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2013-02-04 16:55:40

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  1. Best initial test in suspecting thyroid disease?
  2. How do you differentiate between exogenous and endogenous thyroid hormone production?
    exogenous wont have high thyroid binding globulin but endogenous will
  3. what increases thyroid binding globulin?
    what decreases it?
    • increases---pregnancy, ocp
    • decreases--nephrotic syndrome, liver disease
  4. increased T4 and T3, low TSH and high RAI uptake scan is high?
    increased T4 and T3, low TSH and low RAI?

    low T4 and T3, low TSH and LOW RAI?
    • graves--diffuse uptake
    • toxic nodular goiter-- focal uptakes

    exogenous thyroid or acute thyroditis

    secondary hypothyrodism
  5. graves disease?
    • hyperthyrodism
    • goiter
    • exopthalmos
  6. how is graves disease diagnosed?
    • decreased tsh
    • increased t4 and t3
  7. best initial rx for graves?
    Long term rx?
    • propranolol
    • PTU in pregnancy
    • Methimazole

    • RAI ablation
    • Thyrodectomy
  8. adverse effect of ptu or methimazole?
  9. rx for pregnant woman with graves?
  10. new onset of afib in an elderly?
    toxic multinodular goiter
  11. thyroid storm?
    • cns
    • cardiovascular
    • fever of 104
    • manifestations
  12. rx for thyroid storm?
    • anti thryoid meds
    • propranolol
    • iodine--downregulates
    • dexamethasone
    • cooling blankets
    • fluids
  13. most common cause of hypothyrodism?
    hashimotos thyroditis
  14. most common causes of hypothyrodism?
    • hashimotos
    • drugs
    • post ablative surgery
    • iodine deficiency
    • biosynthetic defects
  15. causes of bilateral carpal tunnel syndrome?
    • gh excess
    • hypothyroid
  16. How long does it take for tsh to come down to normal?
    6 weeks
  17. rx of hypothyrodism with suspected secondary hypothyrodism?
    • replace thyroid hormone
    • give hydrocortisone
  18. severe form of hypothyrodism?
    myxedema coma
  19. only case where u give t3?
    rx of myxedema coma
  20. most accurate test for hashimotos?
    anti-microsomal antibodies
  21. when does a euthyroid sick syndrome occur?
    in severe sickness like in sepsis
  22. When a tsh is normal but t3 is low, what is it?
  23. next appropriate test in exogenous thyroid intake?
    thyroglobulin test
  24. what is the only hyperthyroid state that has proptosis?
    graves disease
  25. all non functional nodules on the thyroid are presumed to be what?
    cancers untill proven otherwise
  26. toxic nodule has what chance of being a cancer?
    no chance at all
  27. what factors make thyroid cancer more likely?
    • male
    • elderly
    • lymphadenopathy
    • radiotion therapy to the head and neck
  28. next best step with a non funcitoning thyroid nodule?
  29. with multiple nodules, whichone do you nodule?
    the biggest one
  30. at the onset of a new nodule, what do you do?
    biopsy the new nodule
  31. most common thyroid cancer?
    how do you make sure its gone?
    • papillary¬†
    • thyroid binding globulin
  32. what is the next step when on fine needle aspiration you see a follicular cell?
    you go to sx and see if it is a malignant or benign adenoma
  33. which thyroid cancer spreads hematagneously while the others spread to lymph nodes?
  34. which men syndromes are associated with the ret gene?
    • men2a--medullary
    • pheochromocytoma
    • parathyroid
    • men2b--medullary pheo
    • marfanoid habitus
  35. who gets anaplastic thyroid cancer?
  36. how do you follow the cancer activity post thyrodectomy?
    following TBG
  37. what drugs cause hypothyrodism?
    • lithium
    • amiodarone
  38. why is thyroid replacement is above the normal level post thyrodectomy for cancer?
    to suppress tsh bc cancers respond to tsh and grow
  39. 2 cases when u give t3 replacement?
    • post cancer
    • myxedema coma
  40. function of pth?
    • pulls ca and po4 from bone
    • reabsorbs ca in kidney
    • excretes po4 in kidney
  41. dd for vitamin d deficiency?
    • no light
    • no vit d in food
    • pancreatic insufficiency
    • proximal small intestine pathology like crohns, celiac, tropic, whipple
  42. vit d function?
    • increases ca absorbption from intestine
    • increase po4 in proximal tubule
  43. how does malignancy cause hypercalcemia?
    • pth like peptide
    • metastasis
  44. dd for hypercalcemia?
    • hyperparathyrodism
    • hyperthyrodism
    • malignancy
    • sarcoidosis
    • hctz
    • familial hypocalciuric hypercalcemia
    • prolonged immobilization
  45. what is the only cause of hypercalcemia that has low calcium in the urine?
    familial hypocalciuric hypercalcemia
  46. side effects of loops and thiazide diuretics?
    • hyper
    • glucose
    • uricemia
    • lipids
    • calcemia
  47. what changes occur with high calcium on ekg?
    short qt interval
  48. mngt of hypercalcemia?
    • fluids
    • furosemide after fluids have been given and the patient is hydrated
    • calcitonine
    • bisphosphanates
  49. acute way of lowering hypercalcemia?
    chronic way of lowering hypercalcemia?
    • calcitonin
    • bisphosphantes
  50. primary hyperparathyrodism is due to what?
    • most of the time due to a single adenoma
    • 4 gland hyperplasia in 25% of the time