endocrine Flashcards by catriona forsyth

3 criteria of DKA

ketones >3
glucose >11
bicarbonate <15

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treatment of DKA

0.9% saline
insulin 0.1 unit/kg/hr

when glucose <14 start 10% dexterose

after 24hrs if not resolved specialist review

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antibodies in type 1 diabetes

anti GAD
islet cell antibodies (destroy beta cells of islets of langerhan)

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HbA1c levels

≤41 normal
42-47 pre-diabetes
≥48 diabets
<53 goal for diabetics

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type 2 diabetes + CVD

metformin + sglt-2

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insulin in ramadan

1/3 before sunrise
2/3 after sunset

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treatment of diabetic peripheral neuropathy

amitryptilin
duloxentine
gabapentin
pregabilin

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MODY inheritance pattern

autosomal dominant

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cause of cranial DI

decreased production of ADH -

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cause of nephrogenic DI

desensitisation of ADH - lithium, heamochromatosis

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treatment of DI

cranial = desmopressin
nephrogenic - thiazides, low salt

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treatment of SIADH

fluid restriction

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type 1 diabetes + BMI >25

insulin + metformin treatment

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when should type 1s measure glucose

before each meal and before bed

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abg of cushings

hypokalaemia

metabolic alkalosis

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high dose dexamethasone test results

cortisol & ACTH

both decreased - cushings disease
both increase - steroids
1 increases (cortisol) 1 decreases - something else

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pseudo-cushings

alcohol excess

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blood results in SIADH

decreased blood sodium
increased urine sodium

diluted blood - concentrated pee

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treatment of MODY

sulphonureas

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posterior pituitary hormones

ADH & oxytocin

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treatment of prolactinoma

dopamine agonists

cabergoline
bromocriptine

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investigation into acromegaly

screen - serum IGF - 1
definitive - OGTT

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treatment of acromegaly

surgery

octreotide/ pegrisomant

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what is addisons

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decreased adrenal function

decreased mineralocorticoids (aldosterone), androgens & glucocorticoids (cortisol)

investigation into Addison's

short synACTHen test or 9am cortisol

treatment of addisons

cortisol replacement - hydrocortisone aldosterone replacement - fludrocortisone

what happens in an addisons crisis

pt stops taking hysrocortisone - cortisol plummets

periods and thyroid

hypothyroid - heavy hyper - irregular

cause of follicular thyroid cancer

low iron

hyperparathyroid primary vs secondary vs tertiary

primary (tumour) - increased Ca, low phosphate secondary (decreased Vit D) - low Ca, high phosphate tertiary (long secondary) - very high PTH, high Ca

blood results in hyperaldosteronism

low potassium high sodium (high BP)

treatment of bilateral adrenal hyperplasia (hyperaldosterone)

spirinolactone

MEN 1

parathyroid (hyper) pancreas pituitary

MEN 2a

(RET oncogene) parathyroid (hyper) phaechromocytoma medullary thyroid cancer

MEN 2b

(RET oncogene) phaechromocytoma medullary thyroid cancer marfanious

radioiodine & graves disease

makes eye problems worse

C peptide in T1DM

low

when to treat subclinical hypothyroid

+ve result twice in 3 weeks

treatment of thyroid storm

beta blockers propylthiouracil hydrocortisone

which organism causes diabetic foot ucers

pseudomonas

treatment of hyperparathyroid

surgery if not - cinacalcel

how to determine the cause of precious puberty in boys via testi size

bilateral large testis - intracranial lesion one large testi - gonadal tumour small testes - adrenal cause

blood results in bone mets

high Ca high ALP lytic bone lesions

treatment of HHS

0.9% saline no insulin

investigation into primary aldosteronism

saline suppression

palliation in bone mets

analgesia bisphosphonates

antibody in drug induced lupus

antihistone

insulin diabetes DVLA

must notify 1 year only 1 hypo >3 months ago

diabetes med that causes weight loss

sitagliptin - DPP4

acid base imbalance in cushings

hypokalaemic metabolic alkalosis

DPP-4 moa

increases levels of incretin (GLP-1_

investigation into insulinoma

CT of pancrease

hyperglycemia before the age of 25

think MODY (refer to endocrine)

pseudohypoparathyroid vs secondary hyperparathyroid

psuedo = normal eGFR (normally picked up in kids) hyper = low Vitamin D or CKD

dexamethasone suppresion tests

1. low dose 2. normal ACTH low = adrenal cause normal ACTH normal = not 3. high dose ACTH & cortisol suppressed = pituitary cause ACT suppressed cortisol not = a different cause

cushings ABG

hypokalalemia metabolic alkalosis

investigation into hypercalceamia

PTH

causes of increased Ca using PTH

high Ca low PTH - cancer high Ca normal PTH - refer to endocrine both high - hyperparathyroid

painful goiter

suabute (de quevrians)

endocrine Flashcards

(59 cards)