Endocrine Flashcards
Hypothalmus releasing factors
Gonadotropin RH
Growth Hormone RH
Thyroid RH
Corticotropin RH
Pituitary Function
Ant: TSH, PRL, FSH/LH, GH, ACTH
Post: ADH, Oxytocin
Hyperprolactinemia S/S
Amenorrhea
Galactorrhea
Dec libido
+/- Bitemporal hemianopsia
F>M, MRI
Acromegal
90% pituitary tumors
NEED MRI
Short- adulthood
Tall- before epiphyseal closure
Primary Hyperthyroidism
Grave’s
Autoimmune, F 20-40
S/S: heat intolerance, exopthalmos
Complications: A-fib, osteoporosis
Primary Hypothyroidism
Hashimotos
MC cx of hypothyroidism in the US
Tx for Grave’s
- Propanolol cardiac sxs
- Radioactive Iodine 131 (NOT in pregnancy or nursing)
- PTU in pregnancy
Pt hx of goiter, grave’s dz, recent surgery or RI-131 with GI flu like symptoms (delirium, tachycardia, n/v, fever)
THYROID STORM
Starting dose for hypothyroidism
Synthroid/levothyroxine (safe in pregnancy)
young: 0.1mg/d
elderly: 0.025mg/d
Definitive test for thyroid nodules
FNA bx
thyroid scan cold- higher risk of malignancy; hot- benign
Thyroid CA
Hx of radiation to the nex
cold thyroid scan
Most PEOPLE have PAPILLARY
PTH
Kidneys- hold onto Ca2+
Bones- clasts release Ca2+
Urine- PEE out PHOSsphorus
MC cx of hypercalcemia
#1- Primary hyperPTH #2- Malignancy
MC cx of primary hyperPTH
Adenomas
Dx for hyper PTH
Elevated PTH
Tx for hyper PTH
Parathyroidectomy
Observe if asx and mild Ca2+
MC cx of hypoCa2+
Renal Failure
Adrenal Glands responsible for….
CORTISOL
Cushings
cortisol excess
Dx: Suppression test
Dexamethasone
Addison’s
cortisol deficient
Dx: Stimulating test
Cosyntropin
What do you need to do FIRST before the suppression test?
STOP all steroids
Prednisone, inhaled, progestin, herbals etc
Aldosterone
stimulated by hypovolemia, tells renal tubules to hold onto Na+ and get rid of K+
Primary HyperAldosteronism
Electrolytes
High Na+ (Edema, HTN)
Hypo K+
Best test for Pheo
- 24 hr urine (catecholamines and metanephrines)
- If plasma is negative -repeat x2
DM Dx (except in pregnancy_
1) 2 FBS > 126
2) OGTT > 200mg/dl after 75g
3) Random BS >200 w/ sxs
4) A1C >6.5
When can A1C NOT be used in dx DM
1) Pregnancy
2) B12, Fe def anemia, Thalassemia, sickle cell
3) Recent blood donation
4) Kidney/Liver dz
Unexplained WL despite hunger, Polyuria, Polydipsia, Polyphaghia
DM I
-beta cells of pancreas do not produce insulin
Rapid Acting Insulin
Lispro (Humalog)
Aspart (Novolog)
Long Acting Insulin
Detemir (Levimir)
Glargine (Lantus)
SIADH
DON’T pee- Hold fluid
SO much ADH
DI
PEE - Get rid of fluid
Dec ADH
Nephro- Kidney Failure
Neuro/Central- Pituitary Failure (no ADH being produced) if you STIMULATE kidneys (AVP/desmopressin), pt will respond appropriately
