METABOLIC Flashcards

1
Q

What is the most common etiology for hypothyroidism?

A

Hashimoto’s (autoimmune)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the classic sxs of hypothyroidism?

A

Constipation, weight gain, fatigue, cold intolerance, menstral irregularities, and hair loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The TSH is elevated – what diagnosis?

A

Hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What should we remember about TSh levels in the elderly?

A

They are higher than normal, thus higher target ranges (4-6)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do we treat hypothyroidism?

A

Levothyroxine (Synthroid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the most common cause of hyperthyroidism?

A

Graves disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the classic sxs of hyperthyroidism?

A

heat intolerance, weight loss, hyperdefecation, anxiety, and tachy/palpitations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

TSH is low – what diagnosis? What else do you check?

A

Hyperthyroidism

Need to check free T4 (which would be elevated)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do we treat hyperthyroidism?

A

Beta Blockers, PTU or Methimazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What would the diagnostics show that would indicate diabetes?

A

NON-fasting glucose >200

Fasting glucose >126

2-h OGTT >200

HbA1c >6.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some lifestyle recommendations we can make for diabetes?

A

Mediterranean diet, high fiber, weight loss, exercise!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In a healthy elderly person, what should the goal A1c be?

A

7-7.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In a complex elderly person what should the A1c goal be?

A

7.5-8%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Can we use the sliding scale in a nursing home setting?

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do we give corrective insulin doses for the elderly?

A

1 unit for every 40-50mh/L in excess of 140 at fasting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If an elderly person has poor oral intake how do we treat their diabetes? In comparison to someone with good oral intake?

A

Poor intake = Basal + Correction only

Good Intake = Basal & Prandial insulin + correction (rapid-acting asprat or lispro)

17
Q

What does a diabetic pt need done annually?

A

eye & dental exams

Comprehensive foot eval

Lipid profiles (not needed once stable)

Microalbuminuria

Serum Cr

18
Q

What does a diabetic pt need done initially after their diagnosis?

A

Screen for PAD

Sxs of neuropathy

Detailed eye exam

19
Q

What is considered concerning weight loss in the elderly?

A

> 2% in 1 month

10lbs in 6 months

> 4% in 1 year

20
Q

In a hospitalized pt we are concerned about malnutrition what must we consider checking?

A

Dietary intake, hypoalbuminemia, hypocholesterolemia

CBC, CMP, ESR, CXR, TSH, albumin & pre-albumin

21
Q

Should ensure be taken before meals?

A

NO – use in-between meals, don’t give during meal time