Endocrine cases lec Flashcards
causes of hypothyroidism
radioactive iodine therapy thyroid surgery previous Tx with thiomide drugs autoimmune thyroiditis iodine deficiency lithium, amiodarone hypothalamic or pituitary insufficiency
TSH inc T4 dec
primary hypothryoidism
TSH and T4 decreased
central hypothyroidism
TSH increased T4 normal
subclinical hypothyroidism
TSH increased T4 increased
use of oral contraceptives
medical management hypothyroidism
levothyroxine
repeate TSH every 6 weeks until stabilized
consider liothyronin if no response(problem is in the liver)
What is required for Dx of metabolic syndrome
3 of 5 are met Abdominal obesity BP >130/85 TG >150 HDL men 100
what is considered obese in men and women
men >102 cm
women >88cm
causes of metabolic syndrome
obesity insulin R increasing age proinflammatory state genetics endocrine
labs and imaging for metabolic syndrome
fasting lipids fasting glucose HbA1c liver funciton tests Free testosterone level
medical management in metabolic syndrome
dyslipidemia
HTN control
insulin control
ddx addisons
adrenal fatigue substance abuse malignancy DM HIV
causes of addisons
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
lab levels that suggest addisons
low cortisol and high ACTH
no increase in cortisol after an ACTH stimulation test
in utero size depends on
ETOH tobacco, stress
after how long do children generally reach there general growth velocity percentil
18-24 mo
what is growth fialure
pathologic state abnormally low rate
loss of 2+ percentile lines
reasons for growth failure
failure to thrive, hormonal, metabolic
what is idiopathic short stature
height > 2SD below average
familial short stature
short in comparison to matched population but consistent with familial
what is non familial short stature
short in comparison to both population and family
what is consititutional delay of growth and puberty
temporary delay in the skeletal growth and height of child with no other physical abnormalities causing the delay
catch up later
what helps narrow differential for short stature
onset of growth delay
signs of Turners
webbed neck, low set ears, broad chest
