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Test used to screen thyroid disease - ✔✔TSH Normal TSH values - ✔✔ 0. 5 - 5 What labs look like in hyper thyroidism - ✔✔Low TSH High T3/T What labs look like in hypothyroidism? - ✔✔High TSH Low T 3 /T 4 Treatment for hyperthyroidism - ✔✔Methimazole In pregnancy: during first trimester, use PTU, after first trimester can use methimazole Alternate therapy includes
- Beta blockers to control, palpitation and cardiac symptoms
- Thyroidectomy.
- Radioactive iodine. And hyper thyroidism of a patient in the first trimester what medication when you use - ✔✔PTU Treatment therapy in hypothyroidism - ✔✔Levothyroxine
In an elderly patient with hypothyroidism what medication would you prescribe and what does - ✔✔Level thyroxine started at 12 .5. In patients with cardiac issues what medication does would you start for hypothyroidism - ✔✔Level thyroxine, 12. 5. In a newly diagnosed hypothyroidism, patient with no medical history, what medication would you start?
- ✔✔Levothyroxine 25 to 50 mg How soon do you check TSH after starting or changing a dose of levothyroxine? - ✔✔Six weeks Once the patient is stable on level thyroxine, how often should you check their TSH - ✔✔Every 6 to 12 months if you order a TSH and it is abnormal what test should you order next to evaluate thyroid function? - ✔✔T3 and T What is the most important lab value to assess kidney function? - ✔✔EGFR What is a normal EGFR - ✔✔> 90 At what EGF far must you start hemodialysis - ✔✔ 15 which is CKD 5 What urinalysis finding would be a true indicator of kidney damage - ✔✔Red or white blood cell Casts What is normal creatinine? - ✔✔Around one At what number of creatinine do we become concerned? - ✔✔ 2 What is a normal BUN - ✔✔ 10 - 20
Triglycerides: < 150 Total cholesterol: < 200 If a patient has triglycerides over 500 what condition are they at risk for? - ✔✔Pancreatitis How often should you check lipid panel? - ✔✔In a normal patient: every five years Any patient with risk factors, or being treated: more often What medication treats, hypertriglyceridemia - ✔✔Fenofibrate What is the treatment for elevated cholesterol? - ✔✔Statin therapy Depending on ASCVD risk will determine whether they need a low, mild, high intensity, statin What question is important to ask your patient before starting statin therapy - ✔✔ 1. If they have ever had any liver disease or elevated liver enzymes.
- If they have or have ever had problems with muscle aches, or pains. What labs are important to check before starting statin therapy - ✔✔LFTs What condition can be a potential side effects of statin therapy - ✔✔Rhabdomyolysis What lab checks for rhabdomyolysis and at what level is rhabdomyolysis? - ✔✔CK at least five times the normal limit When started on statin therapy how often should you check LFTs? - ✔✔Should be checked prior to starting statin
Should be checked in at least 12 weeks What is the antidote for Coumadin? - ✔✔Vitamin K What do you do with Coumadin dosing if the INR is greater than 10? - ✔✔If there is no active bleeding, you will get a vitamin K by mouth If there is active bleeding, you will get vitamin K intravenous What would be your treatment plan for a patient with an INR that is elevated but less than 10 - ✔✔Ask patient if there is active bleeding If there is active bleeding, they will receive vitamin K If there is no active bleeding, then you will hold their Coumadin dose and decrease it What is the typical goal for patients INR on Coumadin? - ✔✔ 2 - 3 What labs monitor for pancreas - ✔✔Amylase and lipase What labs monitor the liver? - ✔✔AST and ALT What does a BNP measure? - ✔✔indicator of heart failure, normal is < 100 What to labs monitor inflammatory markers - ✔✔CRP and ESR If a patient has inflammatory bowel disease, do you suspect there ESR and CRP maybe elevated - ✔✔Yes
