Endocrinology Flashcards
Next step in management for pituitary mass/incidentolomas
Check functionality (Prolactin, TSH/T4, IGF1, 1mg DMS test)
Clinical features of prolactinoma/hyperprolactinemia
Management
F: galactorrhea, amenorrhea
M: impotence, decreased libido
Dopamine agonist
(Bromocriptine, carbegoline)
Surveillance for prolactinoma
> 1cm: MRI q6mo + visual field testing
< 1cm: MRI q1year
DM drug of choice in kidney disease
Meglitinides
DM Med to avoid in obese
Sulfonylureas (ie glyburide)
DM drug of choice in obese
Metformin
DM Med to avoid in kidney disease
Metformin
Acarbose
DM Med to avoid in CHF
Thiazolidinediones (ie pialitazone)
Side effects of GLP-1 agonist (ie liraglutide) and DPP-4 inhibitors (ie sitagliptin)
Pancreatitis
Side effect if SGLT2 inhibitors (ie empagliflozin)
UTI
Euglycemic Ketoacidosis
Fourniers gangrene
False elevation of HbA1c
Decreased RBC turnover Anemia (iron, B12, folate def) ESRD Asplenia Hemiglobinopathies Sickle cell trait
Falsely lower HbA1c
Increased RBC turnover Hemolytic anemia HIV Blood transfusions Iron, B12, folate def treatment EPO
Most common bacteria in diabetic foot ulcer
Staph aureus
Elevated proinsulin
Elevated c-peptide
Elevated insulin
Sulfonylurea use
No proinsulin
No c-peptide
Elevated insulin
Insulin use
Very Elevated proinsulin
Elevated c-peptide
Elevated insulin
Insulinoma
RAIU with diffuse uptake
Grave’s disease
TSH adenoma
RAIU with areas of increased uptake surrounding by areas of decreased uptake
Multinodular goiter
RAIU with areas of increased focal uptake surrounded by area of decreased uptake
Toxic nodule
RAIU with < 5% uptake
Thyroiditis
Next step in management for hypopituitary hypothyoidism
ACTH stim test
r/o adrenal insufficiency
Treatment for thyroid stone
Beta blockers
Then steroids
TrAb (thyroid receptor Ab)
Graves
Treatment for myxedema coma
Steroid + T4 + T3 + Abx
Management of levothyroxine during pregnancy
Increase dose by 50%
Thyroid nodule
High TSH
Cold
FNA
Thyroid nodule
Low TSH
Hot
RAIU