Please enable JavaScript.

Coggle requires JavaScript to display documents.

ENDOCRINOLOGY-IM, with toxic adenoma and multinodular goiter usually…

- - - - propanolol
        
        PTU + SSKI( KI)
        
        hydrocortisone
  - - - basadown RAIU scan--> cao/thấp---> tg
- - - - PTH bt/cao: tăng Ca phụ thuộc PTH
        
        cường cận giáp nguyên phát
        
        lithiium
        
        tăng canxi mau giảm canxix niệu gd
        
        PTH giảm: tăng CA ko phụ thuộc PTH
        
        PTHrp/ 25/1,25
        
        bênh ác tình
        
        Malignancy-associated hypercalcemia
        
        PTHrP production ( 80% ac tình)
        
        squamous cell cancer ( lung/ head/ neck)
        
        renal/ bladdder cancer
        
        buổng trứng/ vú
        -----> kích hoat thụ thể PTH---> tăng hấp thu CA xương
        1,25 oh
        
        lymphomas
        -----> tăng hấp thu Ca ở ruột
        u di căn Xương
        
        ung thư vú/ multiphe myeloma
        ----> giải phóng yếu tố tại chỗ ( cytokines) kích thích hấp thu
        Ectopic PTH production ( hiếm )
        
        đa dạng
        -----> hất thu xương
  - - - PT thuyến cận giáp
        
        viêm tụy cấp
        
        Chelation
        
        chelation: truyên máu ( citrate), EDTA, foscarmet
      - dau cơ
        
        bàn tay phụ khoa
        
        dị cảm
        
        tăng px..
      - dtri: Calcium gluconat/ chlorie
- - - - chuyện gì ne1u ko dtri bệnh to dầu chi:
        1..u lớn---> ảnh hưởng
        2.tim--->cao HA, bệnh cơ timm, HF,coronary artery disease,
        3.Phỏi----> ngưng thở khi ngủ/ colon polyps
        4 NT: DTD
  - - - thai
        
        TSH,FSH, prolactin- tăng
        ( suy giáp/ suy BC sớm/ U ruýn ye6n
  - - - dopamin dồng vận (Cabergoline)
        
        PT qua sàn sọ trước
      - Quản lý 1 BN cường prolactinemia + trước mãn kinh
        1.khám LS
        2 . loai trừ có thai
        
        MRI tuyền yen
        
        u nhỏ< 10mm + ko TC--> ko dtri
        
        u lớn> 10mm + TC---> thuôc / PT
      - GYNECOMASTIA
        
        cơ ché bênh sinh và nguyên nhân:
        tăng Estrogen / chuyển hóa ngoại vị
        
        u ở cá vi trí: tinh hoàn/ TT/ Gnotrophin
        
        xơ gan- spinorolactione
        
        andogen use
        thếu Androgen
        
        Klinefelter syndrome
        
        tăng prolactiine
        
        suy thạn
  - - - SHEEHAN SYNDROME
        
        Symptoms can occur in immediate post-partum period or several years later
        
        Management: evaluation of pituitary hormones and replacement as needed
        
        TUO^T HUYẾt ap
- - - - Metanephrinen nc tiẻu
        
        nen cắt tuyến thượng tahn truoc khko cắt tuyến giap
  - - - primary hyperaldosteronism
        
        tăng HA/ giảm K/ kiểm chuyể hóa + ko phù
        
        A/ R> 2 + A> 15
        
        CT or adrenal venous sampling Pb dc adenomal hay hyperplasia)
        
        dtri:
        
        u 1 bên edeoma---> PT
        
        hyperplasia 2 ben: thuốc kháng aldsterone
  - - - bt/ suy tuyến tt nguyện phát, thứ phát
        
        PB nguyên phát và thứ phát( nguyen phát: aldosteron giàm/ thức phát : bt
        ----> 1st: tư miên
        2st: cdtri corticoid mãn
        ----> Cortiocid/ ACTH
        
        The key differentiating features of PAl from central adrenal insufficiency are hyperpigmentation
        and hyperkalemia seen in PAI
        
        C/F of Primary Adrenal Insufficiency (Addison’s disease)
        
        Chủ yếu do AUtoimmune
        lao...
        
        CƠN cấp : Shock giãm thể tich ( HA giảm..) + Na giảm K ca tăng
        
        đau bung /sốt/ nôn ói/ giảm cân
        
        YTNC: chày máu / nhồi máu vỏ thượng thận
        
        Bênh nền/ PT; suy TT mãn/ sd steroid mãn/ tăng sàn TT bẩm sinh
        
        chẩn đoán: ......+ diện giải/bun
        
        dtri : hydrocortisone or dexamethasone
        
        CONGENITAL ADRENAL HYPERPLASIA-Depends on the deficiency of enzyme
        
        11B hydroxylase
        
        triệu chưng giống vs 21 nhưng tăng huyế ap vi ( weak mineralcoritcoid + 11 deoxycortid
        
        17 A hydroxylase ( chuyể đổi)
        
        giảm: costisol + testo
        
        tăng aldosterol +weak mineralcoritcoid
        -----> tăng huyết áp
        
        21-hydroxylase deficiency-90% case ( phóng thích 1 )
        
        giảm: Aldosterone+ corticol
        
        tằng testoterol
        
        tằng 17 hydroxypreogesterone
        ------> bất thường cơ quan sinh duc nữ+ má muổi ( HA giảm/ NA gảm/ k tăng )
        
        1 more item...
        
        mãn: tăng sắc tố da( ACTH tằng) + ( ha HA, giảm Na Ca tăng K)
        
        thiếu máu/ eoniphial/ mệt mỏi chán ăn, sụt cân
        
        đo ACTH/ cortisoi máu+ test 250
        
        1 st: cortisol giảm, ACTH tăng
        
        2st: giảm cả 2
        
        Low cortisol (<5µg/dl)+ high ACTH (>50pg/dl) primary adrenal insufficiency (Addison disease)
        
        Low cortisol (<5µg/dl)+ low ACTH (<50pg/dl) central adrenal insufficiency (pituitary or
        hypothalamus)
        
        ntermediate dose of glucocorticoids (5-20mg or equivalent)
- - - - TBG—synthesized and sialylated in liver. Oral estrogen or pregnancy (↑estrogen) ↓ clearance of
        
        TBG↑TBG↓free T4↑dose of levothyroxine. Transdermal estrogen bypass liver TBG not
        
        affected