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Flashcards in ENDOCRINE Deck (139)
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1

How to treat hyperthyroidism in first trimester preg

PTU

2

How to treat hyperthyroid in 2nd and 3rd trimester pregnancy

Methimazole

3

Teratogenic effects of methimazole when used during first trimester of pregnancy

Aplasia cutis
Scalp defects
Omphalocele
TE fistula

4

Cause of 60-90% of congenital heart block

Neonatal lupus

5

Girl missed her period for 2 months and prig test is negative. Next step?

TSH or prolactin.

6

Treatment for heart failure and/or a fib in thyroid storm

Digoxin

7

If pt is hyperthyroid based on TSH and thyroid sono, next step?

radionucleotide uptake scan

8

If radio nucleotide uptake scan shows a hot nodule?

Treat as hyperthyroid

9

If radio nucleotide uptake scan shows a cold nodule?

FNA

10

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.

11

What to do if FNA of thyroid is non diagnostic

Repeat FNA.

12

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.

13

Somogyi effect

Evening NPH is too high so pt ends up bottoming out overnight and the release of stress hormone GREATLY increases morning glucose.

14

Treatment of somogyi effect

Decrease nighttime dose of NPH or give it later.

15

What is the dawn phenomenon?

Too low dose of evening NPH so glucose creeps up throughout the night, causing very high morning glucose.

16

Treatment of dawn phenomenon

Increase nighttime dose of NPH.

17

How to distinguish between dawn and smoggy effect

Check a 3am glucose.

18

Which 2 oral DM agents have the most common SE of hypoglycemia

Sulfonylurea, meglutinides

19

Which is the oldest and cheapest of DM oral agents?

Sulfonylureas

20

Which oral DM agent also helps lower TG and LDL

Metformin

21

Which oral DM agent is not safe in settings of CHF

TZD

22

Which 2 oral DM agents should not be used in pts with elevated serum creatinine

Metformin, sulfonylureas

23

Which oral DM agent should not be used in pts with IBD

Alpha glucosidase inhibitors (acarbose)

24

Hepatic serum transaminase levels should b carefully monitored when using these oral DM agents.

Metformin or TZDs

25

Which oral DM agent is metabolized by the liver and is thus an excellent choice in pts with renal disease

TZD

26

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.

27

SE of exenatide

Acute pancreatitis.

28

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.

29

How is eventide administered

SQ twice daily at morning and evening meals

30

MOA of Pramlintide

Amylin analog, normally secreted with insulin, decreases glucagon secretion and gastric emptying. USED ONLY IN PTS TAKING INSULIN.