SARAH MICHELLE LIVE EXAM REVIEW STUDY GUIDE LATEST UPDATE

SARAH MICHELLE LIVE EXAM REVIEW STUDY GUIDE LATEST UPDATE What is the screening tool for the thyroid? - CORRECT ANSWER TSH Level What is the normal range for TSH? - CORRECT ANSWER 0.5-5.0 When do you order a full thyroid profile? - CORRECT ANSWER If thyroid screening of TSH comes back abnormal, then we will reorder TSH and T3, T4. What disorder demonstrates a low TSH level and high T3 and T4 levels? - CORRECT ANSWER Hyperthyroidism What disorder demonstrates a high TSH level and low T3 and T4 levels? - CORRECT ANSWER Hypothyroidism What medication is used to treat hypothyroidism? - CORRECT ANSWER Levothyroxine (Synthroid) What dose of Synthroid do you want to start your patient on? - CORRECT ANSWER If patient is elderly or if they have a significant cardiac history then we are going to start at a lower dose of 12.5-25 mcg po daily. In a normal healthy patient, we will start at 25-50 mcg po daily. After initiation of medication for treatment of hypothyroidism, when do you recheck TSH level? - CORRECT ANSWER 6-8 weeks When TSH level is stabilized, how often do you recheck their level? - CORRECT ANSWER Every 6-12 months What is the go to medication for treatment of hyperthyroidism? - CORRECT ANSWER Tapazole and PTU How do you manage treatment for hyperthyroidism in a pregnant patient? - CORRECT ANSWER We need to use PTU instead if they are in their first trimester. After first trimester, then they can be switched to tapazole. What medication class is used to treat symptoms of hyperthyroidism? - CORRECT ANSWER Beta-blockers- these help manage tachycardia and palpitations What are 2 other treatments for the hyperthyroidism? - CORRECT ANSWER Thyroidectomy and radioactive iodine SARAH MICHELLE LIVE EXAM REVIEW STUDY GUIDE LATEST UPDATE 2 | P a g e What labs are used to measure and evaluate kidney function? - CORRECT ANSWER GFR, BUN, Creatinine What lab value is most accurate description of kidney function? - CORRECT ANSWER GFR- this is going to tell us how the kidneys are filtering the blood and how well they are removing waste. What is a normal GFR value? - CORRECT ANSWER 90 What GFR value indicates an absolute need to start a patient on dialysis? - CORRECT ANSWER 15- this means that patient is in CKD stage 5 What is the second most important lab value to measure kidney function? - CORRECT ANSWER Creatinine What is creatinine? - CORRECT ANSWER A waste product in the blood. If your kidneys are functioning properly, then this waste product is removed by your kidneys. When kidney function decreases, your creatinine level starts to rise. What is a normal creatine value? - CORRECT ANSWER Around 1 Why is BUN least telling for kidney function? - CORRECT ANSWER Blood urea nitrogen is a normal waste product when your body breaks down urea. However, this is not specific to the kidneys. It can also indicate liver issues. What is a normal BUN level? - CORRECT ANSWER 10-20 With which first-line BP medication do we want to check the BUN/Cr? - CORRECT ANSWER ACE Inhibitors What finding on a UA id indicative of true kidney damage? - CORRECT ANSWER Casts- WBC or RBC casts always need to be referred out When do we screen for microalbumin in the urine? - CORRECT ANSWER We're always going to screen when DM and HTN is first diagnosed. What are the most common causes of CKD? - CORRECT ANSWER HTN and DM Why is it important to perform early screening for microalbumin in the urine? - CORRECT ANSWER Patients who have mild kidney damage do not have symptoms, this screening will ideally identify damage early and prevent progression. SARAH MICHELLE LIVE EXAM REVIEW STUDY GUIDE LATEST UPDATE 3 | P a g e What stage of CKD do patients show true symptoms? - CORRECT ANSWER Stage 3 or worse How often are we screening for micro albumin? - CORRECT ANSWER Bare minimum is going to be annually for patients with DM or HTN or both. What is the normal range of microalbumin? - CORRECT ANSWER 30 What is the most common symptom of all anemias? - CORRECT ANSWER Fatigue What is a normal hemoglobin level? - CORRECT ANSWER 12-18 Women are on the lower end, and men are on the higher end What is a normal hemoglobin to hematocrit ratio? - CORRECT ANSWER 3 to 1 36-54% What does MCV stand for? - CORRECT ANSWER mean corpuscular volume What is a normal MCV? - CORRECT ANSWER 80-100 What does low MCV indicate? - CORRECT ANSWER Microcytic anemias What is the most common microcytic anemia? - CORRECT ANSWER Iron deficiency anemia What is the biggest risk faction for the development of IDA is int he first year of life? - CORRECT ANSWER The ingestion of cow's milk What does high MCV levels indicate? - CORRECT ANSWER Microcytic anemia What are the most common microcytic anemias? - CORRECT ANSWER B12 and folate What symptoms are common with B12 deficiency anemia? - CORRECT ANSWER Neuro symptoms- the most common symptom is parasthesia What surgery typically leads to B12 deficiency anemia? - CORRECT ANSWER Gastrectomy patients- who have part of their stomach removed Why do gastrectomy patients typically have B12 deficiency anemia? - CORRECT ANSWER In order for B12 to be absorbed, it needs to be able to combine with intrinsic factor, which is produced in the stomach. If we remove a large portion of the stomach then we lose a lot of that intrinsic factor.