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best initial rx for gh secreting pit adenoma?
sx for aaa?
specific diagnoistic test and result for each hormone deficiency?
low TSH, Low thyroxine
Low acth, low cortisol
Low FSH, low LH
- no elevation due to TRH
- no cortisol elevation due to cosyntropin
- no test
- no response to arginine or GRH
- no response due to TRH
causes of nephrogenic DI?
2 electrolyte disturbances causing DI?
- sickle cell
DIagnostic test for DI?
- vasopressin infusion for central Di
- correction of eletrolyte imbalance like high calcium, low potassium, diuretics and nsaids
best initial test?
most accurate test for increased GH from a pituaitary adenoma?
- IGF levels
- glucose suppression test--GH should be suppressed by high glucose
Rx for pituitary adenoma secreting GH?
when is radiation therapy used?
- Transphenoidal resection
- Dopamine agonists like cabergoline
- pegvisomant--gh receptor antagonist
- when surgery or meds are not effective
4 causes of hyperprolactinemia?
- high GH
- high TRH
- low dopamine
- kidney failure
- liver failure
best initial test for hyperprolactinemia?
when is an MRI done?
- exluce medication
- after all of the above causes are excluded
Rx for hyperprolactinemia?
when is transphenoidal surgery done?
- dopamine agonist
- when meds dont work
most common cause of hypothyrodism?
What processes are slowed down in hypothyrodism?
everything except for menstrual flow
BEst initial test for thyroid disorders?
What is only cause of Hyperthyrodism that has elevated TSH?
What hyperthyrodism disorder has a high RAIU?
Most accurate test for Grave's disease?
What is the only use for radioactive iodine to destroy the gland?
Best initial therapy for graves ophthalmopathy?
Management of acute hyperthyrodism and thyroid storm?
- methimazole or PTU
- iodinated contrast
- radioactive iodine
next step in management of a thyroid nodule?
most common cause of hypercalcemia?
Rx of acute hypercalcemia?
if the hypercalcemia persists?
- saline hydration with loop diuretic
- add calcitonin
what effect does calcium have on QT interval?
short QT interval
Rx of hyperfunctioning parathyroid glands?
causes of hypocalcemia?
- low magnesium
- kidney failure
- low vitamin D
what effect does calcium have on the ekg?
- low calcium--short qt
- high calcium--long qt
most common cause of hypercorticolism?
best initial test for hypercorticolism or cushing syndrome is?
- 24 hour urine cortisol
- 1mg dexamethasone overnight suppression test
what is the best initial test for determining the cause of hypercorticolism?
next best step if ACTH level is elevated in the picture of hypercorticolism?
- MRI of pituitary
- biopsy of petrosal venous sinus
- if the above are unequivical..scan the chest for an ectopic source of ACTH
3 steps in ruling out the need to remove adrenal lesions that are found accidentally on a ct?
- metanephrines--r/o pheo
- renin and aldosterone--r/o hyperaldosteronism
- 1mg dexamethasone suppresion test--r/o hypercorticolism
Most common cause of Addison disease?
most specific test of adrenal function?
Best initial test for hyperaldosteronism?
plasma level of aldosterone/renin
You should never start with what kind of diagnostic test in endocrinology?
most accurate test for a an adrenal adenoma producing hyperaldosteronism?
adrenal vein showing high levels of aldosterone
how is bilateral hyperplasia of the adrenal producing high aldosterone treated?
with spironolactone or eplerenone
Best initial test for pheochromocytoma?
More accurate test?
When is ct imaging of the adrenals done?
- Plasma metanephrine
- 24 hour urine metanephrine
- after biochemical markers are found such as plasma and urine metanephrines
Best initial Rx for pheochromocytoma?
Definition of DM?
- fasting glucose over 125mg/dl on 2 separate occasion
- 1 fasting glucose over 200 with symptoms
best initial therapy for dm?
What dm meds are contraindicated in chf?
Rx of DKA?
saline hydration +insulin + potassium
How is diabetic retinopathy treated?
When is ACEI started in a patient with DM?
at trace or microalbuminuria?
microalbuminuria---<300mg/24 of protein