Endocrine Labs Flashcards
Diabetes dx
-Random Blood Sugar: 200mg/dL with DM symptoms
-Fasting Blood Sugar: > or = 126mg/ dL after 8 hr fast on an Initial screening test
-Oral glucose tolerance test: glycemic response after a 75g glucose load, if 2 hrs post glucose >200 mg/dL
-HgbA1C: >6.5% -> Also used for monitoring tx
-steroid use can increase sugar
HgbA1C
-4 months
-8-12 week glucose average
-RBC in a sugar bath -> saturated
Criteria for diabetes dx
-1. A1c >= 6.5%
OR
-2. FPG (fasting plasma glucose) >= 126 (7mmol/L) -> 8 hours fast
OR
-3. 2 hour plasma glucose >= 200 (11.1mmol/L) during an OGTT- 75g glucose drink
OR
-4. in a pt with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose >= 200
current guidelines: sugars
-Retest every 3 years when fasting glucose <100mg/dL or A1C <5.7%.
-Retest every 1-2 years when fasting glucose is 100 to 125 mg/dL or 5.7-6.4 %
-Counseling on smoking cessation, diet, exercise.
-Diabetics should have intensive lifestyle counseling
categories of increased risk for diabetes: PREDIABETES
-A1C 5.7 to 6.4%
-FPG 100-125 (5.6-6.9)
-2 hour post load glucose on the 75 OGTT 140-199
screening
-screening for diabetes in adults aged 45 years or older and screening in persons with multiple risk factors regardless of age
point of care glucose
-finger prick
-Monitoring before meals
-Assessing for hypoglycemia or hyperglycemia
-Not used for diagnosis
-under 126 is goal (she said this)
-not used for dx just monitoring
microalbuminuria
-early marker of nephropathy
autoantibodies: type 1 diabetes
-Pancreatic autoantibodies against one or more:
-for type 1 diabetes you test for autoantibodies ***
-dont need to know specifics:
-GAD65,
-IA2
-Insulin
-ZnT8
what you need to know for test
-normal
-pre-diabetes
-diabetes- 6.5 or greater
-diagnosis and target value is different for all
thyroid hormones
-TRH – thyrotropin releasing hormone. Hypothalamus, induces TSH.
-TSH- Thyroid Stimulating Hormone. Anterior pituitary, stimulates thyroid.
-T3- Triiodothyronine. Thyroid gland
-T4- Thyroxine. Thyroid gland (active)
-TGB- Thyroid binding globulin -> Plasma protein for transport
-Free T4**- unbound to protein -> Better indicator of thyroid status
-free T4 is what you typically order
continuous glucose monintor
-prevents hospitalizations
-on your body 247
-monitors glucose every 3 mins
-A1c monitored
-only used for injection therapy as of right now
endocrine hormone pictures
thyroid hormone negative feedback
anti-thyroid antibodies
-Anti- TPO: Anti-thyroid peroxidase antibodies -> Antibodies against a protein in the thyroid gland that produces thyroid hormones -> Autoimmune thyroid disease
-Anti- TG: Anti-thyroglobulin antibodies
-same antibodies cause hypo and hyperthyroidism
hyperthyroidism
-Thryotoxicosis
-Nervousness, palpittions, muscle weakness, heat intolerance, weight loss, perspiration, exophthalmos, fine tremor of hands.
-Low TSH, high free T4
-Graves disease (autoimmune, TSH receptor antibodies), toxic multinodular goiter, toxic adenoma
-thyroiditis
initial screening modality for thyroid abnormality
TSH
-T3, T4, and antibodies -> if TSH is abnormal
hyperthyroid: toxic multinodular goiter, toxic adenoma, thyroiditis, painless thyroiditis
TOXIC MULTINODULAR GOITER
-Less severe
-Normal to high radioactive uptake
-Iodine localized to active nodules
-hot nodule -secreting T3 and T4
TOXIC ADENOMA
-Adenoma that secretes thyroid hormone
-Radioactive uptake local to adenoma
THYROIDITIS
-Viral infection
-Eventual return to normal
-NO radioactive uptake
-Can progress to hypothyroid after inflammation
PAINLESS THYROIDITIS
-Drug reaction
-Low TSH, elevated Free T4 & T3
-LOW radioactive uptake
hypothyroid
-Infants: cretinism
-95% issue in the thyroid
-Increased TSH, low free T4
-High anti-TPO = Hashimoto thyroiditis 90% of hypothyroid cases
-Dry hair, dry skin, cold intolerance