Quiz #2 Flashcards
DDX for fatigue
Cancer Anemia Depression Endocrine Malabsorption/Nutritional Def. HIV Sleep Apnea
3 Most common causes of fatigue
Depression
Thyroid
Anixety
Anemia PE Findings
Conjunctiva pallor Nail beds pallor SOB; tachycardia Delayed cap refill Petechiae Jaundice
Labs to order for fatigue
CMP CBC with iron panel Thyroid panel Lipid panel UA Glucose Hemoccult
Risk factors for DM
Age > 45 y/o 1st degree relative with DM HTN Dyslipidemia Gestational DM Obesity Sedentary lifestyle
Diagnosis Criteria for DM
- two fasting glucose > 126
- one glucose level > 200 w/ sx
- A1c > 6.5%
- positive 2 hr oral glucose tolerance test
Signs/Symptoms of hypothyroidism
Constipation Weight gain Fatigue Hair loss Constipation Menstrual irregularities Cold intolerance
PE Exam Findings for hypothyroidism
Weight gain
Hair loss
Decreased/slow relaxation phase on DTRs
Dryness in skin
Labs for hypothyroidism
CBC CMP Thyroid panel Iron study (after thyroid result) Blood glucose Lipid panel
Signs/Symptoms of hyperthyroidism
Weight loss heat intolerance Anxiety Palpitations Tachycardia Hyperdefecation Menstrual irregularities
PE Findings of hyperthyroidism
Exophthalmos Pretibial myxedema Tachycardia Dry skin Lid retraction Thyroid may be diffuse, firm Hyperactive bowel sounds Tremor
Tx for hyperthyroidism
Methimazole
PTU
Radioactive Iodine Ablation
Beta Blocker
Risk Factors for Thyroid Cancer
Head/Neck Radiation Family hx of thyroid CA Rapid growth Hoarseness, vocal cord paralysis Dysphagia Calcifications (salted appearance) Cervical lymphadenopathy
Types of Thyroid Cancer
- Papillary
- Follicular
- Medullary
- Anaplastic
Thyroid Nodule Workup
- Check TSH
If TSH high/normal, ultrasound
If TSH low, thyroid radioactive iodine uptake scan - If uptake cold, biopsy
- If uptake warm, do not need biopsy unless characteristics of cancer
- If ultrasound shows > 1-1.5 cm, biopsy
- If > 0.5 with characteristics of cancer, biopsy
Common causes of anemia
Menses GI bleed Pregnancy PCOS Drugs
Signs/Symptoms of anemia
Dyspnea on exertion
Fatigue
palpitations
Chest pain/syncope if severe enough
Iron deficiency lab results
Low serum iron, high TIBC, low ferritin, high platelet count