Endocrine Labs

Question 1

Normal TSH, with multiple endocrine-like symptoms. Order what…

Answer 1

T4 for clarification

Question 2

Weeks it takes for the TSH to equilibrate

Answer 2

4-6 weeks

Question 3

Total T4 is not commonly used. It is less accurate because the protein bound portion can be affected by

Answer 3

pregnancy, medications and this is not measuring the protein bound hormone, but the globulin

Question 4

Free T3 can be good for

Answer 4

Cases of Hyperthyroidism, as levels of it tend to change more dramatically than T4 levels in hyperthyroidism. but this is more rare

Question 5

TSH comes back low

Answer 5

Order FT4 and FT3 to confirm. prob end up referring

Question 6

TSH comes back high

Answer 6

Order FT4 to confirm

Question 7

TSH high, T4 low

Answer 7

Hypo. levo. monitor with periodic TSH

Question 8

TSH high, T4 normal

Answer 8

“subclinical hypothyroidism” (Tx if symptomatic or TSH >10 or planning pregnancy)

Question 9

TSH high, T4 high

Answer 9

refer

Question 10

DM2 screening repeats

Answer 10

Repeat the same test ordered originally

Question 11

General rule of sp/sn of DM tests

Answer 11

good Specificity, but poor sensitivity (when positive=def have DM, when negative=may still have DM)

Question 12

FBG level for DM dx

Answer 12

> /= to 126 on TWO separate tests

Question 13

IGT levels

Answer 13

impaired glucose tolerance = 101-125

Question 14

A1c dx of DM

Answer 14

> /= 6.5% on TWO separate tests

Question 15

A1c high risk values and dx

Answer 15

5.7% - 6.4% IGT

Question 16

Changes in RBCs could affect

Answer 16

results of A1c

Question 17

2hOGTT steps

Answer 17

(Two-hour) Oral Glucose Tolerance Test.

Must fast for 8hrs ` pt first drinks 75g Glucose Solution/load ` waits 2hrs ` blood drawn. (F8,75G, 2hrs, Blood)

Question 18

OGTT dx values

Answer 18

same as any other blood glucose.

1. > /=200 DM
2. levels 140 - 199 are diagnostic for impaired glucose tolerance IGT
3. Under 140 is NORMAL

Question 19

Monitoring tests for DM pt’s

Answer 19

Complete Urinalysis
Lipid Panel
CMP(liver fnx)
A1c (biannually in stable pt’s, quarterly in unstable pt’s)

Question 20

Goal A1c for DM?

Answer 20

<7%

Question 21

Protein portion of lipoprotein?

Answer 21

apolipoprotein

Question 22

Normal life of LDL, and abnormal life?

Answer 22

attach to receptors and “used up”. but if oxidized it can not attach and cause all sorts of shenanigans like atherosclerosis

Question 23

Main transporter of triglycerides and cholesterol is? life of them?

Answer 23

VLDLs. from the liver into the plasma. degrade to become LDL. which last longer in the blood. (test of choice is LDL due to this)

Question 24

HDL fnx?

Answer 24

Significant transporters of cholesterol from the peripheral tissues and arteries to the liver “good”

Question 25

80/15

Answer 25

Triglycerides in the plasma are a combo of VLDLs (80%) and LDLs (15%)

Question 26

plasma triglyceride level is used to calculate

Answer 26

LDL level

Question 27

Components of Lipid Panel

Answer 27

``` Total Cholesterol HDL-C LDL Triglycerides Total Cholesterol-to-HDL ratio ```

Question 28

Total cholesterol Normal levels

Answer 28

140-199mg/dL

Question 29

HDL Normal levels

Answer 29

Men: 35-65mg/dL Women: 35-80mg/dL

Question 30

LDL normal levels

Answer 30

optimal is <100mg/dL but individualized based on rf

Question 31

Triglycerides normal levels

Answer 31

<150mg/dL

Question 32

TC-to-HDL ratio

Answer 32

higher the ratio the greater the risk for developing atherosclerosis (optimal is <3.5)

Question 33

other optional ratio besides tc-to-hdl (do not use this)

Answer 33

LDL/HDL ratio, optimal <4.5 DO NOT USE THIS

Question 34

RF list for Statin therapy

Answer 34

dyslipidemia as detected by screening labs(LDL>130 or HDL <40) DM HTN Smoker

Question 35

One method for Statin plan

Answer 35

tx until LDL goal is reached then maintain that dose.

Question 36

other labs for CVD eval

Answer 36

Apolipoprotein A and B. lower the ratio, the higher the risk bc it mimics A/B ~ LDL/HDL

Question 37

Exercise and LDL

Answer 37

changes make-up of LDLs found in plasma by reducing the portion of LDLs that are oxidized