Term
| how would a pt w/subacute thyroiditis present? |
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Definition
| after a URI improved, the pt would experience neck tenderness, temporary hyperthyroidism (elevated free T4/suppressed TSH) and zero iodine uptake test then followed by hypothyroidism (increased TSH). |
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Term
| how could a pt w/acromegaly (GH adenoma) present? |
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Definition
| headache, hyperhidrosis, increased sweating, and heat intolerance. the jaw may be protruding. |
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Term
| what tests could dx acromegaly? |
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Definition
| *increased IGF-1 and *increased GH w/glucose administration (GH would go down in normal pts) |
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Term
| how can central diabetes insipidus be differentiated from psychogenic water drinking? |
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Definition
| administer ADH/vasopressin then check urine osmolarity/volume - it should go up. the fluid deprivation test could also be used and a DI pt's osmolarity would remain the same (would go up in normal pts). |
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Term
| what is the most common cause of hyperthyroidism in the elderly? tx? |
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Definition
| toxic multinodular goiter - which can cause apathetic thyrotoxicosis (high thyroid, but pt is still fatigued). tx: propylthiouracil (PTU) and methimazole (reduces T4 synthesis) |
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Term
| what is a possible cause of paradoxical response to anesthesia? tx? |
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Definition
| pheochromocytoma - which is usually sporadic, unilateral, and benign. tx: alpha blocker |
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Term
| what is the basic rule for approaching hormone dysregulation? |
|
Definition
| high number you want to suppress it, if you have a low number you want to stimulate it |
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Term
| what is the most common cause of thyroid CA? tx? |
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Definition
| papillary CA (papillary follicular mixed carcinoma) - usual presentation is a thyroid nodule solid on ultrasound, cold on scan. tx: near-total thyroidectomy |
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Term
| how does latent autoimmune diabetes pts in adults present? |
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Definition
| these pts look like type I on paper and have auto-antibodies - tx: insulin |
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|
Term
| what should urine micro albumin and lipids be in a DM pt? |
|
Definition
| urine micro albumin: < 30 and lipids < 100 |
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|
Term
| what is klinefelters the prototype for? |
|
Definition
| hypergonadotrophic hypogonadism |
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|
Term
| what is the best test to determine testosterone levels? |
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Definition
|
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Term
| how will adrenal CA pts present? |
|
Definition
| hypokalemic metabolic alkalosis |
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Term
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Definition
| adrenal adenoma which produces excessive aldosterone = hypokalemia and alkalosis |
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|
Term
| how do pts w/21-hydroxylase deficiency present? |
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Definition
| HTN, hypokalemia, amenorrhea, and hirsuitism |
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