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Flashcards in Endocrine Deck (20):
1

Name 5 essential components to clinically assess, investigate & manage in order to treat & prevent recurrence of diabetic foot complications.

1. Peripheral neuropathy
2. Peripheral vascular disease
3. Ulceration
4. Infection
5. Maximise diabetes control

2

At what toe pressure is an ulcer unlikely to heal?

3

How do you diagnose infection of an ulcer?

1. Purulent discharge
OR
2. Two or more of: pain, swelling, redness, warmth

4

What are serological markers of osteomyelitis from a foot ulcer?

-Elevated WCC, CRP/ESR
-Elevated ALP

5

What serum test is most diagnostic of prolactinoma?

Elevated serum prolactin

6

What are the clinical features of prolactinoma in women & in men?

Women: galactorrhoea, oligomenorrhoea, amenorrhoea, infertility

Men: decreased libido, infertility, impotence, gynaecomastia (rarely galactorrhoea)

7

What is the usual treatment for prolactinoma?

Dopamine agonists (cabergoline, bromocriptine)

8

What common test is useful for the diagnosis of acromegaly?

Oral glucose tolerance test - failure to suppress GH release is diagnostic

9

Pituitary macroadenoma =

GH-secreting

10

Pituitary microadenoma =

Prolactinoma

11

What is the first-line treatment of acromegaly?

Transphenoidal-hypophysectomy

12

What blood test results could you expect in Cushing's syndrome?

FBE: high-normal Hb, high WCC with low neutrophils
Glucose: elevated
Electrolytes: hypokalaemia & metabolic acidosis in ectopic ACTH
Hypercalciuria (urine test)

13

What tests are used to diagnose Cushing's syndrome?

-24-hour urine free cortisol
-Dexamethasone suppression test (lack of suppression is diagnostic)

14

What blood test results could you expect in Addison's disease?

-Electrolytes: hyponatremia, hyperkalaemia, moderate acidosis, increased urea

-Hypoglycaemia

15

What are some clinical features of Addison's disease?

-Postural hypotension
-Fatigue
-Unintentional weight loss
-Hypoglycaemia
-Hyperpigmentation
-Unexplained hyperkalaemia

16

What test is diagnostic of Addison's disease?

Synacthen test (ACTH infusion test) - shows whether the adrenals can respond to an appropriate stimulus or not

17

What is the management of an Addisonian crisis?

-Hydrocortisone 100mg IV 6 hrly
-Fluid replacement: IV N saline
-Glucose if hypoglycaemic

18

What is the clinical triad of Conn's syndrome?

-Hypertension
-Hypokalaemia
-Metabolic alkalosis

19

What is diagnostic of primary hyperaldosteronism?

High aldosterone/renin ratio

20

What are the treatment options in primary hyperaldosteronism (Conn's syndrome)?

-Adrenal adenoma removal
-Aldactone (aldosterone antagonist)
-Amiloride (decreases potassium excretion)