a patient present with a thyroid nodule what should be done?

A

Draw a TSH and order an ultrasound

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20
Q

What are symptoms of type 1 diabetes?

A

The polys, weight loss, ketonuria

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21
Q

To diagnose diabetes a fasting sugar must be above?

A

126

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22
Q

To diagnose diabetes a random sugar must be above?

A

200

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23
Q

Diabetics have an A1C of > what?

A

6.5

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24
Q

If a patient is meeting their goals how often do you check an A1C?

A

2 X yearly

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25
Q

If a patient is not meeting their goals how often do you check the A1C?

A

Every 3 months

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26
Q

In regards to insulin when is it likely to see a hypoglycemic episode?

A

During the insulin’s peak

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27
Q

What is the goal for fasting sugars in a a person with diabetes?

A

<100

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28
Q

What is the goal for 1-2 post prandial sugars in a a person with diabetes?

A

<140-180

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29
Q

In a person with diabetes what is the goal for A1C?

A

7

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30
Q

What is the goal for a person with diabetes who is an older adult?

A

8

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31
Q

What eGFR requires us to STOP metformin

A

<30

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32
Q

Metformin in a patient with a eGFR of less than 30 can cause an increased risk of what?

A

Lactic Acidosis

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33
Q

What is an example of a popular TZD?

A

Pioglitazone

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34
Q

What population should NOT take TZDs?

A

Those with heart failure, on nitrates, or those who are also on insulin. It causes increased fluid load and subsequent weight gain.

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35
Q

In TZD an insulin sensitizer, insulin releaser, or insulin secreater?

A

Insulin Sensitizer

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36
Q

Sulfonylureas work by doing what?

A

Releasing insulin

37
Q

Glipizide is what category?

A

Sulfonyurea

38
Q

Do sulfonylureas cause weight gain?

A

yes

39
Q

Are sulfonylureas expensive?

A

no

40
Q

DPP-4 Inhibitors do what? (secrete, excrete, or sensitize)

A

They “smart” release

41
Q

Are DPP-4s expensive? Do they have many side effects?

A

Yes! No.

42
Q

DPP-4s end in the suffix?

A

“Gliptan”

43
Q

GLP-1s do what?

A

Smart releasing

44
Q

Which diabetes drugs promote weight loss?

A

GLP-1s & SGLT2s

45
Q

Which diabetic drug class delays gastric emptying and should be avoided in patients with gastroparesis?

A

GLP-1. Also avoid these drugs in people with neuropathy as they likely have damage to the nerves in the gut as well.

46
Q

GLP-1s are good for people with what disorders?

A

CKD, ASCVD

47
Q

GLP-1s should not be prescribed yo those with a history of what acute abdominal disease?

A

pancreatitis

48
Q

SGLTs does what to glucose?

A

Off loads it via the kidneys

49
Q

At what eGFR would it be inappropriate to prescribe an SGLT2?

A

eGFR<30

50
Q

Are SGLTs expensive?

A

You bet!

51
Q

SGLT2s are good drugs for those with what conditions?

A

ASCVD, HF, CKD

52
Q

Gastroparesis is a symptom of what class of diabetic drugs?

A

GLP-1s

53
Q

If the pancreatic beta cells are dead which two classes of diabetes drugs will no longer be effective?

A

Sulfonyurea & DPP-4

54
Q

What normal physiologic response causes a high 4-8am glucose?

A

Dawn Phenomenon. Suspect this phenomenon if the 2-3am blood glucose is normal or high.

55
Q

Rebound hyperglycemia due to overtreatment of bedtime insulin is called what?

A

Somogyi effect. To fix eat a snack before bed or limit NPH insulin. Suspect this if blood glucose is low at 2-3am.

56
Q

The surge of what hormone leads to ovulation?

A

LH

57
Q

PTH affects what mineral?

A

Calcium

58
Q

The most common form of grave’s disease is caused by what?

A

Autoimmune process. Look for other autoimmune d/o such as RA, pernicious anemia, and osteoporosis.

59
Q

Is Grave’s disease hyper or hypo thyroidism?

A

HYPERthyroid

60
Q

Amenorrhea, pre-tibial myxedema (orange peel appearance) and lid lag are physical signs of what?

A

Grave’s disease

61
Q

Calcium and Vitamin D are given in hyper or hypothyroidism?

A

Hyper

62
Q

Treating a pregnant woman for hyperthyroidism requires treatment with which medication?

A

PTU

63
Q

PTU can cause what side effects?

A

Liver failure, skin rash, granulocytopenia/aplastic anemia, and thrombocytopenia

64
Q

Thyroid Storm requires hospitalization and presents with what symptoms?

A

Fever, abdominal pain, altered level of consciousness

65
Q

Can a 24 hour radioactive iodine test be done in a pregnant or breast feeding woman?

A

Nope

66
Q

What are three lab markers of autoimmune thyroid disease?

A

TRab, TSI, TPO

67
Q

Hypothyroid does what to cholesterol?

A

Increases it.

68
Q

Which drugs can lead to thyroid disease?

A

Amiodarone, Lithium, High dose iodine, interferon alfa, & dopamine

69
Q

Cold are spots are indicative of what on a thyroid?

A

Cancer

70
Q

Which diabetes drug causes photosensitivity?

A

Sulfonylureas

71
Q

In women HDL needs to be higher than what?

A

50

72
Q

In males HDL needs to be higher than what?

A

40

73
Q

Peak postprandial sugars should be less than what?

A

180

74
Q

TZDs should be avoided among what three populations?

A

HF III/IV, bladder cancer, liver disease

75
Q

Decreasing transfat will do what to the LDL and HDL?

A

lower and raise!

76
Q

What is the 15-15 rule in hypoglycemia?

A

give 15g and check again in 15 minutes

77
Q

the “ides” are what class of diabetes drugs?

A

sulfonylureas

78
Q

Metformin prevents absorption of what?

A

B12

79
Q

pH of < 7.2 indicates what?

A

Lactic acidosis

80
Q

A patient on metformin is scheduled for a dye study what should I counsel?

A

Hold metformin the day of the procedure and for 48 hours later

81
Q

All insulins can cause what two things?

A

Hypoglycemia and weight gain

82
Q

Rapid acting insulin peaks in how many minutes?

A

30

83
Q

Short acting insulin peaks in how many hours?

A

1-5

84
Q

Intermediate insulin peaks in how many hours

A

6-14

85
Q

SGLT-2 can cause what three things?

A

Weightloss, DKA, and increased risk of foot or leg amputation

86
Q

DPP-4 s protect what organ?

A

Kidneys

87
Q

Can I combine GLP-1s and DPP-4s?

A

No ma’am

88
Q

If you’re at risk for DM type II how much weightloss is recommended?

A

7%

Adult Cardiac (5 decks)

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