Endo Q's Flashcards
(23 cards)
anorexia nervosa
*requires BMI <18.5
1o adrenal insufficiency presentation
*salt cravings, hyponatraemia, hyperkalaemia
*wt loss, hypotension,
*fatigue, low mood, low appetite
*loss of pubic and axillary hair(women), loss of libido
investigation:- cosynotropin stimulation test if no increase of cortisol confirms diagnosis
How to avoid exercise induced hypoglycemia in type I DM
- increase carb intake
*if exercising for <60mins then reduce dose of premeal insulin prior to exercise
*if exercising for >60min reduce dose of basal insulin and premeal insulin
Craniopharyngioma presentation
*benign slow growing tumor age 5-14 and 50-75 yrs
*C/O polyuria, polydipsia, dehydration
*bitemporal hemianopsia, diabetes insipidus, growth failure
*LOw TSH, Low GH, Low FSH,LH, low ADH
*CT scan suprasellar tumor calcified
DKA presentation
*young age
*acute onset of polyuria, polydipsia, blurred vision
*hypotension, wt loss
*diffuse abdominal pain, altered mental state
*hyperventilation
indications for parathyroidectomy
*age <50
*symptomatic hypercalcaemia
*complications:- osteopenia/osteoporosis, renal stones, CKD
*Ca levels >1g/dl above upper limit
* 24hr urine Ca excretion >400mg/day
who is at higher risk of hypoglycaemia on insulin therapy
- type I DM
- pancreatogenic DM ( due to damage to pancreas e.g CF, chronic pancreatitis)
pt with +ve TPO, low TSH, high free T4, painless goiter, low radio iodine uptake, hyperthryroid features. diagnosis & mgx
painless subacute thyroiditis
treat with B blockers for symptoms
Cushing disease diagnostic test
- late night salivary cortisol assay
*24hr urine free cortisol test
*overnight low dose dexamethasone suppression test
after confirming hypercortisolisim then do ACTH level to see if ACTH dependent or independent
Cushing’s Syndrome features
High cortisol
central obesity
glucose intolerance
proximal muscle weakness
HTN
toxic adenoma
- common cause of hyperthyroidism after Graves disease
- due to TSH receptor mutation
- hot nodule rarely turns malignant
toxic adenoma hyperthyroidism complication if not treated
rapid bone loss leading to osteoporosis
hypercalcuria, hypercalcaemia
Thyroid nodule investigation
*TSH level + U/S
* if low TSH –> radionucletide scan
* if TSH normal or high —> if size > 2cm/ cold nodule –> FNA
sick euthyroid syndrome
*occurs in pts who have severe, acute illness
*low T3 with normal T4 and TSH
adrenal crisis
- hypotension, shock, abdo pain
*in patient with adrenal insufficiency/ or taking longterm steroids for another reason –> under surgery, illness, injury
*mgx:- steroid injection
VHL
*cerebral + retinal haemangioblastoma
*phaeochromocytoma –> excess catecholamines –> sever HTN
*Renal cell cancer
*
cause of hypercalcaemia with a low PTH
*malignancy
*immobilisation
*thiazide diuretics
*vitamin D toxicity
*thyrotoxicosis
*milk alkali syndrome
mgx of papillary thyroid cancer
*surgical resection
* if high risk of recurrence then follow up with radio iodine ablation and thyroid replacement to suppress TSH
stress hyperglycemia
*seen in pts in ICU with burns, trauma/haemorrhage, sepsis
*high blood glucose with no hx of DM
*if mild no treatment if glucose lever >180-200 –> short acting insulin
Drugs that can cause SIADH
*carbamezaoine
*NSAIDS
*SSRIs
* intranasal desmopressin
complications of prolactinoma
*osteoporosis
*infertility
serotonin syndrome
*HTN
*autonomic dysfunction (tachycardia, sweating, dilated pupils)
*hyerreflexia
*muscle rigidity
Phaeochromocytoma
*headaches
*HTN
*tachycardia
* HTN surges with surgery, anesthesia, inc abdominal pressure
