Endocrinology Flashcards
Metabolic syndrome
TG > 150 Abdominal obesity (>40in men; >35in women) Fasting glucose >100 BP >130/85 HDL <50 women
Goal cholesterol for 0 or 1 CHD risk factors
LDL <160
Goal cholesterol for 2 or more CHD risk factors and 10-year risk of MI <10%
LDL <130
Goal cholesterol for 2 or more CHD risk factors and 10-year risk of MI 10-20%
LDL< 130 (optional <100)
Features consistent with benign adrenal mass
- Low CT attenuation (50% at 10 min)
- Size <4cm
- No evidence of excess hormonal secretion.
Repeat testing in 6-12 mos
Cholesterol goal if CHD or CHD risk equivalents or 10-year risk of MI>20%
LDL <70)
Biochemical work up of adrenal incidentaloma
Urine metanephrines (pheo) Cortisol (Cushing) Aldo/renin ratio (hyperaldo) if HTN present
Anti-thyroid peroxidase (TPO) antibodies
Hashimoto thyroiditis
TSH-receptor antibodies
Graves’ disease
What blood test makes the dx of central hypothyroidism?
Free thyroxine (T4), in setting of low-normal TSH
ADA diagnostic criteria for diabetes
- Fasting glucose >126
- Random plasma glucose >200
- HgbA1c >6.5
ADA diagnostic criteria for pre-diabetes
- Fasting glucose 100-125
- A1c 5.7-6.4
- Random plasma glucose (or during OGTT) 140-199
Indications for surgical removal of adrenal mass
- Functional tumor
- Unfavorable imaging characteristics (Hounsfield units>20, delayed contrast washout)
- Size >6cm
Workup for gynecomastia in men
- Check testosterone
- If normal, check estradiol –> if high, check testicular u/s + adrenal CT
- If +hypogonadism, check karyotype (Klinefelter)
Indications for FNA biopsy of thyroid nodule
(1) All nodules >1cm with a normal TSH
(2) Nodules <1cm in patient with risk factors (+radiation, fam hx of thyroid cancer) or suspicious U/S characteristics (hypoechoic, microcalcification, blurred nodule margins, increased central vascularity)
