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PRP2 > Endocrine - Thyroid/ Steroids > Flashcards

Endocrine - Thyroid/ Steroids Flashcards

1
Q

Hyperthyroidism Biomarkers

A

High T3 & T4

Low TSH

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2
Q

Hyperthyroidism symptoms

A

Hyperactivity
Insomnia
Diarrhoea
Weight loss
Increased appetite
Goitre

HIDWIG

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3
Q

Hyperthyroidism Treatment 1st line?

A

Carbimazole

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4
Q

Hyperthyroidism treatment 2nd line?

A

Propylthiourouracil

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5
Q

Propylthiouraricil side effect?

A

Risk of Liver disorder or Jaundice

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6
Q

Graves’ disease is hypo or hyper thyroidism?

A

Hyperthyroidism

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7
Q

Graves’ disease treatment 1st line?

A

Radioactive iodine

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8
Q

Graves’ disease remission treatment?

A

Consider carbimazole

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9
Q

If iodine or surgery not tolerated in Graves disease then?

A

Carbimazole and levothyroxine (block and replace ) combo or alone
12-18 months

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10
Q

Which drug to use in Hyperthyroidism in pregnancy 1st trimester?

A

Propylthiouracil

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11
Q

Which drug to use in Hyperthyroidism in pregnancy 2nd and 3rd trimester?

A

Carbimazole

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12
Q

Why can’t propylthioracil be used in 2nd or 3rd trimester?

A

Due to propylthiouracil being hepatotoxic in 2nd and 3rd trimester

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13
Q

Hypothyroidism biomarkers?

A

Low T3 and T4

High TSH

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14
Q

Hypothyroidism symptoms?

A

Fatigue
Weight gain
Cold intolerance
Constipation

Menstrual irregularities
Depression
Dry skin

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15
Q

Hyperthyroidism metabolism?

A

Increased metabolism

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16
Q

Hypothyroidism metabolism?

A

Decreased metabolism

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17
Q

Hypothyroidism 1st line treatment?

A

Levothyroxine

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18
Q

Monitoring in levothyroxine and how frequent?

A

Monitor TSH, 3months until stable then yearly

19
Q

Levothyroxine counselling?

A

Take in the morning, 30mins before breakfast or caffeine

20
Q

Benefit of Liothyroxine rather than levothyroxine?

A

More potent, more rapid output

21
Q

Which is more potent, levothyroxine or liothyroxine?

A

Liothyroxine

22
Q

Liothyroxine brand importance?

A

Non uk brand may not be bio equivalent

23
Q

Mineralcorticosteroid fluid retention and inflammatory effect?

A

High fluid retention and low inflammatory effect

24
Q

Highest mineralcorticosteroid activity drug?

A

Fludrocortisone

Hc also has high activity

25
Q

Postural Hypotension treatment?

A

Fludrocortisone (fluid retention)

26
Q

Mineralcorticoid steroid - Fludrocortisone side effect?

A

Hypertension
Hypokalaemia
Hypocalcaemia

27
Q

Corticosteroid anti inflammatory effect and fluid retention?

A

High Anti Inflammatory effect

Low fluid retention

28
Q

Highest glucocorticoid activity drug?

A

Dexamethasone & Betamethasone

29
Q

Which other glucocorticoid steroids have high activity?

A

Prednisolone, prednisone, Deflazacort

30
Q

Glucocorticoids side effects?

A

Diabetes
Osteoporosis
Muscle wasting
Gi ulcer & perforation

31
Q

Corticosteroid symptoms

A

Cushing syndrome
Osteoporosis
Retardation of growth
Thin skin
Immunosupression
Chorioretinopathy
Oedema
STriae (stretch marks)
Emotional disturbance
Rise in BP
Obesity
Increase hair growth
Diabetes (Hyperglycaemia)
Ulcers
Suppression
Electrolyte imbalance (Hypokalaemia)

CORTICOSTEROIDUSE

32
Q

Moon face, Striae, Acne, Hirsutism describes what condition?

A

Cushing Syndrome

33
Q

Cushing syndrome treatment and management?

A

Treat with Ketoconazole

Manage with Metyrapone

34
Q

How to stop insomnia from steroids?

A

One dose in the morning

As cortisol is produced in morning

35
Q

Steroid use in children major side effect to consider?

A

Stunting growth even with inhalers

36
Q

Steroid immunosuppression - risk of which infections?

A

1) Chickenpox

2) Measles

37
Q

How to prevent steroid use chicken pox from occurring?

A

Varicella Zoster vaccines

38
Q

How to prevent steroid use measles infections from occurring?

A

Prophylaxis IM immunoglobulin

39
Q

MHRA warning associated with Corticosteroids?

A

Chorinoretinopathy

Symptoms: Blurred vision, visual disturbances

40
Q

Corticosteroid other MHRA warning?

A

Psychiatric Reactions

41
Q

Steroid withdrawal criteria?

A

1) Over 40mg daily over 1wk

2) Repeating evening doses

3) Over 3week treatment

4) Short course with 1 year of stopping long term therapy

5) Other possible causes of adrenal suppression

42
Q

Topical steroid mild to very potent list?

A

Mild -> Hydrocortisone

Mod -> Clobetasone

Potent -> Betamethasone

V. Potent -> Clobetasol

***Sol means sole one and only strong

43
Q

Adrenal insufficiency- Addison disease treatment?

A

Hydrocortisone

Primary also treated with Fludrocortisone

44
Q

Adrenal crisis?

A

Severe Dehydration
Seizure/ stroke
Cardiac arrest

PRP2 (74 decks)

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