Endocrine Lab Flashcards
Where does the isthmus of the thyroid lie?
2-4th tracheal rings
Describe how you perform a thyroid exam?
1) anterior or posterior a0 approach
2) locate isthmus and have patient flex neck slightly to relax SCM
3) place index fingers just below cricoid cartilage
4) have patient swallow
5) displace trachea to right and left to palpate lobes
What to do if thyroid feels enlarged?
detect bruits over lobes
can be heard in goiter or hyperthyroidism
Name 4 possible findings from a thyroid exam and how the thyroid feels?
1) Goiter : non or multi nodular
2) graves disease : soft
3) Hashimoto’s thyroiditis and malignancy : firm
4) thyroiditis : tender
What positive signs can indicate hypocalcemia?
- Chvostek sign
- trousseau’s sign
Describe Chvostek’s sign
twitching of facial muscles by tapping on facial nerve
Describe Trousseau’s sign
carpopedal spasm caused by ischemia from inflating the BP cuff
What are some physical findings of hypocalcemia?
- cataracts
- dry, coarse skin
- hyperpigmentation
- eczema
- steatorrhea
Describe the steps of a diabetic exam
1) exam feet (b/w toes too)
2) pressure using monofilament
3) vibration sensation using tuning fork
4) superficial pain sensation using pinprick/temperature sensation
5) bilateral DTRs of ankle
6) Bilateral pulses (dorsalis pedis, posterior tibial)
What are the 3 main Pilars to the diabetic foot exam?
1) inspection of feet, toes, and nails
2) pulses of foot
3) 10-g monofilament plus testing of any one of the following: - vibration sensation, pinprick, ankle reflexes
What are you doing when inspecting the feet toes and mails of a diabetic?
- ulcers, claw toes, Charot foot, amputations, think toenails, ingrown, callus, wounds
- checking for warmth
What pulses are you checking in a foot exam?
- dorsalis pedis
- posterior tibial
What is acanthuses nigricans?
hyperpigmentation in body folds of skin (neck) due to diabetes
What is a normal fasting glucose?
<100 mg/dL
What is a normal 2 hr post- prandial glucose?
<140mg/dL
