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)
Most common anterior pituitary hormone disorder after brain trauma
Growth hormone deficiency
Dx: IGF-1 measurement
Hypertension control in pheochromocytoma
alpha blockade BEFORE beta-blockade
Somogyi phenomenon
The lower the blood glucose level decreases during the night, the higher it increases the next morning because of increasingly severe rebound hyperglycemia
Dawn phenomenon
An elevation in blood glucose levels during the early morning hours (4 AM-8 AM) that is thought to be related to the increased physiologic release of cortisol and growth hormone that occur during this time period
Factors that can change sex binding hormone globulin
- Obesity
- Older age
- Insulin resistance
Why you might want to check a free testosterone level
Examples of dopamine agonists
Bromocriptine, cabergoline
Treatment of diabetic neuropathy
(1) Topical capsaicin cream
(2) TCAs (desipramine)
(3) SNRIs (duloxetine)
(4) Antiseizure meds (gabapentin, pregabalin, carbamazepine, phenytoin)
Thyroid malignancy associated with Hashimoto’s
Thyroid lymphoma
