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Hyperthyroidism

Diffuse radioiodine uptake

Treatment:
Beta blocker
Methimazole (non-pregnant patients, 2nd/3rd trimester pregnancy)
Propothiouracil/PTU: 1st trimester pregnancy
Graves' Disease
Asymptomatic hyperkalemia
Typically NO hyponatremia
Hypoaldosteronism
Symptoms:
Weight loss
Abdo pain
Asthenia (physical weakness, lack of energy)
Amenorrhea
Fatigue
Weakness
Poor appetite
Hyperpigmentation

Signs:
Hyponatremia
Hyperkalemia
Mild hyperchloremic metabolic acidosis

Diagnosis:
Morning cortisol, ACTH
ACTH stim test
Adrenal Insufficiency
US first, and to monitor small nodules <1cm not suspicious for malignancy
Then FNA if suspicious for cancer, high TSH

Low TSH --> radionuclide scintigraphy
Hot nodule (high uptake)--> BENIGN
Cold nodule--> possibly cancerous
Thyroid nodule evaluation
Acute exacerbation treated with oral steroids
Asthma treatment
Necrolytic migratory erythema (Rash with central clearing)
Diabetes
Abdo pain/cramps, diarrhea, facial flushing, lethargy, weight loss
Glucagonoma
Diarrhea
Dermatitis
Dementia
Stomatitis
Cheilosis
Niacin Deficiency (Vitamin B3)
Rate or rhythm control
Rate (beta blocker, diltiazem, amiodarone, digoxin)

Anti-coagulation: CHADS2VASC >= 2, anticoagulate
Atrial Fibrillation
Endemic areas: Wisconsin, Pennsylvania, Minnesota, NY, NJ, delaware, rhode island, maine

Initial: viral prodrome (headache, myalgias, fatigue), erythema migrans (may initially be confluent rash)


Early disseminated: CN palsies, meningitis, carditis, migratory arthralgias

Late: arthritis, encephalitis, peripheral neuropathy

Treatment: Doxycyciline
Lyme Disease
Multiple motor (blinking, grimacing) + at least 1 vocal tic (throat clearing) > 1 year

Treatment:
Anti-psychotics
Alpha agonists (clonidine, guanfacine)
Tourette's
Age 55-80
>= 30 pack year history of smoking
Current smokers
Quit smoking within 15 years

Helical low dose CT
Lung Cancer screening