high yield 4 Flashcards
paget disease bone
labs, signs, tx
- enlarged skull + deaf
- bone pain
- increase ALK PHOS
tx: bisphosphonates
myxedema coma
extreme hypothyroidism
- bradycardia
- hypothermia
- hypotension
Addison’s disease Lab
hyponatremia, hyperkalemia
Addison’s dx
HIGH dose ACTH ( Cosyntropin) stim test
Addison tx
corticosteroid replacement
1st- hydrocortisone
mineralcorticoid repalcement- fludrocortisone
addisonian crisis
addisons disease + shock
caused by stressor
cushing’s endogenous cause
pituitary adenoma leading to ACTH overproduction
Cushing’s dx
1st -24 hour urinary free cortisol
high dose dexamethasone suppression test
Cushings labs
hyperglycemia, hyokalemia, dyslipidemia, met alkalosis
Conn’s syndrome
adrenal aldosteronoma
primary hyperaldosteronism
renin-independent
bilateral adrenal hyperplasia
or conn’s ( adrenal aldosternoma)
primary hyperaldosteronism
sxs
TRIAD:
HTN, low K, met alkalosis (similar to cushings)
tx of primary hyperaldosteronism
bilat hyperplasia: spironolactone + ACEi
conn: spironolactone + surgical excision
primary hyperthyroidism
dx
aldosterone to renin ration
ARR >20:1
Pheochromocytoma
s/s
P: palpitations
H: Headache (MC)
E: excessive sweating
Pheochromocytoma
dx
24hr urine fractionated catecholamines
–> increaased metanephines and vanillylmandelic acid
Pheochromocytoma
tx
- nonselective alpha blockade : PHEoxybenzamine or PHEntolamine 1-2weeks
- FOLLOWED by Beta blockade
( can lead to HTN crisis if BB first!!) - SURGERY- -2 weeks after meds
med causes of hypothyroidism
- lithium
- amiodorone (also causes hyperthyroidism)
- alpha interferon
