-
what is the prolactin level in macroadenoma
micro adenoma?
-
rx for prolactinoma
- carbergoline
- dopamine agonist
-
PRL<100 and no symptoms, rx
ocp
-
PRL>1cm, WTD
PRL <1cm WTD in terms of follow up
- q6m with visual field testing
- q1y
-
pt with Prolactiona, wants babies, wtd
give bromocrytpine, B for babies
-
pt on bromocriptine for proloctinoma and best pregnant
- stop bromo, if no visual field abnormalities, montior
- If + visual field changes, start bromo
-
how do you follow acromegaly rx
with IGF-1
-
how many mg for glucose tolerance test
75g, if more than 200, then DM
-
when do you check FBS for DM, what age
- >40 without c0-morbiditites
- >35 with obesity of high BP
-
rx for acromegaly
octerotide and transphenoidal surgery
-
first ab to appear in DM
anti-gad
-
1% AIC is how many mg/dl
30
-
cons of insulin pump
- dka
- infections
- frequent BG checks
-
effect of sulfonylurea on mortality
increase it
-
MOA for repaglenide
increase insulin from pancreas
-
repaglenide can be used in pt with ESRD
yes, it is excreted thru bile
-
can't use metformin with what GFR
30
-
MOA of metformi
decrease hepatic gluconeogenesis, increase insulin sensitivity
-
what said improves glucose control and decrease need for meds
salsa late
-
what diabetes med gives thigh high edema
pioglitazone
-
SE of all incretin
pancreatitis, joint pain
-
what incretin is approved for weight loss
liraglutide
-
MOA of incretin mimes
decrease GLP1 glujconeogeneis, decrease gastric emptying
-
MOA of pramlinitide
decrease glucagon, and slows gastric emptying
-
Pt on DPP4, now has joint swelling and pain
stop it
-
name a SGLT2 inhibitor
MOA
- canfoaflozin(invoking)
- Decrease absorption of glucose by kidneys
-
goal for OP pre-prandial glucose
80-130
-
what drugs can cause hyperglycemia
- antipyschitics
- HAART
- HCTZ
- BB
- Statns
- niacin
-
pt with diarrhea after 2 days of metformin, wtd
continue for 1 week
-
what meds do you stop prior to contrast study
metformin and nsaids
-
what med can you start in advanced CKD for DM
repaglinide-linaglitide
-
what med is approved for weight loss
eventide-linaglutide
-
hemolysis has what effect on AIC
falsely elevated
-
what test allows to track diabetic regimen in short interval without waiting for 3 months
fructosamine
-
in whom do you use fructosamine to manage DM
diabetics, hemolytic anemia, hemoglobinopathy
-
what gives falsely elevated AIC
falsely decreased AIC
decreased RBC turnover
Increase RBC turnover
-
what can cause elevated ketones when gap is closed in DKA
acetone-do not worry about it, its a bystander
-
how do you follow DKA rx
agap
-
pt is going to be NPO next day, wtd glargine
half it
-
what is the goal FBS in pregnant woman
goal for post prandial glucose in prengnay
-
asymptomatic hypoglycemia, wtd
nothin, and adjust the regimen
-
rx for post herpetic neuralgia
amitryptylline
-
-
rx for urinary incontincne
timed voiding
-
rx for orthostatic hypotension due to DM
fludrocortisone
-
can Dm give you a foot or wrist drop
yes
-
best way to prevent ulcer from Demo
monofilament testing
-
risk factor for gastroparesis
fluctuating BG i.e. 50-400
-
cause of foot ulcer in Diabetics
peripheral neuropathy, not PAD
-
when should you do eye exam for TIDM
5 years after dx of age 30
-
how often you check AIC
q3m
-
rx for hypoglycemia
dextrose then glucagon then octerotide
-
Graves has more t3 or t4
t3
-
how to differentiate thyroiditis vs factitious thyroiditis
thyroglobulin
-
rx of thyrotoxicosis in thyroid opthalmopathy
pregnancy
all others
-
rx for mild opthalopathy
severe
-
lymphocytic thyroiditis
- usually in post partum
- can be hyper or hypo
- give BB and it resolves
- can become sometimes chronic
-
how do you follow primary hypothyroidi
how do you follow secondary hypothyroid
-
rx for torsaids
procainamide
-
rx for myxedema coma
hydrocortisone +t3+t4+ abx
-
target for hypothyroidism in pregnancy
<2.5
-
rx for hypercalcemia in sarcoidosis
prednisone
-
high calcium and normal PTH
familial benign hypocalciuric hypercalcemia
-
what vitamin D level do you measure in sarcoidosis
vit D 1-25 OH
-
what is the only diagnosis of hypercalcemia that gives you low phosphate
primary hyperparathyroidism
-
for which cancer you check the RET gene
medullary thyroid
-
indication for surgery for primary hyperparathyroidism
- <50
- osteoporosis
- kidney failure
- high Ca
-
pt with hyperparathyroidism, refuses surgery, wtd
cinacalcet
-
X-ray with short 4th and 5th MCP, dx
pseudohypoparathyroidism
-
when do you use frax scoring
women >50 and <65. 20% for major fracture or 3% for hip fracture
-
how much prednisone dose requires dexa
5mg and then check dexa yearly
-
when do you take teriparatide
- when taking bisphosphonate and fracture
- can only take it for 2 years
-
common SE of zolendronate
fever and myalgia
-
OA and renal insufficiency, what can you give
denosumab
-
bisphosphonate that decreases mortality
zolendronate
-
hypothyoroidism and osteoporosis, how do you treat
treat with synthroid
-
what is abnormal in terms of tests in pages dz
ALP and + bone scan
-
best way to diagnose menopause
clinical--> give estrogen challenge , FSH not reliable
-
young woman with menopause and high tsh, wtd
HRT
-
rx for premenstrual dysphoric disorder
SSRI
-
what effect does ACTH have on epi and norepinephrine
none
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