Endocrinology Workshop Flashcards
What should be the correct starting dose of levothyroxine?
25mcg daily or on alternative days, increased slowly by 25mcg every 4-6 weeks until managed.
What impact would high dose levothyroxine have on a patient with angina?
Make it worse.
What is the dose of aspirin for seconday prevention of cardiovascular disease?
75mg
What is the reference range to aim for in those with newly diagnosed primary hypothyroidism?
Lower half of: 0.4 - 2.5mU/L
What is the statin of choice for those recieving treatment for secondary prevention of cardiac disease?
80mg Atorvastatin.
LFTs, baselin U&Es, myopathy,
Initially, 3 months, Annually.
Cholesterol reduction, aim for 40% reduction in non-HDL.
What are the targets for cholesterol reduction?
40% non-hdl reduction.
Why should levothyroxine be taken on empty stomach?
Food can reduce absorption by up to 40%.
How long should hyperthyroid patients be on beta blocker?
Only until the condition is managed.
What is the target cholesterol range?
5mmol/L
What are the main type of medication used to treat hyperthyroidism?
Thionamides.
Carbimazole and propylthiouracil.
How long do patients normally take thionamides before any benefit?
A month or two.
How does Carbimazole functions?
Inhibits the organification of iodide and hence, the synthesis of thyroid hormones.
Why do patients taking Carbimazole need to be aware of the development of sore throats?
Immunosupressive activity - very important.
Of spontaneuous causes of Cushings, what percentage are due to pituitary ACTH producing tumour?
70%
Of spontaneuous causes of Cushings, what percentage are due to ectopic ACTH production?
15%
Of spontaneuous causes of Cushings, what percentage are due to a primary adrenal tumour?
15%
Why are pituitary adenomas hard to identify?
MRI only detects 70% of them, <1cm in size.
Food reduces the absorption of levothyroxine by how much?
40%
Aspirin is used for _______ prevention of cardiovascular disease.
Secondary never primary.
What is the TSH reference range?
0.4 - 4.0mU/L
What can cause AF?
Hyperthyroidism.
What monitoring is important for carbimazole?
Sore throat - immunosuppressive.
A curb score of 3 indicates what?
Severe infection
What would be an appropriate CAP treatment?
Co-amoxiclav 1.2g TDS IV
Clarithryomycin 500mg BD IV
How often should co-amoxiclav for CAP be administered and at what dose/route?
Co-amoxiclav 1.2g TDS IV
How often should clarithromycin be administered and at what dose/route?
Clarithromycin 500mg BD IV
What is an appropriate dose of a VTE prophylactic agent?
Dalteparin 5000UI s/c od.
Why do we need to control the hydrocortisone/steroid doses of a person in hospital who has addisons disease?
So that their body can cope with the stress of being in hospital.
