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OPP IV midterm > Endocrine cases lec > Flashcards

Endocrine cases lec Flashcards

1
Q

causes of hypothyroidism

A 
radioactive iodine therapy
thyroid surgery
previous Tx with thiomide drugs
autoimmune thyroiditis
iodine deficiency
lithium, amiodarone
hypothalamic or pituitary insufficiency
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2
Q

TSH inc T4 dec

A

primary hypothryoidism

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3
Q

TSH and T4 decreased

A

central hypothyroidism

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4
Q

TSH increased T4 normal

A

subclinical hypothyroidism

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5
Q

TSH increased T4 increased

A

use of oral contraceptives

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6
Q

medical management hypothyroidism

A

levothyroxine
repeate TSH every 6 weeks until stabilized
consider liothyronin if no response(problem is in the liver)

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7
Q

What is required for Dx of metabolic syndrome

A 
3 of 5 are met
Abdominal obesity
BP >130/85
TG >150
HDL men 100
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8
Q

what is considered obese in men and women

A

men >102 cm

women >88cm

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9
Q

causes of metabolic syndrome

A 
obesity
insulin R
increasing age
proinflammatory state
genetics
endocrine
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10
Q

labs and imaging for metabolic syndrome

A 
fasting lipids
fasting glucose
HbA1c
liver funciton tests
Free testosterone level
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11
Q

medical management in metabolic syndrome

A

dyslipidemia
HTN control
insulin control

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12
Q

ddx addisons

A 
adrenal fatigue
substance abuse
malignancy
DM
HIV
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13
Q

causes of addisons

A 
withdrawal long term corticosteroids
sheehan
autoimmune adrenal insufficiency
TB
HIV
waterhouse friderichesen syndrome
fungal disease
adrenal hemorrhage or infarction from anticoagulants
metastatic disease
drugs
sarcoidosis
amyloidosis
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14
Q

lab levels that suggest addisons

A

low cortisol and high ACTH

no increase in cortisol after an ACTH stimulation test

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15
Q

in utero size depends on

A

ETOH tobacco, stress

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16
Q

after how long do children generally reach there general growth velocity percentil

A

18-24 mo

17
Q

what is growth fialure

A

pathologic state abnormally low rate

loss of 2+ percentile lines

18
Q

reasons for growth failure

A

failure to thrive, hormonal, metabolic

19
Q

what is idiopathic short stature

A

height > 2SD below average

20
Q

familial short stature

A

short in comparison to matched population but consistent with familial

21
Q

what is non familial short stature

A

short in comparison to both population and family

22
Q

what is consititutional delay of growth and puberty

A

temporary delay in the skeletal growth and height of child with no other physical abnormalities causing the delay
catch up later

23
Q

what helps narrow differential for short stature

A

onset of growth delay

24
Q

signs of Turners

A

webbed neck, low set ears, broad chest

25
Q

what are signs of noonan

A

webbed neck, double curve scoliosis and rib deformities

26
Q

signs russel silver

A

triangular face, clinodactyly, blue sclera, lack of subcut fat

27
Q

what are signs of skel dysplasias

A

multiple fractures, missing collar bones, underdeveloped joints, impaired tooth development

28
Q

work up for dropping off the growth chart (severe growth failure)

A

CMP, CBC, Esed rate, liver function tests, UA

imaging: bone age with XR of left hand and wrist

29
Q

if GH stimulation test is +

A

GH deficiency

30
Q

Tx GH deficiency

A

daily growth hormone injections

31
Q

what is the idea behind somatosensory mapping

A

relationships maintained through proprioception via articular surfaces, ligaments, tendons and muscles
removes obstacles to optimal biomechanical function to encourage optimal somatosensory mapping

32
Q

What are growth spurts

A

period of rapid growth or rapid motion of the body

33
Q

when is the best time to manipulate a child with growth deficiency

A

before projected growth spurt

34
Q

what areas are good to Tx in growth deficiency

A

junctions, limbs/joints, cranial base (most proprioception)

35
Q

set up for diaphragm release in child

A

doc posterior and reachs fingers anteriorly inferior border rib cage
posteriorly thumbs are engaging thoracolumbar junction 11-12 ribs T12-L1

36
Q

methods to Tx cervial thoracic junction

A

BLT
first rib and thoracic inlet
seated toddler alternative approach

OPP IV midterm (6 decks)

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