Flashcards in ENDOCRINE Deck (139)
How to treat hyperthyroidism in first trimester preg
How to treat hyperthyroid in 2nd and 3rd trimester pregnancy
Teratogenic effects of methimazole when used during first trimester of pregnancy
Cause of 60-90% of congenital heart block
Girl missed her period for 2 months and prig test is negative. Next step?
TSH or prolactin.
Treatment for heart failure and/or a fib in thyroid storm
If pt is hyperthyroid based on TSH and thyroid sono, next step?
radionucleotide uptake scan
If radio nucleotide uptake scan shows a hot nodule?
Treat as hyperthyroid
If radio nucleotide uptake scan shows a cold nodule?
If hypothyroid based on thyroid sono and TSH, next step?
Replace thyroid hormone and monitor for decrease in nodule size. If nodule persists AFTER thyroid replacement, do an FNA.
What to do if FNA of thyroid is non diagnostic
If FNA of thyroid is benign ...
Repeat sono q 6m-1 yr to make sure no increase in size. If size does end up increasing, repeat FNA.
Evening NPH is too high so pt ends up bottoming out overnight and the release of stress hormone GREATLY increases morning glucose.
Treatment of somogyi effect
Decrease nighttime dose of NPH or give it later.
What is the dawn phenomenon?
Too low dose of evening NPH so glucose creeps up throughout the night, causing very high morning glucose.
Treatment of dawn phenomenon
Increase nighttime dose of NPH.
How to distinguish between dawn and smoggy effect
Check a 3am glucose.
Which 2 oral DM agents have the most common SE of hypoglycemia
Which is the oldest and cheapest of DM oral agents?
Which oral DM agent also helps lower TG and LDL
Which oral DM agent is not safe in settings of CHF
Which 2 oral DM agents should not be used in pts with elevated serum creatinine
Which oral DM agent should not be used in pts with IBD
Alpha glucosidase inhibitors (acarbose)
Hepatic serum transaminase levels should b carefully monitored when using these oral DM agents.
Metformin or TZDs
Which oral DM agent is metabolized by the liver and is thus an excellent choice in pts with renal disease
MOA of exenatide
Glucagon like peptide-1 derived from Gila monster saliva. It prolongs incretin secretion, which decreases glucagon secretion and increases insulin secretion. It also delays gastric emptying.
SE of exenatide
MOA of Sitagliptin
Inhibitor of dipeptidyl peptidase IV which affects GLP-1 among other hormones. Therefore it prolongs uncertain secretion which decreases glucagon secretion and increases insulin secretion. It also delays gastric emptying.
How is eventide administered
SQ twice daily at morning and evening meals