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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
Q

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

A

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

26
Q

Cause of Primary hyperparathyroidism

A

Parathyroid adenoma
Parathyroid hyperplasia
Parathyroid carcinoma
Drug induced e.g. lithium

27
Q

Cause of Secondary hyperparathyroidism

A

Vitamin D deficiency

Chronic Kidney Injury

28
Q

Cause of Tertiary hyperparathyroidism

A

Prolonged secondary hyperparathyroidism

29
Q

Conservative treatment of primary hyperparathyroidism

A

Monitoring

Increase oral fluid intake

30
Q

Medical treatment of primary hyperparathyroidism

A

Bisphosphonates

31
Q

Surgical treatment of primary hyperparathyroidism

A

Parathyroidectomy

32
Q

Conservative treatment of secondary hyperparathyroidism

A

Diet low in phosphate and high in calcium

33
Q

Medical treatment of secondary hyperparathyroidism

A

Calcimimetics e.g. cinacalcet

34
Q

Surgical treatment of secondary hyperparathyroidism

A

Parathyroidectomy if unresponsive to medical therapy

35
Q

Surgical treatment of tertiary hyperparathyroidism

A

Parathyroidectomy

36
Q

Complications of hyperparathyroidism

A

Renal calculi
Acute pancreatitis
Peptic ulceration
Calcification of the cornea

37
Q

Conservative treatment of Cushings syndrome

A

Education about the condition

Advise patient to decrease alcohol consumption since alcohol increases cortisol levels

38
Q

Medical treatment of Cushings syndrome

A

KETOCONAZOLE,
METYRAPONE,
MITOTANE
Treat complications such as hypertension and diabetes mellitus

39
Q

Surgical treatment of Cushings syndrome

A

Trans-sphenoidal surgery to remove pituitary adenoma or bilateral adrenalectomy to remove adrenal adenoma, if indicated

40
Q

Complications of Cushings syndrome (high cortisol)

A 
Osteoporosis
Diabetes mellitus
Hypertension
Immunosuppression
Cataracts
Striae formation
Ulcers
41
Q

Conservative treatment of adrenal insufficiency

A

Patient education

Patient must carry a steroid alert card

42
Q

Medical treatment of adrenal insufficiency

A

Replace glucocorticoids and mineralocorticoids with hydrocortisone and fludrocortisone
Treat complications

43
Q

Surgical treatment of adrenal insufficiecny

A

Surgical excision of tumour, if indicated

44
Q

Conservative treatment of Acromegaly

A

Patient education

Inform patient that bone changes will not revert after treatment

45
Q

Medical treatment of Acromegaly

A

Somatostatin analogues e.g. Octreotide
Dopamine agonists e.g. Cabergoline
GH receptor antagonists e.g. Pegvisomant

46
Q

Surgical treatment of acromegaly

A

Trans-sphenoidal surgical excision of the adenoma (treatment of choice)

Medicine Phase 2a (22 decks)

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