Endocrinology - Revision history

Aesetholephews at 16:31, 16 January 2023

2023-01-16T16:31:20Z

2023-01-15T06:17:20Z

Thyroid

2023-01-15T04:35:31Z

Hyponatremia

2023-01-15T04:34:42Z

2023-01-15T04:30:09Z

Missed Concepts

2023-01-14T19:52:40Z

Missed Concepts

2023-01-14T19:47:00Z

Missed Concepts

2023-01-14T18:05:55Z

Electrolyte Imbalanaces

2023-01-14T17:53:20Z

Electrolyte Imbalanaces

2023-01-14T17:52:56Z

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 *'''Prolactin-secreting''' pituitary adenomas, including large ones, are first treated with '''oral dopamine antagonists''', whereas other pituitary adenomas are treated with surgery if large enough.
 *Congenital Adrenal Hyperplasia is most commonly '''21-hydroxylase deficiency''' (hypotension, low Na, high K, hypoglycemia, ambiguous genitalia in girls), but can also be '''11β-hydroxylase deficiency''' (hypertension, low K, hypoglycemia, ambiguous genitalia in girls) or '''17α-hydroxylase deficiency''' (hypertension, low K, euglycemia, ambiguous genitalia in boys).
 =Thyroid=

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 *Total T3 and T4 in pregnancy can be 1.5x normal range and still be physiologic. TSH is suppressed. '''There is no role for measuring free T4 in pregnancy'''
 *Amiodarone decreases peripheral conversion of T4 to T3, but generally this self resolves in 6-9 months after treatment initiation. Amiodarone has a half-life of 100 days.
 =Glucose Homeostasis=

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 ==Hyponatremia==
-*Moderate to severe hypothyroidism can cause cause mild euvolemic hyponatremia.
+*Dx: Correct for Glucose. '''Moderate to severe hypothyroidism''' can cause cause mild euvolemic hyponatremia.
 ==Hypercalcemia==

← Older revision		Revision as of 04:34, 15 January 2023
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	*Dx: Best initial test is '''PTH'''		*Dx: Best initial test is '''PTH'''
	*Tx:		*Tx:
		+
		+	==Hypocalcemia==
		+	Dx: correct for albumin (Ca + 0.8[4 - albumin])

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 =Missed Concepts=
 *Workup of thyroid nodule almost always ends with FNA, the one exception is '''a patient without suspicious US findings or cancer risk factors, a low TSH, and a hot nodule on 123-Iodine scan (toxic adenoma).''' For these patients '''go straight to treatment (Methimazole pretreatment to achieve euthyroid > RF ablation vs. surgery)'''
 *Hashimoto thyroiditis can be associated with other autoimmune conditions such as atrophic gastritis (pernicious anemia).
 *Total T3 and T4 in pregnancy can be 1.5x normal range and still be physiologic. TSH is suppressed. '''There is no role for measuring free T4 in pregnancy'''
 *Hyperglycemia and catabolic symptoms (weight loss, urinary frequency) are indications for insulin.
-*One complication of SGLT2 inhibitors is '''euglycemic DKA with BG < 250, but still with an elevated AG and low pH.'''
+*Young, normal weight patient, without family history of diabetes presents with symptomatic DKA? '''T1DM'''
 =Electrolyte Imbalanaces=

@@ Line 17: / Line 17: @@
 | Sodium || Example || Example
 |-
-| Potassium || Example || Example
+| Potassium || Nausea, vomiting, ECG changes, asystole || Example
 |-
-| Calcium || Example || Increased DTRs
+| Calcium || Example || Usually asymptomatic, but can cause increased DTRs, muscle cramps, convulsions
 |-
-| Magnesium || Low-absent DTRs || Example
+| Magnesium || Low-absent DTRs, flaccid paralysis, apnea || Example
 |-
 | Phosphorus || Example || Example