THYROID STUDIES.......Made Simple

The answer to the question in the previous posting is MAGNESIUM.



Today we'll review the common labs tests in interpreting of thyroid function studies,
that you are likely to be asked on your boards....or encounter in daily pratice.


Q: What is the single BEST screening test to determine thyroid function status?


A: TSH level....It will tell you whether patient is hyper/hypothyroid or neither.
Low levels=Hyperthyroidism. High levels=Hypothyroidism. HINT: This is
first test to obtain, regardless of which thyroid disorder you are looking for.
.


Q: What is the BEST test to determine if person is surreptitiously abusing thyroid hormone?
(For weight loss/ psychiatric reasons...resulting in EXOGENOUS HYPERTHYROIDISM).


A: Serum THYROGLOBULIN level...(on the boards). This test is also elevated in thyroiditis.



Q: What test is the BEST indicator of EUTHYROID SICK SYNDROME?
(This is generally an asymtomatic disorder seen in hospitalized/terminally ill patients.
Therapy consist of treating the underlying cause without thyroid medications).

A: LOW T3 level.



Q: What test are commonly seen elevated in HASHIMOTO'S THYROIDITIS?


A: Being an AUTOIMMUNE disorder...besides the expected elevated TSH/low FT4
combination...ANTIBODY tests will be positive... TPO (anti-thyroid peroxidase antibody)
and TG (anti-thyroglobulin antibody) will both be increased in this disorder.



Q: What is the BEST test to determine NEONATAL THYROTOXICOSIS in a pregnant
patient with GRAVES' Disease?



A: SERUM TSI (Thyroid Stimulating Immunoglobulin)....since this hormone crosses the
placenta.






To think about until next time........Which thyroid condition causes APATHY?....The answer
may surprise you!


Thanks for your time.

MORE CLINICAL WORD TIPS....

The answer to the previous posting suggests a person with Obsessive Compulsive Disorder(OCD). The correct response for the treatment is : CLOMIPRAMINE..(on the boards)
So, who wants to be a super PA Student or Medical Resident????

Let's continue with more clinical word tips.....and recall... answer what the "boards" are
looking for.



Q: Which drug is used for prophylactic treatment of a patient with ESOPHAGEAL VARICES?


A: NADOLOL or Propanolol (non-selective B-blocker) has been shown to reduce bleeding.



Q: What is the BEST serum test to order for diagnosis of VITAMIN D Deficiency?


A: 25-OH Vitamin VITAMIN-D. (NEVER!!! order 125-Vitamin-D on the boards)



Q: What is the BEST treatment for an adult (or pediatric) patient with acute ITP?


A; High dose PREDNISONE and platelet transfusion.



Q: What is the ONLY intervention known to increase LIFE EXPECTANCY in a hypoxemic
COPD patient?


A: OXYGEN therapy.



Q: Which drug has been shown to increase survival in a patient with PRIMARY PULMONARY
HYPERTENSION (PPH)?


A: WARFARIN




Q: What is the BEST test to diagnose PULMONARY EMBOLISM in a pregnant patient?


A: VENTILATION-PERFUSION SCAN (Can augment dx. with bilateral venous Dopplers)




......To ponder until next time....What is the BEST treatment of an ALCOHOLIC patient
with recurrent VENTRICULAR TACHYCARDIA?


Thanks for your time....we'll be back soon

CLINICAL WORD TIPS.....

We are well into the New Year, so it's time to pick up the books and continue on....

Short TIPS to memorize will add to your score and will help you in clinical practice,

so, when you read these WORDS on the exam....just ANSWER the question.



Q: What condition causes a BIRD BEAK appearance of the esophagus on barium swallow.


A: ACHALASIA.....an aperistaltic denervation of the esophageal smooth muscles.



Q: What vitamin deficiency will a strict VEGETERIAN/VEGAN develop?


A: VITAMIN B 12 (cyanocobalamin) deficiency.



Q: What condition causes ENAMEL LOSS of frontal teeth?


A: BULEMIA.....the repeated emesis of acidic contents will erode the enamel.
(This can also lead to premature dental caries)


Q: What organism can cause soft tissue cellulitis after swimming/contact with
SEAWATER?


A: VIBRIO VULNIFICUS infection.



Q: What bacteria is commonly involved in acute inflammatory neuropathy...
GUILLAIN-BARRE SYNDROME?


A: CAMPOLYBACTER JEJUNI....causing an acute diarrheal illness.




Q: What causes a grossly BLOODY NIPPLE DISCHARGE?


A: INTRADUCTAL Breast Cancer.



Q: What condition causes progressive PAIN, between the 2nd-3rd toes of the FEET?


A: MORTON'S NEUROMA.



Q: What condition causes CYANOSIS and COOLNESS of FEET, but perfectly
normal pulses in an otherwise healthy adult?


A: REFLEX SYMPATHETIC DYSTROPHY.





...........AND finally....What is the treatment of a PHYSICIAN ASSISTANT STUDENT
or for that matter a PGY-3 MEDICAL RESIDENT....who wants to be a SUPER?

A: ....BE PATIENT....we'll tell you in the next posting!




Thank for your time....see you soon.