endocrine

Question 1

PTU and methimazole which one

Answer 1

always methimazole because hepatotoxicity only in the first trimaster PTU

after

Question 2

infections in hemochromatosis

Answer 2

listeria, vibrio vulnificus, yersinia entrocolitica

Question 3

amiodarone on TFT

Answer 3

peripheral conversion of t3 to t4 reduced ,
high inodine contentinhibits hormone synthesis (wolf chiakoff effect)
or induced thyrotoxicosis

that can be 2 type

1; induced hormone sythesis RAIU reduced (radioactive iodine uptake and increased vascularity

2. destructive; RAID non and decreased vascularity ( treatment for this is glucocorticoids)

if the patient is clinically euthyroid, no treatment is necessary

Question 4

sick thyroid syndrome

Answer 4

T3 decreased ; weight loss !!!!!!!

Question 5

subclinical hypothyroidisim

Answer 5

if tsh more than 10 : levo

if between 5-10 first antithyroid peroxidase ; positive levo

if negetiveif : goier or syptome or preg or ovulatorydysfunction, hypercholesterolemia : levo

if not routine monitoring

Question 6

subclinical hyperthyroidism;

Answer 6

high chance of normalizing repeat in 6-8 weeks

Question 7

euthyroid syndrome

Answer 7

decreseard conversion of t4 to t3 ; starvation certain medication(glucocorticoids, amiodarone) inflammatory cytokines

Question 8

management of hypoparathyroidisim

Answer 8

more than 7.5 ; oral calcium and calcitriol
sever less than 7.5 or high risk features(seizure, tetany, prolonged QT; iv calcuim gluconate

if hyper calciuria; add thiazideand

Question 9

calciphylaxis

Answer 9

arteriolar calcification and tissue ischemia; in end stage renal disease and secondary hyperthyroidism fe

Question 10

metaidobenzylguanidine (MIBG)

Answer 10

for pheo more than 5 cm

or negerive MRI or CT and still cilincaly suspected

Question 11

major drug interactions of levothyroxine

Answer 11

levothyroxin absorbtion; bile acid -binding agents(cholestryamine), Iron , calcium , aluminum hydroxide,

increase TBG; estrogen replacement , oral contoception, tamoxifen

decrease TBG; anderogen, glucocorticoids, anabolic steroid,

increase thyroid hormone metabolism; rifampin. phenytoin, carbamazepine

Question 12

beneficial detrimental and neutral effects of MHT9menoposal hormone therapy )

Answer 12

Beneficial; menopausal symptomes, bone mass, fractures, colon cancer, type 2 diabetes mellitus , all cause mortality age<60

detrimental; venous thromboembolism, breast cancer, coronary heart disease, stroke, gall bladder disease,

neutral, cognition, dementia, endometrial cancer(only increased with unopposed estrogen, ovarian cancer, all cause mortality age>60

Question 13

necrolytic migratory erythema

Answer 13

glucagonema