Endocrine Flashcards
Most common type of hypothyroid
Hashimoto’s thyroiditis (autoimmune)
Medications that contain iodine and may affect TSH levels
Lithium, amiodarone, interferon
Thyroid tests
TSH
Free T4
TPO antibody (to confirm hashimotos)
Most common cause of hyperthyroid
Graves’ disease (autoimmune)
Treatment of hypothyroid
Levothyroxine 1.6mcg/kg/d adults
1.0mcg/kg/d in elderly
4.0 mcg/kg/d in children
>/= 50% increase during pregnancy
Treatment of hyperthyroidism
Beta-blockers for symptom mgmt.
Refer to Endocrinologist for tx:
Propylthiouracil PTU, methimazole (Tapazole), radioactive iodine treatments.
How long do u need to follow up/recheck labs after change in synthroid dosage?
8 weeks
What does parathyroid gland make (hormone) and control?
Makes PTH-parathyroid hormone, which controls levels of calcium and phosphorus in the blood. Also makes Vit D and helps prevent loss of too much calcium in the urine.
Primary hyperparathyroidism etiology and clinical presentation
^PTH ^Ca+ Elevated levels of PTH cause hypercalcemia
Sx- fatigue, poor concentration and memory, depression, osteoporosis/osteopenia, GERD, kidney stones.
“Moans, groans, stones, bones, with psychic overtones”
Treatment of primary hyperparathyroidism
Surgery to remove problematic gland
Cinacalcet (Sensipar) to signal for less PTH release by parathyroid gland.
Bisphosphonates to prevent bone loss
Secondary hyperparathyroidism etiology and presentation
Secondary condition that lowers calcium levels, causing the parathyroid gland to overproduce PTH. Leads to calcium/vitamin D deficiency and/or CKD
Sx- presentation same as primary
Treatment of secondary hyperparathyroidism
Vitamin D analogues, phosphate binders and Sensipar
Surgery if medical tx fails
Ensure adequate amounts of calcium and vitamin D intake.
Addison’s disease (hypocortisolism) etiology and presentation
Hypo secretion of adreno-cortical hormones from the adrenal glands, leading to metabolic disturbances (sugar, fluid, electrolytes, salts)
Sx- decreased tolerance to stress, irritability, low libido, bronze-like colored skin pigment.
Low cortisol, low Na+, hypoglycemia, HYPERkalemia
Treatment of Addison’s disease
Long term steroids
Cushings disease (hypercortisolism) etiology and presentation
Hyper secretion of adreno-cortical hormone (from the adrenal glands)
Sx- increased susceptibility to infections, MOON FACE, BUFFALO HUMP, hirsutism, acne, striae, easy bruising.
High cortisol level, Na+ high, glucose high, HYPOkalemia.
