Endocrine 1b Flashcards
Why might you need to give insulin to a patient with low glucose? How is it administered?
A patient with DKA might have low glucose but high ketones. Give that patient insulin and glucose at the same time.
What is AGEs?
Advanced Glycosylation Endproducts. Intermediate and Advanced glycosylation endproducts are irreversible and can lead to microvascular disease.
What is mononeuropathy?
dysfunction of a single nerve, often reversible with time.
What is mononeuropathy?
dysfunction of a single nerve, often reversible with time.
What is polyradiculopathy?
Affects nerve roots and commonly hits anterior thigh. Muscle weakness, atrophy and pain.
What is autonomic neuropathy?
Affects autonomic nervous system: bladder, GI, genitals, etc.
What is symmetric polyneuropathy?
Numbness, tingling, pain, etc. in the feet.
What is symmetric polyneuropathy?
Numbness, tingling, pain, etc. in the feet. This is the most common form of neuropathy.
What is symmetric polyneuropathy?
Numbness, tingling, pain, etc. in the feet. This is the most common form of neuropathy.
Where is 5’ deiodinease found?
liver
kidney
thyroid
target organs
Where is 5’ deiodinease found?
liver
kidney
thyroid
target organs
Which disease has diffuse uptake on thyroid scan? Which has patchy uptake?
Diffuse: Graves
Patchy: Toxic Multinodular Goiter
Which disease has diffuse uptake on thyroid scan? Which has patchy uptake?
Diffuse: Graves
Patchy: Toxic Multinodular Goiter
If a patient is taking amiodarone, can you do a thyroid uptake scan?
No. Amiodarone has iodine in it already, so the thyroid is already saturated with iodine.
When is PTU always used?
First trimester of pregnancy.
In absence of TSH, what color should the uptake scan be?
Clear. The thyroid should not be uptaking iodine if there is no TSH.
What has germinal centers in the histology?
Hashimotos hypothyroidism.
What has germinal centers in the histology?
Hashimotos hypothyroidism.
Where is d1 located?
Plasma membrane of target cell.
Where is d2 located?
ER of target cell. Has a short half life and is major activating hormone.
Where is d3 located?
Plasma membrane of target cell. Major deactivated.
When is the fetus entirely dependent on maternal hormone?
Before 18 weeks the fetus is entirely dependent onmaternal thyroid hormone
What is thyroid storm?
A life-threatening condition manifested by severe
hyperthyroidism plus decompensation of one or more organ systems
- Occurs in 0.2% of hyperthyroid patients
- Mortality is 11%
- Precipitated by a sudden release of thyroid hormone or increase in metabolic stress
• Symptoms may include fever, marked tachycardia, arrhythmias, heart failure, metabolic encephalopathy and hepatic failure
Which drug I nhibits the action of 5’ deiodinase D1
Put
Myxedema Coma
Typical case
- Elderly woman, often with mild dementia
- History of treated hypothyroidism
- Thyroid hormone discontinued or taken erratically - Presents with apparently unrelated systemic illness
For women who become pregnant while taking L-T4…
As soon as a period is missed and pregnancy is suspected increase from 7 to 9 L-T4 tablets/week (a 29% increase)
Don’t wait to check TSH !
What has germinal centers in the histology?
Hashimotos hypothyroidism.
What is the role of methimazole and PTU? How does PTU differ?
They do everything (decrease iodination and T4/3 formation) except prevent the secretion of stored T3/4.
PTU is different bc it inhibits the action of D1 and decreases conversion of T4 to T3.
