Endocrine Flashcards
What are common electrolyte imbalances seen with Addison’s Dz?
Addison’s disease =
hyperkalemia
hyponatremia
What lab findings will you see in adreanal insufficiency?
Labratory findings of adrenal insuffiency include
hyponatremia
hyperkalemia
hypercalcemia
low cortisol
what is the best test to confirm primary adrenal insuffiency?
The best test to confirm adrenal insuffiency is
cosyntropin stimulation test
*Cosyntropin is a synthetic ACTH. if a person has primary adrenal insuffiency, cortisol levels will remain low after a dose of cosyntropin.
What is pituitary apoplexy?
pituitary apoplexy is a hemorrhage into the pituitary gland usually in the presence of an adenoma.
S/S include sudden onset of neurological impairment, diplopia, headache, and pituitary insufficiency
What type of thyroiditis is associtated with recent upper respiratory tract infection and a painful goiter?
Subacute thyroiditis (De Quervain’s thyroiditis) is associated with a recent history of URI
Treatment is with NSAIDS
What are the characteristics of a thyroid storm?
Look for a stimulus: surgery, trauma, infection, childbirth
S/S: really high fever, coma, delerium, stupor
Labs: really low TSH
other clues: non-compliance with methimazole. Methimazole blocks conversion of T4 to T3- its used as a treatment for Graves Dz.
What are the characteristics of Myxedema Coma?
Myxedema Coma is severe hypothyroidism, altered mental status, hypothermia, and respiratory depression
What are the initial tests for cushing syndrome?
for a diagnosis of Cushing syndrome you must have 2/3 (+)
24 hour urine free cortisol
11 pm salivary cortisol (x2)
low dose dexamethasone
*low dose dexamethasone will supress cortisol levels in normal patients- the absense of supression = + test.
What are the diagnostic criteria for diabetes?
To diagnose DM type 2
- HbA1c . 6.5
- fasting glucose >126
- 2 hour glucose >200 if patient is asymptomatic
- fasting glucose >200 if patient is symptomatic
Signs/Symptoms
nonclassical congenital adrenal hyperplasia
Nonclassical CAH usually
presents in adolescent/adule females
s/s of androgen excess: hirsutism, acne, irregular menses
*first step: measure 17-hydroxyprogesterone, confirm with ACTH
Tx: OCP
What is Conn Syndrome?
Conn Syndrome is primary aldosteronism
The increased production of aldosterone leads to retention of Na in the distal tubules leading to hypertension
this also leads to excretion of hydrogen and K+ ions leading to metabolic acidosis and hypokalemia
What is Plummer Disease?
Plummer disease = toxic multinodular goiter
hyperplasia of follicular cells
descrete nodules
“patchy uptake”
decrease TSH causes atrophy of underproducing parts of the thyroid
What is thyrotoxicosis?
Thyrotoxicosis is a hypermetabolic state due to increased thyroid hormones
you’ll get the typical symptoms of hyperthyroidism including palpitations, nausea, weight loss, heat intolerance
Look for a woman 2-6 months post partum
what is the drug of choice to treat thyroid storm?
Treat thyroid storm with PTU
PTU inhibits the conversion of T4 to T3 (it opposes the organification of thyroid residues) it has a short half life and is safe to use in pregnancy.
Methemaziole is the treatment of choice for long term treatment of hyperthyroidism because of its longer half life. It does not prevent the conversion to T3 which is why it is not considered appropriate for treating a thyroid storm.
What medication do you give to reduce the progression and complications of a thyroid storm?
Give iodine one hour after PTU to reduce the release of thyroid hormone
