Endocrinology
Revision as of 17:53, 14 January 2023 by Aesetholephews (talk | contribs) (→Electrolyte Imbalanaces)
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).
- During vitamin B12 repletion, you should monitor serum potassium, which can drop as new RBCs are formed.
- Young, normal weight patient, without family history of diabetes presents with symptomatic DKA? T1DM
- 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.
- 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.
Electrolyte Imbalanaces
Electrolyte | High | Low |
---|---|---|
Sodium | Example | Example |
Potassium | Example | Example |
Calcium | Example | Increased DTRs |
Magnesium | Low-absent DTRs | Example |
Phosphorus | Example | Example |
Hyponatremia
- Moderate to severe hypothyroidism can cause cause mild euvolemic hyponatremia.
Hypercalcemia
- H&P:
- Dx: Best initial test is PTH
- Tx: