Endocrine SM Flashcards
What is the first lab to order for thyroid evaluation?
TSH
A high TSH, low T3/T4 is
hypothyroidism
A low TSH, high T3/T4 is
hyperthyroidism
First line medication for hypothyroidism? What organ will this commonly effect?
levothyroixine/Synthroid
cardiac effects - start low in elderly
How often is TSH rechecked?
every 4-6 weeks
First line medications for hyperthyroidism
beta blocker
Tapazole, PTU (PTU first trimester, then Tapzole 2nd)
What is the purpose of the parathyroid?
calcium and phosphorus levels
What happens in hyperparathyroidism? What is a possible concern?
Ca is HIGH
Phosphorus is LOW
malignancy
What happens in hypoparathyroidism?
Ca is LOW
Phosphorus is HIGH
What is happening in type 1 diabetes? What will this patient develop/how do you find out they are type 1?
antibodies destroying beta cells = insulin dependent
DKA - ketones
Somogyi vs Dawn effect
hyperglycemia upon awakening
S: drop in glucose 1-2 am, high in morning (exercise before bed, insulin doses)
D: steady rise in glucose all night long (increase in growth hormone)
What A1C determines diabetes?
6.5%
What labs should be monitored for Metformin?
renal (eGFR <30 STOP!, <46 decrease dose)
stop if CT with contrast
B12
Side effects of Metformin? Max dose? Anemia? Also treats what?
GI distress
2550 mg per day
B12 deficiency
PCOS in females
How is type 2 diabetes diagnosed?
A1C
2 random glucose
fasting glucose
OGTT
When should insulin be initiated for type 2 diabetes?
> 9% A1C
What diabetic medications are likely to cause hypoglycemia?
sulfonylureas (zide, mide, ride)
TZDs
What diabetic medications are cardioprotective?
GLP-1 (tides)
SGL2 (gliflozin)
What annual screenings are necessary for diabetics?
Podiatrist
Ophthalmology
Microalbumin in urine - kidney
What are long acting insulins?
L
Lantus
Levemir
What are the expected signs and symptoms of Addison’s disease?
too little cortisol - addrenal insufficiency (needs steroids) hyperpigmentation - dark/tan ammenorrhea crave salt weak weight loss excess urine all labs are LOW except potassium - hyperkalemia
What is the biggest concern of Addison’s disease?
addisonian crisis
need emergency kit of steroids
What are expected signs and symptoms of Cushing’s disease?
too much cortisol - too much steroid drugs
moon face
purple striae
abdominal obesity, thin arms and legs
osteoporosis, excess sweating/hairiness/hunger, high BP
labs are HIGH except potassium - hypokalemia
How is Lupus diagnosed?
ANA in conjunction with symptoms
What are expected findings of lupus?
malar rash - butterfly, spares nasolabial folds
raised red patches, light sensitivity, ulcers in mouth, arthritis/swelling/tenderness, protein in urine
What organ is affected the most by lupus?
kidneys
Sjogren’s syndrome consists of?
dry eyes and mouth
