Diabetes And Endocrinology

Question 1

What is diabetes?

Answer 1

High blood sugar

Question 2

What is the WHO classification of diabetes?

Answer 2

Normal- fasting plasma glucose <6.0, 2hr post prandial plasma glucose <7.8
Diabetes- fasting plasma glucose >7.0, 2hr post prandial >11.1
Impaired glucose tolerance- fasting <7.0, 2hr post prandial 7.8-11.1
Impaired fasting glucose- fasting 6.0-6.9, 2hr post prandial <7.8

Question 3

How is diabetes diagnosed?

Answer 3

HbA1c (average blood glucose)

Question 4

What are the types of diabetes?

Answer 4

Type 1
Type 2
Gestational diabetes 
Drug-induced diabetes 
Genetic 
Secondary- pancreatitis, Cushing’s syndrome, acromegaly

Question 5

What is the difference in type 1 and type 2 diabetes?

Answer 5

Type 1- autoimmune destruction of the pancreatic beta cells

Type 2- insulin resistance +/- pancreatic failure

Question 6

What are the symptoms of type 1 diabetes?

Answer 6

Polyuria
Polydipsia
Weight loss
Ketosis

Question 7

What are the symptom of type 2 diabetes?

Answer 7

May be asymptomatic
Hyperglycaemic symptoms
Fatigue
Complications of diabetes

Question 8

What is the management of type 1 diabetes?

Answer 8

Insulin- rapid acting (novorapid), short acting, intermediate acing, long acting (levemir)

Question 9

What is the management of type 2 diabetes?

Answer 9

Diet and lifestyle changes

Drug therapy- metformin, thiazolidinediones

Question 10

What are some common emergencies in diabetes?

Answer 10

Diabetic ketoacidosis
Hyperosmolar hyperglycaemic state
Hypoglycaemia

Question 11

What is hypothyroidism?

Answer 11

Underactive thyroid glands- low fT4, high TSH

Question 12

What are the symptoms and signs of hypothyroidism?

Answer 12

Fatigue 
Weight gain 
Heavy periods 
Cold intolerance 
Lethargic appearance 
Dry skin 
Dry and brittle hair 
Outer eyebrows lost 
Bradycardia
Slow relaxing reflexes 
Goitre

Question 13

What is hyperthyroidism?

Answer 13

Over active thyroid gland- high fT4 (thyroxine), low TSH

Question 14

What are the signs and symptoms of hyperthyroidism?

Answer 14

Fatigue 
Weight loss
Light periods 
Heat intolerance 
Tremor 
Warm sweating palms 
Goitre 
Pressure of speech 
Emotional lability 
Tachycardia

Question 15

What is Grave’s disease?

Answer 15

An immune system disorder that results in the over production of thyroid hormones

Question 16

What is the treatment of Grave’s disease?

Answer 16

Drugs- carbimazole
Radioactive iodine therapy
Surgery

Question 17

What are the signs of thyroid cancer?

Answer 17

Cervical lymphadenopathy
Thyroid nodule hard
Goitre
Hoarseness

Question 18

What is the treatment for thyroid cancer?

Answer 18

Surgery

Radioactive iodine therapy

Question 19

What hormones does the pituitary gland secrete?

Answer 19

Anterior-
Follicle stimulating hormone 
Lutenising hormone 
Growth hormone 
Thyroid stimulating hormone 
Adrenocorticotropic hormone 
Prolactin 
Posterior-
Antidiuretic hormone 
Oxytocin

Question 20

What is acromegaly?

Answer 20

A hormonal disorder that develops when your pituitary gland produces too much growth hormone during adulthood

Question 21

What are the symptoms of acromegaly?

Answer 21

Headache
Sweating
Loss of peripheral viison

Question 22

What are the signs of acromegaly?

Answer 22

Prognathism
Separation of teeth
Coarse facial features
Doughy skin cancer

Question 23

What is the diagnosis of acromegaly?

Answer 23

Oral glucose tolerance test

Question 24

What is the treatment of acromegaly?

Answer 24

Surgery

Somatostatin analogues

Question 25

What is Cushing’s syndrome?

Answer 25

A condition caused by having too much cortisol in your body

Question 26

What are the symptoms of Cushing’s syndrome?

Answer 26

Weight gain Muscle weakness Amenorrhoea

Question 27

What are the signs of Cushing’s syndrome?

Answer 27

``` Buffalo hump Striae Cervical fat pad Osteoporosis Proximal myopathy ```

Question 28

How is Cushing’s syndrome diagnosed?

Answer 28

24 hour urinary free cortisol Dexamethasone suppression test Differential- imaging, vein sampling

Question 29

What is the treatment for Cushing’s syndrome?

Answer 29

Ketonazole | Mitotane

Question 30

What is paechromocytoma?

Answer 30

Tumour of the adrenal glands

Question 31

What are the signs and symptoms of phaeochromocytoma?

Answer 31

``` Headaches Palpitations Sweating Tachycardia Hypertension Family history Pale Clammy Neuromas on the tongue and around the mouth ```

Question 32

What is Addison’s disease?

Answer 32

Where the adrenal glands don’t produce enough hormones?

Question 33

What are the signs and symptoms of Addison’s disease?

Answer 33

``` Weight loss Postural dizziness Neuroglycopenia Family history Low BP Pigmentation ```

Question 34

What is the treatment of Addison’s disease?

Answer 34

Glucocorticoid- hydrocortisone 15mg | Mineralocorticoid- fludrocortisone