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38 Cards in this Set
- Front
- Back
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when Ca2+ is high but P is low, think:
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PTH excess
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when Ca2+ is high and P is ALSO HIGH, think:
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Vit. D excess
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PTHrp ~~ malignancies, causes:
(3) |
1. high Ca2+
2. low P 3. low PTH |
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PTHrp uses:
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PTH r's
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3 options to acutely lower serum Ca2+:
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1. fluids
2. furosemide 3. bisphosphonates |
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FHH is due to:
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**inactivating** mutations of *CaSR*
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pseudohypoPTH ~~
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**inactive** GNAS
- vs. overactive in McCune-Albright |
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PTH converts:
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25-OH to 1,25-D in the kidney
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Granulomas can cause hypercalcemia by acting as:
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**sites of extra-renal conversion to 1,25-D**
that's why 1,25-D is high in granulomatous or lymphoproliferative dz's |
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hypercalcemia ~~
(2 more symps) |
polydipsia,
polyuria |
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the difference between radioactive iodine uptake and a thyroid scan is that the RAIU is:
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quantitative (a measurement of how much iodine is taken up at 4 and 24 hours)
and the thyroid scan is a picture. |
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RAIU/thyroid scan should only be ordered if:
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**the TSH is suppressed**
- they are not very helpful with normal or high TSH |
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connection between hyperprolactinemia and thyroid:
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low T3/T4 causes increase in TRH, which increases prolactin
- treating hypothyroidism will treat the hyperprolactinemia |
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treatment for prolactinoma =
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MEDICAL
- try to avoid surgery |
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treatment for acromegaly is generally:
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SURGERY
- otherwise, Somatostatin analogs |
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diagnosis of SIADH =
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OPPOSITE of CDI
- hyponatremia, HIGH urine osm. |
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treatment of SIADH =
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**fluid restriction,**
unless AMS, => 3% or NS |
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CAH is a type of:
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adrenal insufficiency
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women who presents late with CAH will have:
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male-pattern hair
- not really anything in men |
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once you've established Primary Hyperaldo, the next step is to determine where it's coming from: test =
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confirm with salt suppression (if aldo STAYS high, it confirms adrenal origin of excess aldo)
- nly, increased salt would decrease RAAS |
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IHA = idopathic hyperplasia of aldo; will often respond to:
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salt suppression, etc.
- **but Aldosterone-Producing Adenomas (Conn Syndrome) DON'T respond to such maneuvers** - salt suppression, standing up vs. lying down |
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Spironolactone blocks:
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corticosteroid r's
- blocks aldo and cortisol |
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apart from Pheo, what can raise cats?
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stress,
lots of different meds |
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Primary Polydipsia =
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psychological issue in which pt drinks a ton
=> **urine is dilute** (low osm) |
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Primary Polydipsia in response to WDT =>
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increased urine osm
- will retain water since it's not coming in - (otherwise, you're drinking so much that ADH is shut off) |
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to diagnose GHD:
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induce hypoglycemia
- GH should rise - if it doesn't, it's GHD |
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bicarb will be low in:
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primary adrenal insufficiency
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differentiating Primary Adrenal Insufficiency from Secondary Adrenal insufficiency = ***adding synthetic ACTH:***
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RISE in cortisol = Secondary adrenal insufficiency
• = problem with ACTH release from the PITUITARY. NO CHANGE in cortisol = PRIMARY Adrenal Insufficiency |
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difference between 21-OH deficiency and 11-OH deficiency =
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HTN in 11-OH, due to excessive 11-deoxysterone
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Aldo should _____________ when you stand, to offset:
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increase;
to offset postural hypotension |
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low sugar should induce _______ as well as GH
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ACTH
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Addison’s ~~
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destruction via AI or TB
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What is euthyroid sickness?
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Being sick can decrease thyroid hormone levels, without affecting TSH
~~ thyroid being affected by another illness – just make sure you rule out pituitary cause of hypothyroid |
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treatment order of Graves:
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meds ≥ RAI >> surgery
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treatment order of toxic nodule(s):
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RAI > surgery >> meds
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treatment order of thyroiditis:
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observe, treat symptoms
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Make sure that if the issue is central hypothyroidism, you give:
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**hydrocortisone** before you give levothyroxine
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post-partum thyroiditis =
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painless thyroiditis
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