METABOLIC Flashcards
What is the most common etiology for hypothyroidism?
Hashimoto’s (autoimmune)
What are the classic sxs of hypothyroidism?
Constipation, weight gain, fatigue, cold intolerance, menstral irregularities, and hair loss
The TSH is elevated – what diagnosis?
Hypothyroidism
What should we remember about TSh levels in the elderly?
They are higher than normal, thus higher target ranges (4-6)
How do we treat hypothyroidism?
Levothyroxine (Synthroid)
What is the most common cause of hyperthyroidism?
Graves disease
What are the classic sxs of hyperthyroidism?
heat intolerance, weight loss, hyperdefecation, anxiety, and tachy/palpitations
TSH is low – what diagnosis? What else do you check?
Hyperthyroidism
Need to check free T4 (which would be elevated)
How do we treat hyperthyroidism?
Beta Blockers, PTU or Methimazole
What would the diagnostics show that would indicate diabetes?
NON-fasting glucose >200
Fasting glucose >126
2-h OGTT >200
HbA1c >6.5
What are some lifestyle recommendations we can make for diabetes?
Mediterranean diet, high fiber, weight loss, exercise!
In a healthy elderly person, what should the goal A1c be?
7-7.5%
In a complex elderly person what should the A1c goal be?
7.5-8%
Can we use the sliding scale in a nursing home setting?
NO
How do we give corrective insulin doses for the elderly?
1 unit for every 40-50mh/L in excess of 140 at fasting