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Medicine Phase 2a > Endocrine CMS Treatments > Flashcards

Endocrine CMS Treatments Flashcards

1
Q

Conservative treatment of hyperthyroidism

A

Patient education

Smoking cessation

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2
Q

Medical treatment of hyperthyroidism

A

Symptomatic control
Antithyroid medication
Radioactive iodine ablation (DEFINITIVE TREATMENT, patients must be euthyroid before commencing treatment)

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3
Q

Medical treatment of hyperthyroidism: Symptomatic control

A

Palpitations and tremor = beta-blockers

Eye symptoms = eye drops for lubrication

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4
Q

Medical treatment of hyperthyroidism: Antithyroid medication

A

Carbimazole

Propylthiouracil

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5
Q

Side effects of antithyroid medication

A

Agranulocytosis

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6
Q

Surgical treatment of hyperthyroidism

A

Subtotal thyroidectomy

Patients must be euthyroid before the procedure, by giving Potassium iodide.

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7
Q

Why are patient given potassium iodide before surgery for hyperthyroidism

A

Must be euthyroid before procedure as decreases the vascularity of the thyroid gland

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8
Q

Conservative treatment of hypothyroidism

A

Patient education

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9
Q

Medical treatment of hypothyroidism

A

Lifelong replacement of thyroid hormone with LEVOTHYROXINE

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10
Q

What does treatment of thyroid carcinoma depend on?

A

Histological classification

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11
Q

Treatment of papillary carcinoma of thyroid if:
Lesion <1cm
Lesion >1cm

A

Lesion <1cm:
Thyroid Lobectomy, Lifelong Levothyroxine and Annual thyroglobulin measurements
Lesion >1cm:
TOTAL Thyroidectomy, Radio-iodine ablation then lifelong levothyroxine and annual thyroglobulin measurements

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12
Q

Treatment of Follicular carcinoma of thyroid if:
Lesion <1cm
Lesion >1cm

A

Lesion <1cm:
Thyroid lobectomy, then lifelong Levothyroxine and annual thyroglobulin measurements
Lesion >1cm:
Total thyroidectomy, Radio-iodine ablation then lifelong levothyroxine and annual thyroglobulin measurements

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13
Q

Treatment of Medullary carcinoma of thyroid

A

Total thyroidectomy then lifelong Levothyroxine

Screen family members for multiple endocrine neoplasia (MEN) syndrome and thyroid cancer

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14
Q

Treatment of Anaplastic carcinoma of thyroid

A

Debulking surgery and palliative care

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15
Q

Conservative treatment of Diabetes Mellitus Type 1

A 
Dietary advice
BMI measurement
Smoking cessation
Decrease alcohol intake 
Regular blood glucose and HbA1c monitoring
Encourage exercise
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16
Q

Conservative treatment of Diabetes Mellitus Type 2

A

Dietary advice: high in complex carbohydrates, low in fat
BMI measurement
Smoking cessation
Decrease alcohol intake
Regular blood glucose and HbA1c monitoring
Encourage exercise

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17
Q

Conservative treatment of Diabetes Insipidus

A

Education on how to monitor fluid levels and dietary salt levels
Advise patient to wear a MedicAlert bracelet

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18
Q

Medical treatment of Diabetes Insipidus of cranial cause

A

DESMOPRESSIN - a synthetic replacement for vasopressin; it increases the number of aquaporin-2 channels in the distal convoluted tubules and the collecting ducts. This increases water reabsorption

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19
Q

Medical treatment of Diabetes Insipidus of nephrogenic cause

A

High-dose desmopressin
Correction of electrolyte imbalances
Thiazide diuretics
Prostaglandin synthase inhibitors

20
Q

Surgical treatment of Diabetes Insipidus

A

Excision of tumour if indicated

21
Q

Conservative treatment of hypoparathyroidism

A

Diet high in calcium and low in phosphate

Support for parents

22
Q

Medical treatment of hypoparathyroidism

A

Calcium and vitamin D supplements

23
Q

Describe levels of all below in Primary Hyperparathyroidism:
PTH levels
Serum calcium
Serum phosphate

A

PTH levels - Increased
Serum calcium - Increased
Serum phosphate - Decreased

24
Q

Describe levels of all below in Secondary Hyperparathyroidism:
PTH levels
Serum calcium
Serum phosphate

A

PTH levels - Increased
Serum calcium - Decreased
Serum phosphate - Increased

25
Describe levels of all below in Tertiary Hyperparathyroidism: PTH levels Serum calcium Serum phosphate
PTH levels - Increased Serum calcium - Increased Serum phosphate - Decreased
26
Cause of Primary hyperparathyroidism
Parathyroid adenoma Parathyroid hyperplasia Parathyroid carcinoma Drug induced e.g. lithium
27
Cause of Secondary hyperparathyroidism
Vitamin D deficiency | Chronic Kidney Injury
28
Cause of Tertiary hyperparathyroidism
Prolonged secondary hyperparathyroidism
29
Conservative treatment of primary hyperparathyroidism
Monitoring | Increase oral fluid intake
30
Medical treatment of primary hyperparathyroidism
Bisphosphonates
31
Surgical treatment of primary hyperparathyroidism
Parathyroidectomy
32
Conservative treatment of secondary hyperparathyroidism
Diet low in phosphate and high in calcium
33
Medical treatment of secondary hyperparathyroidism
Calcimimetics e.g. cinacalcet
34
Surgical treatment of secondary hyperparathyroidism
Parathyroidectomy if unresponsive to medical therapy
35
Surgical treatment of tertiary hyperparathyroidism
Parathyroidectomy
36
Complications of hyperparathyroidism
Renal calculi Acute pancreatitis Peptic ulceration Calcification of the cornea
37
Conservative treatment of Cushings syndrome
Education about the condition | Advise patient to decrease alcohol consumption since alcohol increases cortisol levels
38
Medical treatment of Cushings syndrome
KETOCONAZOLE, METYRAPONE, MITOTANE Treat complications such as hypertension and diabetes mellitus
39
Surgical treatment of Cushings syndrome
Trans-sphenoidal surgery to remove pituitary adenoma or bilateral adrenalectomy to remove adrenal adenoma, if indicated
40
Complications of Cushings syndrome (high cortisol)
``` Osteoporosis Diabetes mellitus Hypertension Immunosuppression Cataracts Striae formation Ulcers ```
41
Conservative treatment of adrenal insufficiency
Patient education | Patient must carry a steroid alert card
42
Medical treatment of adrenal insufficiency
Replace glucocorticoids and mineralocorticoids with hydrocortisone and fludrocortisone Treat complications
43
Surgical treatment of adrenal insufficiecny
Surgical excision of tumour, if indicated
44
Conservative treatment of Acromegaly
Patient education | Inform patient that bone changes will not revert after treatment
45
Medical treatment of Acromegaly
Somatostatin analogues e.g. Octreotide Dopamine agonists e.g. Cabergoline GH receptor antagonists e.g. Pegvisomant
46
Surgical treatment of acromegaly
Trans-sphenoidal surgical excision of the adenoma (treatment of choice)

Medicine Phase 2a (22 decks)

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