Endocrino Flashcards

1
Q

Tx cancer thyroïde

A

1- Propylthiouracil ou methinazole (anti-thyr pr rendre pt euthyr)
2- lugol (iode) jr de chx = stop relache t3-t4
3- thyroïdectomie quasi-total (épargne parathyroïdes), + tx ablatif Iode 131
4- post-chx: synthroide de remplacement
5- suivi: thuroglobuline + TSH + echo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Sx hyperthyr piste vers mx A-I

A

Vitiligo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Présence goitre si adenome thyroidien?

A

Non reste de la glande = atrophique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Triade de Whipple (Sx hypoglycémie)

A

1- hypoglycemie capillaire
2- Sx neuro/adrénergiques
3- soulagé en <10 min par carbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Definition acidocetose db

A

Glycemie >13.8
pH <7.3
HCO3 <15
Cetonurie/emie modere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Tx acidocetose db

A

1) NS 1L/h IV
2) tx causal
- augm apport liq selon stab hemodyn
- Insuline IV 0.10 U/Kg bolus IV: vise chute glycemie 2.5-4 mmol/l/h, qd atteint glycemie <10 : passage insuline sc (5-10 U q 3h) et admin glucose
- K: si <3.3 admin 40 mmol/L IV, si 3.3-5.4 admin 20-30 mmol/l IV, controle q 2h
- HCO3: si pH <6.9 admin NaHCO3 100mmol/2h IV, si pH 6.9-7 admin NaHCO3 50 mmol/1h IV controle q 2h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Definition etat hyperglycemique hyperosmolairs

A
Glycémie >33 
PH >7.3
HCO3 >15
Osm >320 (2x Na + glycemie + uree)
Pas de cetones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Tx etat hyperglycemiqur hyperosmolaire

A

1) NS 0.9% 1L/h IV
2) tx causal
- augm apport selon stab hemodyn
- Insuline: bolus 0.15 U/Kg IV puis maintient a 0.10 U/Kg IV, controle q 1h, switch a sc qd alimentation PO
- K: si <3.3 admin 40 mmol/L IV, si 3.3-5.4 admin 20-30 mmol/L IV, controle q 2h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

CAT nodule thyroidien

A
  • TSH: si diminué, alors scinti/captation iode
  • mesure CEA + calcitonine
  • echo
  • biopsie aspi aiguille fine (tout nodule >1 cm)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

3 sx primaires Db type 1

A

Synd polyuropolydipsique
AEG
Amaigrissement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Complications macrovasculaires db

A

Coronaropathie
ACV
Arteriopathie MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Complications microvasc db

A

Retinopathie
Nephropathie
Neuropathie

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cibles therapeutiques db

A
Glycemique: HbA1C <7%
HTA: <130/80
DLP: LDL<2 et n-HDL <2.6
Depister et traiter complications
Changement habitudes de vie
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Checklist protection vasculaire db

A
ABCDEF
A1C: controle glycemie optimale <7%
BP: <130/80
Cholesterol: LDL <2
Drugs: pour protection cardiaque = A (ACEI) + S (statine) + A (ASA) 
Exercice: >3x 30 min/sem 
Fumer: cesser
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Sick euthyroid syndrom

A

“Syndrome de la T3 basse”

-toute maladie/infection/condition grave peut entrainer dim T3 2r. Dim act D1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Carcinome thyroïdien le plus frequent

A
Carcinome papillaire (80%)
-mesure la thyroglobuline
17
Q

MC exces androgène chez la femme

A

1- Hirsutisme, Acné, alopécie
2- arret developpement folliculaire
A) ovaires polykystiques
B) anovulation
-sgmt anovulatoire: cycles irreg
-subfertilité
-dim relâche progesterone = augm estrogene non oppose = hyperplasie endometre = augm risque cancer endometre

18
Q

Cause pseudo-cushing syndrom

A

ROH
DEPRESSION
OBESITE

19
Q

MC secretion ACTH ectopique

A

MINCE
HYPERPIGMENTÉ
FAIBLE ++: via myopathie et hypoK
HYPOK MARQUÉ

20
Q

Insuffisance surrenalienne 1r vs 2r

A

1r = deficit en mineralo ~> hypoNa et hyperK

2r = deficit en gluco ~> hypoNa (SIADH) et normoK

21
Q

Crise surrénalienne

A

Pt c hypocorticisme 1r (addison) qui subit un stress

  • Fatigue profonde
  • deshydratation
  • HypoTA
  • IR: hypoNa, HyperK, Acidose metabolique
22
Q

Ddx cause maladie addison

A
ADDISON 
A-I (90%)
Degenerative: amyloïde
Drugs: ketoconazole
Infection: Tb, Vih
Secondaire (ACTH faible): hypopituitarisme
Others: saignement surrenalien
Neo: carcinome 2r
23
Q

MC syndrome cushing

A
CUSHING 
Central obesity, Collagen fiber weakness, Comedones
Urine free cortisol and glucose increas
Striae, Suppressed immunity
Hypercorticism, Hta, Hyperglycemia, HyperDLP
Iatrogene
Neo
Glucose intolerance, Growth retardation
24
Q

Impact menopause sur organes (ie dim œstrogène)

A

1- SNC/Stab vasomoteur: chaleurs, sueur nocturne, tr sommeil ~> depression, fatigue diurne
2- muqueuse urogenitale: augm IU stress, augm risque prolapsus organe pelvien, a/n vagin = augm secheresse, irritation, infections et dyspaneurie
3- cardiovasc: augm AOS = augm risque IM
4- os: Osteoporose

25
Q

Labos hypercalcemie

A
TSH
Electrolytes
Phosphore
Palc
Uree, creat
PTH
EPP proteines seriques
RXP
26
Q

Tx aigue hyperCa

A
  • Normal salin
  • si sévère, furosemide + NaCl
  • si MM, lymphome, maladie granulomateuse: corticostéroïdes
  • Si Neo: biphosphonates
27
Q

Etat necessitant augmentation dose levothyroxine

A

TRH

Synd Nephrotique

Synd malabsorption

Grossesse

28
Q

Causes perte de poids c augm appetit

A

Hyperthyroïdie

Db non-contrôlé

Synd malabsorption

Anorexie nerveuse

29
Q

Mnemonic ddx personne âgée c perte ponderale

A
9D
Dentition
Démence 
Depression
Diarrhée
Drogue
Dysfonction
Dysgueusie
Dysphagie
Disorders: cardiac, pulmo, renal severe
30
Q

Bilan perte ponderal

A

Depistage selon age: mammo, colo, pap test

  • Fsc, electrolytes, Ca, TSH
  • pcr
  • Test VIH
  • Test fonction rein et foie
  • RxP
  • Analyse urine