Endocrine Adult Dr. Kirila

Question 1

Primary , Secondary , tertiary thyroid problem

Answer 1

1. primary = thyroid prob
2. secondary = AP problem (TSH)
3. Tertiary = Hypothalamus prob (TRH)

Question 2

high TSH + T4/T3

Answer 2

AP tumor secreting TSH

Question 3

Diffuse Goiter found in

Answer 3

Graves disease (can be dx with radionuclear scan)

Question 4

1. cold nodules
2. warm nodules
3. Hot nodules

Answer 4

1. cold = 85% benign, 15% malignant
2. Warm = 90% benign, 10% malignant
3. Hot = 95 % benign, 5% malignant

Question 5

Thyroid fine needle aspiration

Answer 5

can fail if hypocellular sample, or poor technique

Question 6

Goiter or thyroid nodule can cause what problem + surgery complications

Answer 6

Recurrent Laryngeal N damage (esp during thyroid surgery*) + parathyroid damage in surgery

Question 7

hypothyroidism face

Answer 7

puffy eyes, thickened skin

Question 8

Hypercalcemia caused by what 3 things and associated with what 2 things

Answer 8

1. Parathyroid related, Malignancy, VitD related

2. Renal failure + High Bone Turnover

Question 9

Hypercalcemia and EKG

Answer 9

shortend Q-T interval (T wave is shorter and not as long)

Question 10

bone density test and what values mean

Answer 10

DEXA

1. normal : over -1
2. osteopenia : -1 to -2.5
3. Osteoporosis : under -2.5
4. Severe osteoporosis : under -2.5 + fracture history

Question 11

form to fill out on risk for fracture

Answer 11

FRAX

Question 12

Vit D turns into active form where + resp in metabolic acidosis

Answer 12

Kidney

+ Kussmaul Respirations

Question 13

fluid deficiency in T1D (dka) and T2D (nkhs)

Answer 13

1. 3-5 L (T1D)

2. 8-10L (T2D)

Question 14

Glucose at what level can cuase increased infections

Answer 14

at 150 or above, glucose interferres with Neutrophil functions

Question 15

low PTH with high CA and low P

Answer 15

1. malignancy, multiple Myeloma
   2, granulomatous Dz
2. drug
3. Vit D intoxication

Question 16

acute hypercalcemia is associated with

Answer 16

1. dehydration
2. fluid loss, polyuria
3. renal impairment
4. short Q-T interval
   == Treat with fluids, consider loop diuretics

Question 17

chronic hypercalcemia causes

Answer 17

psychiatric probs, renal stones, bone problems

Question 18

corrected Ca+ calculated how

Answer 18

Ca (corrected) = Ca + 0.8 (4.0 - albumin)

= what you should look at to know if someone has abnormal Ca levels