- COOL THEM DOWN, IVF to help hypotension - 1. beta blocker to reduce autonomic symptoms 2. PTU/methimazole 3. steroids (reduce peripheral conversion of T4)

OME/Books Flashcards by Christian Bernardo

hyperthyroidism then RAIU cold thyroid

hashimotos (t4 leaks out then shrivels)

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multinodal goiter vs toxic adenoma

multiple in multinodal

one in toxic adenoma

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woman in health care field, has body image issue, then has hyperthyroidism

struma ovarii (check ovary scan)

FACTICIOUS CONSUMPTION T4

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rx thyroid storm

COOL THEM DOWN, IVF
to help hypotension
1. beta blocker to reduce autonomic symptoms
  1. PTU/methimazole
  2. steroids (reduce peripheral conversion of T4)

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rx multinodal goiter, struma ovarii, toxic adenoma

radioactive iodine ablation

PTU/methimazole (thiodamides)

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TPO antibodies

hashimoto’s or grave’s

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MCC hypothyroidism

hashimoto’s (get TPO/TSI)

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hypo version of thyroid storm

myexedma coma (coma, hypotension, hypothermia)

give IVF, blankets, IV T4/T3

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recent stressor/surgery/infection, patient develops hypotension, diffuse abdominal pain/tenderness, fever

acute adrenal insufficiency

rx with dex/hydrocortisone

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risk factors for preterm delivery

PRIOR HX OF PRETERM
multiple gestation
hx cervical surgery (i.e. cold knife cone)

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imaging to evaluate risk of preterm delivery

TVUS for measurement of cervical length

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what to give @ 24 weeks to lower risk of preterm delivery

progesterone ingestion (maintains uterine quiescene and decreases risk preterm delivery)

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what to watch out for in acyclovir

crystal induced AKI

watch out for kidney stones that can cause obstruction

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patient with nephrotic syndrome develops acute abdominal pain, fever, hematuria

RVT

a/w MEMBRANOUS GLOMERULOPNEPHROPATHY

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sudden onset acanthosi nigracans OR any explosive onset of sebhorric derm a/w?

underlying malignancy

normal acanthosis usually in younger patients, insulin resistant states

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anti TPO antibodies a/w with higher risk of?

miscarriage

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transferrin sautration = ?

Iron/TIBC

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MCC cervical lymphadenitis in children

staph aureus (think bacterial infection)

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what to do when you find hyperfunctioning thyroid nodule on biopsy

treat hyperthyroid

LOW RISK MALIGNANCY

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what to do when non functioning thyroid nodule?

RISK FOR CANCER
u/s or go straight to FNA

esp if BIG (>1CM)

what to do with non functioning thyroid nodule <1 cm

watch and wait

repeat U/s in 6-12 months to see if growing

4 types thyroid cancer

papillary
follicular
medullary
anaplastic

orphan annie nuclei

papillary thyroid cancer

(BIG EMPTY NUCLEI) CLEAR CIRCLES

which cancer spreads hematogenously

follicular (resembles thyroid tissue)

RET oncogene

MEN 2a/2b syndromes | medullary thyroid cancer

parafollicular/C-Cells

medullary thyroid cancer

pheochromocytoma a/w which kind of thyroid cancer

medullary thyroid cancer

rx papillary thyroid cancer

resection

rx painless thyroiditis (palpitations)

beta blocker

MCC adverse effect inhaled corticosteroid therapy

thrush other (more high dose, less common) - cataracs, adrenal suppression, purpura, decreased growth in children

risk of RAI in Grave's

permanent hypothyroidism

pathophys sickle cell disease SCD

glut -> val subs on chrome 16 causing mutated B2 -> HgB SS

a2Y2 (gamma)

HgbF

GI side effect SCD

hemolysis -> elevated unconj bili -> pigmented gallstones -> may need chole later smear shows sickles? = CRISIS

how to help determine if SCD patient is in crisis?

compare to baseline bili, Hgb, retics

Prophylaxis children with SCD

prophylactic PCN until age 5

bone effects SCD

avascular necrosis OSTEO (with salmonella) but overall most common is staph

acute chest components (3)

chest pain SOB PULMONARY EDEMA

besides acute chest/pain crisis what other acute finding in acute sickle (2)

priapism | STROKE/FND

rx acute crisis SCD

IVF, O2, pain control

prophylaxis acute pain crisis

HYDROXYUREA (increase HgBF)

HgbSC vs HgBSS

SC - not disease, trait, minor baseline anemia, one recessive, counsel pregnancy SS - full on disease

HgB0

worst SCD

ECG finding hypocalcemia

QTC prolongation

how does pregnancy affect thyroid levels

bHCG INCREASES thyroid hormone estrogen increases thyroid binding globulin (increase in TOTAL not free T4) ALL TO HELP KEEP UP WITH INCREASE METABOLIC DEMAND

hospitalized patient TPN develops hypophos, hypok, hypomag...develops arrythmias, cardiopulmonary failure

refeeding syndrome esp dangerous in anorexia INCREASED INSULIN causes this

how can lymphoma affect Ca

can cause incerased 1,25 vit D to increase Ca absorption, lower PTH, increase vit D (part of hypercalcemia of malignancy)

4 characterisitcs of MEN 2B

neuromas medullary thyroid pheochromocytoma MARFANOID HABITUS

primary adrenal insufficiency vs central

primary - usually autoimmune, low cortisol, high ACTH, low aldosterone central - usually due to chronic glucocorticoid, low ACTH, low cortisol, NORMAL ALDOSTERONE