Endocrine Lab

Question 1

Thyroid Exam

Answer 1

• isthmus overlies 2-4th tracheal rings
• have patient flex neck slightly to relax SCM
• place fingers on patients neck so they lie just below cricoid cartilage
• displace trachea to left and right
• if enlarged, listen over lateral lobes to detect bruit

Question 2

Abnormal thyroid findings

Answer 2

Goiter: simple or multinodular
Graves: soft
Hashimoto's: firm
Thyroiditis: tender
Exophthalmos: abnormal protrusion of eyeballs (may be seen with hyperthyroidism)

Question 3

Chvostek sign

Answer 3

• hypocalcemia

- twitching of facial muscles in response to tapping over facial nerve

Question 4

Trousseau’s sign

Answer 4

• hypocalcemia

- carpopedal spasm caused by ischemia from inflating the blood pressure cuff

Question 5

Other physical exam findings of hypocalcemia

Answer 5

-cataracts, dry coarse skin, hyperpigmentation, eczema, steatorrhea

Question 6

Steps of Diabetic Screening

Answer 6

1) examine feet for skin lesions/infections
2) Pressure sensation using microfilament testing
3) vibration sensation using tuning fork
4) superficial pain sensation using pinprick/temp sensation
5) bilateral DTRs of the ankle
6) bilateral pulses

Question 7

DM Foot Exam

Answer 7

• inspection of feet, between toes, and nails
• pulses
• monofilament
• vibration sensation using 128 Hz tuning fork
• pinprick sensation
• ankle reflexes

Question 8

Glucose Testing Routine

Answer 8

1) wash hands
2) alcohol swab, ensure area is dry
3) prepare clean needle
4) remove test strip
5) stick side of fingertip
6) make sure the drop of blood is enough
7) stop bleeding by applying pressure

Question 9

Glucose Interpretation

Answer 9

Normal Fasting: <100mg/dL
Normal 2 hr Post Prandial: <140mg/dL
Normal Random: <200 mg/dL