Endrocrinology - USMLE2
Terms
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Hypothroidism
TFT's -
elevated TSH
decreased T4
tx: give synthetic T4 - Causes of hypothyroidism
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Hashimotos thyroiditis
subacute thyroiditis
following tx for hyperthroidism
sick-euthyroid syndrome
iodine deficinecy - Dx of Hashimotos
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antimicrosomal abx
histology- lymphocyte infiltration of the gland
usually assocaited with other autoimmune diseases - what is subacute thyroiditis
- acute viral inflammation with fever and enlarged, tenderthyroid gland
- what is sick-euthyroid syndrome
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any illness that may decrease t4 and/or t3, but TSH is normal
condition is self-limiting and no treatment is necessary - Treatment for hyperthyroidism
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antithyroid drugs: propylthiouracil or methimazole
surgery for patients under 25/pregnant women
radaiactive iodine for patients over 40 - Causes of hyperthyroidism
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Graves Dz
Plummers Dz/Toxic multinodular goiter
Toxic adenoma
Thyroiditis - signs of graves dz
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exophthalmos
pretibial myxdema
nontender,diffuse goiter - Dx of Cushing's Syndrome
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24 hour urine test for free cortisol
Plasma cortisol is NOT accurate
dexamethasone suppression test - W/u of hyperadrenalism
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check MRI of brain to r/o pituitary adenoma
look for adrenal neoplasm that produces steroids or small cell cancer that prodces ACTH - Primary hyperaldosteronism
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check for hypertension, hypernatremia, hypokalemia and low renin
get CT scan of abdomen
high renin --> secondary hyperldosteronism