Major symptoms and signs of hypothyroidism

ENDOCRINOLOGY

Mechanism Symptoms Signs Slowing of metabolic processes Fatigue and weakness Cold intolerance Dyspnea on exertion Weight gain Cognitive dysfunction Mental retardation (infantile onset) Constipation Growth failure Slow movement and slow speech Delayed relaxation of...

Conditions that Require Higher Doses of Thyroid Medication (Levothyroxine)

ENDOCRINOLOGY, Pharmacy and Therapeutics

Will need to increase the dose of levothyroxine if the patient is: Pregnant (about 30% increase by week 8), On estrogen replacement, or On meds that accelerate T4 catabolism  (e.g. phenytoin, phenobarbital), On meds that impair absorption of levothyroxine. Sucralfate,...

The Meaning of Insipidus and Mellitus as used with Diabetes

ENDOCRINOLOGY

Insipidus Insipidus means “Lacking taste; unpalatable; Lacking flavor or zest; not tasty. E.g. an insipid soup”. Insipidus comes from the Latin word īnsipidus:  Latin in-, not; + Latin sapidus, savory (from sapere, to taste) Diabetes Insipidus [New Latin...

Suppression and Stimulation tests

ENDOCRINOLOGY

In endocrinology, this works almost as a law: If something is low, stimulate the gland. If it is high, suppress the gland. This helps with diagnosis. Stimulating a gland (e.g. the adrenal glands) when the hormone it produces (e.g. cortisol) is low allows you to know...

Bridging Insulin & Feeding the Patient After DKA

ENDOCRINOLOGY

When to start SC insulin and bridge with insulin drip -After the DKA has resolved and when the patient is able to eat, start SC basal insulin (like insulin glargine). In addition, order a pre-meal insulin Lispro regimen, AC TID. -Continue IV insulin infusion for 2hrs...

Insulin Therapy In DKA

ENDOCRINOLOGY

Hold insulin if K+ < 3.3 and give K+ replacement first to get it b/n 3.3 and 5.3 otherwise insulin will drive K into cells and worsen hypokalemia. This can trigger arrhythmias and muscle weakness. Regular insulin 0.1 units/kg/hr IV bolus & then within 5 minutes...