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Endocrine Flashcards

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1
Q

What is the time interval between changing thyroid medications and re-checking labs to evaluate effectiveness?

A

8 weeks

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2
Q

What two betablockers are effective in treating thyroid toxicosis?

A

Propranolol & Nadolol

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3
Q

Methimazole and PTU can cause damage to what organ?

A

Liver (Liver failure)

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4
Q

How is it best to take levothyroxine?

A

Empty stomach with a glass of water

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5
Q

What is the percent risk that a thyroid nodule is malignant?

A

5%

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6
Q

Thyroxine is abbreviated as?

A

T4

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7
Q

How do you dose thyroid medication in a patient who is overweight?

A

Dose them at their ideal body weight

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8
Q

Menorrhagia is caused by hypo or hyper thyroid?

A

Hypothyroidism

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9
Q

Amiodarone and Interferon can cause which endocrine dysfunction?

A

Hypothyroidism

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10
Q

A normal DTR value is what?

A

2+

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11
Q

What is the goal TSH for a patient receiving treatment for hypothyroidism?

A

0.5-2

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12
Q

A patient on levothyroxine treatment for hypothyroidism returns with a TSH of <0.5. What do I do?

A

Decrease the dose by 12.5-25ug/d

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13
Q

A patient on levothyroxine returns with a TSH of >4. What do I do?

A

Increase the dose by 12.5-25ug/d

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14
Q

Diabetes and Hypothyroidism often go hand in hand because they are both considered what type of disorders?

A

autoimmune

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15
Q

A Normal TSH ranges between what values?

A

0.4-4

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16
Q

Free T4 ranges between what?

A

10-27

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17
Q

TPO should be below what?

A

35

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18
Q

When should we treat subclinical hypothyroidism?

A

Infertility, considering pregnancy, pregnancy. those who are symptomatic, with a goiter, or TPO antibodies

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19
Q

If a patient present with a thyroid nodule what should be done?

A

Draw a TSH and order an ultrasound

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20
Q

What are symptoms of type 1 diabetes?

A

The polys, weight loss, ketonuria

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21
Q

To diagnose diabetes a fasting sugar must be above?

A

126

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22
Q

To diagnose diabetes a random sugar must be above?

A

200

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23
Q

Diabetics have an A1C of > what?

A

6.5

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24
Q

If a patient is meeting their goals how often do you check an A1C?

