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Exam (elaborations)

SARAH MICHELLE LIVE REVIEW STUDY GUIDE COMPLETE

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SARAH MICHELLE LIVE REVIEW STUDY GUIDE (COMPLETE) What is the screening tool for the thyroid? What is the normal range for TSH? When do you order a full thyroid profile? What disorder demonstrates a low TSH level and high T3 and T4 levels? What disorder demonstrates a high TSH level and low T3 and T4 levels? What medication is used to treat hypothyroidism? What dose of Synthroid do you want to start your patient on? After initiation of medication for treatment of hypothyroidism, when do you recheck TSH level? When TSH level is stabilized, how often do you recheck their level? What is the go to medication for treatment of hyperthyroidism? How do you manage treatment for hyperthyroidism in a pregnant patient? What medication class is used to treat symptoms of hyperthyroidism? What are 2 other treatments for the hyperthyroidism? What labs are used to measure and evaluate kidney function? What lab value is most accurate description of kidney function? What is a normal GFR value? What GFR value indicates an absolute need to start a patient on dialysis? What is the second most important lab value to measure kidney function? What is creatinine? What is a normal creatine value? Why is BUN least telling for kidney function? What is a normal BUN level? With which first-line BP medication do we want to check the BUN/Cr? What finding on a UA id indicative of true kidney damage? When do we screen for microalbumin in the urine? What are the most common causes of CKD? Why is it important to perform early screening for microalbumin in the urine? What stage of CKD do patients show true symptoms? How often are we screening for micro albumin? What is the normal range of microalbumin?

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SARAH MICHELLE LIVE REVIEW STUDY GUIDE
(COMPLETE)

1). What is the screening tool for the thyroid?

 Ans: TSH Level


2). What is the normal range for tsh?

 Ans: 0.5-5.0


3). When do you order a full thyroid profile?

 Ans: If thyroid screening of TSH comes back abnormal, then we will reorder TSH and
T3, T4.


4). What disorder demonstrates a low tsh level and high t3 and t4 levels?

 Ans: Hyperthyroidism


5). What disorder demonstrates a high tsh level and low t3 and t4 levels?

 Ans: Hypothyroidism


6). What medication is used to treat hypothyroidism?

 Ans: Levothyroxine (Synthroid)


7). What dose of synthroid do you want to start your patient on?

 Ans: 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.


8). After initiation of medication for treatment of hypothyroidism, when do you recheck tsh
level?




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,  Ans: 6-8 weeks


9). When tsh level is stabilized, how often do you recheck their level?

 Ans: Every 6-12 months


10). What is the go to medication for treatment of hyperthyroidism?

 Ans: Tapazole and PTU


11). How do you manage treatment for hyperthyroidism in a pregnant patient?

 Ans: We need to use PTU instead if they are in their first trimester. After first
trimester, then they can be switched to tapazole.


12). What medication class is used to treat symptoms of hyperthyroidism?

 Ans: Beta-blockers- these help manage tachycardia and palpitations


13). What are 2 other treatments for the hyperthyroidism?

 Ans: Thyroidectomy and radioactive iodine


14). What labs are used to measure and evaluate kidney function?

 Ans: GFR, BUN, Creatinine


15). What lab value is most accurate description of kidney function?

 Ans: GFR- this is going to tell us how the kidneys are filtering the blood and how well
they are removing waste.


16). What is a normal gfr value?

 Ans: >90




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, 17). What gfr value indicates an absolute need to start a patient on dialysis?

 Ans: <15- this means that patient is in CKD stage 5


18). What is the second most important lab value to measure kidney function?

 Ans: Creatinine


19). What is creatinine?

 Ans: 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.


20). What is a normal creatine value?

 Ans: Around 1


21). Why is bun least telling for kidney function?

 Ans: 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.


22). What is a normal bun level?

 Ans: 10-20


23). With which first-line bp medication do we want to check the bun/cr?

 Ans: ACE Inhibitors


24). What finding on a ua id indicative of true kidney damage?

 Ans: Casts- WBC or RBC casts always need to be referred out


25). When do we screen for microalbumin in the urine?

 Ans: We're always going to screen when DM and HTN is first diagnosed.


26). What are the most common causes of ckd?



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,  Ans: HTN and DM


27). Why is it important to perform early screening for microalbumin in the urine?

 Ans: Patients who have mild kidney damage do not have symptoms, this screening
will ideally identify damage early and prevent progression.


28). What stage of ckd do patients show true symptoms?

 Ans: Stage 3 or worse


29). How often are we screening for micro albumin?

 Ans: Bare minimum is going to be annually for patients with DM or HTN or both.


30). What is the normal range of microalbumin?

 Ans: < 30


31). What is the most common symptom of all anemias?

 Ans: Fatigue


32). What is a normal hemoglobin level?

 Ans: 12-18
Women are on the lower end, and men are on the higher end


33). What is a normal hemoglobin to hematocrit ratio?

 Ans: 3 to 1
36-54%


34). What does mcv stand for?

 Ans: mean corpuscular volume




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