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Main diseases for each system > Endocrine > Flashcards

Endocrine Flashcards

1
Q

How is diabetes mellitus suspected at bedside?

A

Capillary glucose test, urinary ketones

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2
Q

How is diabetes mellitus diagnosed?

A

Random plasma glucose ≥ 11.1 mmol/l

Fasting plasma glucose ≥ 7.0 mmol/l

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3
Q

Symptoms of diabetes mellitus type 1

A 
Polyuria
Polydipsia
weight loss
blurred vision
nausea and vomiting
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4
Q

Treatment of diabetes mellitus type 1

A

Basal bolus insulin

Premeal corrective insulin

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5
Q

Symptoms of diabetes mellitus type 2

A 
asymptomatic
candidal/skin infections
fatigue
blurred vision
polydipsia
polyuria
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6
Q

Treatment of diabetes mellitus type 2

A

First line; diet and exercise

Second line; metformin

Third line; sulphonylurea

Next can add thiazolidinedione, DPP4 inhibitor, SGLT2 inhibitor, GLP1 receptor agonist

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7
Q

In which patients is thiazolidinedione contraindicated?

A

Those with heart failure

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8
Q

How does DKA present?

A 
nausea or vomiting
abdominal pain
confusion
polydipsia
polyuria
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9
Q

How is DKA diagnosed?

A

plasma glucose
ABGs
capillary/serum ketones
urinalysis

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10
Q

Treatment of DKA

A

IV fluids, supportive care, potassium, insulin once potassium at 3.3mmol/l

May give vasopressors, bicarbonate therapy, phosphate therapy

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11
Q

Symptoms of Conn’s disease

A

nocturia
polyuria
lethargy
mood disturbance

HYPERTENSION

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12
Q

Diagnosis of Conn’s disease

A

plasma potassium; normal/low
aldosterone/renin ratio
Fludrocortisone suppression test

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13
Q

Treatment of Conn’s disease

A

unilateral adrenectomy

bilateral adrenectomy

aldosterone antagonists

IF FAMILIAL; glucocorticoids

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14
Q

Symptoms of cushing’s syndrome

A 
hypertension
weight gain
striae
thin skin
bruise easily
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15
Q

Diagnosis of Cushing’s syndrome

A
  • raised serum glucose
  • late night salivary cortisol raised
  • 1mg overnight dexamethasone suppression test
  • 24hr urinary free cortisol
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16
Q

Treatment of cushing’s syndrome

A

Primary adrenal; unilateral/bilateral adrenectomy

Disease; transphenoidal pituitary adrenectomy

17
Q

symptoms of addison’s disease

A 
fatigue
anorexia
weight loss
nausea
vomiting
hypotension
buccal pigmentation
hyperpigmentation
18
Q

Diagnosis of addison’s disease

A

serum electrolytes
blood urea
FBC
synACTHen test

19
Q

Ongoing treatment of addison’s

A

Gluco and mineralocorticoid replacement

  • hydrocortisone, prednisolone
  • fludrocortisone
20
Q

Treatment of acute adrenal crisis

A

glucocorticoid + supportive therapy

  • corticosteroids
  • saline to correct hypotension and dehydration
  • glucose to correct hypoglycaemia (avoid worsening hyponatraemia)
21
Q

Symptoms of Grave’s disease

A 
heat intolerance
sweating
lid retraction
opthalmopathy
weight loss 
irritability
22
Q

Diagnosis of Grave’s disease

A

TSH
Free T3 T4
TSH receptor antibodies

23
Q

Treatment of Grave’s disease

A 
First line; prolonged antithyroid i.e. carbimazole
ameliorate symptoms
radioactive iodine
corticosteroid
thyroid surgery
24
Q

When is radioactive iodine contraindicated?

A

Pregnancy and planning pregnancy

25
Q

Symptoms of hypothyroidism

A 
weakness
lethargy
cold sensitivity
weight gain
constipation
26
Q

Diagnosis of hypothyroidism

A 
TSH
Free T3/T4
raised cholesterol possible
FBC
anti thyroid peroxidase antibodies
27
Q

Treatment of hypothyroidism

A

levothyroxine

low dose in CAD bc can aggravate angina

28
Q

Hashimoto’s symptoms

A 
fatigue
weight gain
pale/puffy face
cold intolerance
joint/muscle pain
29
Q

Hashimoto’s diagnosis

A 
TSH 
Free T3 T4
TPO antibodies
TSH receptor antibodies
radioiodine/technetium scan (minimal uptake)
30
Q

Treatment of Hashimoto’s

A

Levothyroxine

During thyrotoxicosis ameliorate hypertension with bblockers and CCBs

31
Q

Symptoms of hyperparathyroidism

A 
Osteoporosis
nephrolithiasis
bone pain
poor sleep 
fatigue
32
Q

Diagnosis of hyperparathyroidism

A

serum calcium
serum PTH
Vit D level
ALP (may be raised)

33
Q

Treatment of hyperparathyroidism

A

parathyroidectomy

+/- vit d supplementation

34
Q

Hypoparathyroidism symptoms

A

muscle spasms
anxiety
brittle nails
dry hair

35
Q

Diagnosis of hypoparathyroidism

A

serum calcium
serum albumin (normal)
ECG (prolonged QT)
PTH

36
Q

Treatment of hypoparathyroidism

A

severe hypocalcaemia <1.88 ; IV calcium gluconate

ongoing = oral calcium and calcitriol

37
Q

Symptoms of pheochromocytoma

A 
headache
palpitations
orthostatic hypotension
hypertension
hypercalcaemia
cushing syndrome
38
Q

Diagnosis of pheochromocytoma

A

24hr urinary collection catecholamines

plasma catecholamines

39
Q

Treatment of pheochromocytoma

A

Hypertensive crisis; antihypertensive agents

First line; alpha blockers + bblockers after alpha blockade + volume expansion

Tumour surgical excision

Main diseases for each system (12 decks)

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