A

2 X yearly

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25
If a patient is not meeting their goals how often do you check the A1C?
Every 3 months
26
In regards to insulin when is it likely to see a hypoglycemic episode?
During the insulin's peak
27
What is the goal for fasting sugars in a a person with diabetes?
<100
28
What is the goal for 1-2 post prandial sugars in a a person with diabetes?
<140-180
29
In a person with diabetes what is the goal for A1C?
7
30
What is the goal for a person with diabetes who is an older adult?
8
31
What eGFR requires us to STOP metformin
<30
32
Metformin in a patient with a eGFR of less than 30 can cause an increased risk of what?
Lactic Acidosis
33
What is an example of a popular TZD?
Pioglitazone
34
What population should NOT take TZDs?
Those with heart failure, on nitrates, or those who are also on insulin. It causes increased fluid load and subsequent weight gain.
35
In TZD an insulin sensitizer, insulin releaser, or insulin secreater?
Insulin Sensitizer
36
Sulfonylureas work by doing what?
Releasing insulin
37
Glipizide is what category?
Sulfonyurea
38
Do sulfonylureas cause weight gain?
yes
39
Are sulfonylureas expensive?
no
40
DPP-4 Inhibitors do what? (secrete, excrete, or sensitize)
They "smart" release
41
Are DPP-4s expensive? Do they have many side effects?
Yes! No.
42
DPP-4s end in the suffix?
"Gliptan"
43
GLP-1s do what?
Smart releasing
44
Which diabetes drugs promote weight loss?
GLP-1s & SGLT2s
45
Which diabetic drug class delays gastric emptying and should be avoided in patients with gastroparesis?
GLP-1. Also avoid these drugs in people with neuropathy as they likely have damage to the nerves in the gut as well.
46
GLP-1s are good for people with what disorders?
CKD, ASCVD
47
GLP-1s should not be prescribed yo those with a history of what acute abdominal disease?
pancreatitis
48
SGLTs does what to glucose?
Off loads it via the kidneys
49
At what eGFR would it be inappropriate to prescribe an SGLT2?
eGFR<30
50
Are SGLTs expensive?
You bet!
51
SGLT2s are good drugs for those with what conditions?
ASCVD, HF, CKD
52
Gastroparesis is a symptom of what class of diabetic drugs?
GLP-1s
53
If the pancreatic beta cells are dead which two classes of diabetes drugs will no longer be effective?
Sulfonyurea & DPP-4
54
What normal physiologic response causes a high 4-8am glucose?
Dawn Phenomenon. Suspect this phenomenon if the 2-3am blood glucose is normal or high.
55
Rebound hyperglycemia due to overtreatment of bedtime insulin is called what?
Somogyi effect. To fix eat a snack before bed or limit NPH insulin. Suspect this if blood glucose is low at 2-3am.
56
The surge of what hormone leads to ovulation?
LH
57
PTH affects what mineral?
Calcium
58
The most common form of grave's disease is caused by what?
Autoimmune process. Look for other autoimmune d/o such as RA, pernicious anemia, and osteoporosis.
59
Is Grave's disease hyper or hypo thyroidism?
HYPERthyroid
60
Amenorrhea, pre-tibial myxedema (orange peel appearance) and lid lag are physical signs of what?
Grave's disease
61
Calcium and Vitamin D are given in hyper or hypothyroidism?
Hyper
62
Treating a pregnant woman for hyperthyroidism requires treatment with which medication?
PTU
63
PTU can cause what side effects?
Liver failure, skin rash, granulocytopenia/aplastic anemia, and thrombocytopenia
64
Thyroid Storm requires hospitalization and presents with what symptoms?
Fever, abdominal pain, altered level of consciousness
65
Can a 24 hour radioactive iodine test be done in a pregnant or breast feeding woman?
Nope
66
What are three lab markers of autoimmune thyroid disease?
TRab, TSI, TPO
67
Hypothyroid does what to cholesterol?
Increases it.
68
Which drugs can lead to thyroid disease?
Amiodarone, Lithium, High dose iodine, interferon alfa, & dopamine
69
Cold are spots are indicative of what on a thyroid?
Cancer
70
Which diabetes drug causes photosensitivity?
Sulfonylureas
71
In women HDL needs to be higher than what?
50
72
In males HDL needs to be higher than what?
40
73
Peak postprandial sugars should be less than what?
180
74
TZDs should be avoided among what three populations?
HF III/IV, bladder cancer, liver disease
75
Decreasing transfat will do what to the LDL and HDL?
lower and raise!
76
What is the 15-15 rule in hypoglycemia?
give 15g and check again in 15 minutes
77
the "ides" are what class of diabetes drugs?
sulfonylureas
78
Metformin prevents absorption of what?
B12
79
pH of < 7.2 indicates what?
Lactic acidosis
80
A patient on metformin is scheduled for a dye study what should I counsel?
Hold metformin the day of the procedure and for 48 hours later
81
All insulins can cause what two things?
Hypoglycemia and weight gain
82
Rapid acting insulin peaks in how many minutes?
30
83
Short acting insulin peaks in how many hours?
1-5
84
Intermediate insulin peaks in how many hours
6-14
85
SGLT-2 can cause what three things?
Weightloss, DKA, and increased risk of foot or leg amputation
86
DPP-4 s protect what organ?
Kidneys
87
Can I combine GLP-1s and DPP-4s?
No ma'am
88
If you're at risk for DM type II how much weightloss is recommended?
7%

Adult Cardiac (5 decks)

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