Endocrinology Flashcards
(29 cards)
What viruses can trigger T1D?
Coxsackie B and enterovirus
What is a normal glucose range?
4.4-6.1
How does hyperglycaemia present?
Polyuria
Polydipsia
Weight loss
(bedwetting and recurrent infections)
What tests should be done for T1DM?
FBC, U+E, Lab glucose HbA1C Thyroid function Anti-TTG (Coeliac) Insulin/islet/Anti-GAD Abs (pancreatic destruction)
Name a type of long acting insulin
Lantus
Name a short acting insulin
Actrapid
How does hypoglycaemia present?
hunger, tremor, sweating, confusion, pale, dizziness
In hospital setting how does you treat hypoglycaemia?
IV dextrose and IM glucagon
How do you treat DKA?
Fluid resus followed by fixed rate insulin
What do you need to be aware of in DKA treatment?
Potassium levels, hypokalaemia
Cerebral oedema
How does cerebral oedema present?
Headache, confusion, altered behaviour, bradycardia
What is primary adrenal insufficiency?
Addison’s - damaged adrenal gland with decreased cortisol and decreased aldosterone
What is secondary adrenal insufficiency?
Damaged pituitary (caused by infection, congenital, radiotherapy, etc)
Not enough ACTH released
Adrenal glands aren’t stimulated enough
Not enough cortisol produced in adrenal glands
What causes tertiary adrenal insufficiency?
Inadequate CRH from hypothalamus as a result of long term steroid use suppressing the hypothalamus
What are the symptoms and signs of adrenal insufficiency?
Lethargy, vomiting, hypoglycaemia, jaundice, failure to thrive. Bronze pigmentation (in Addison's only as there's an increase in ACTH which then stimulates melanocytes).
What is a test for Addison’s?
Short Synacthen Test (ACTH stimulation test - if cortisol doesn’t rise less than double the baseline then positive test)
What investigation results are expected in Addison’s?
Low cortisol
Low aldosterone
High ACTH
High Renin
What results are expected in 2’ Adrenal Insufficiency tests?
Low cortisol
Normal aldosterone
Low ACTH
Normal renin
How are adrenal insuff treated?
Hydrocortisone - cortisol
Fludrocortisone - aldosterone
How does Addisonian Crisis present?
Reduced consciousness + hypotension
Hypoglycaemia, hyponatraemia, hyperkalaemia.
How do you manage a Addisonian Crisis?
IV hydrocortisone
IV fluid resus
Correct hypoglycaemia
What is Congenital Adrenal Hyperplasia?
Congenital deficiency of 21-hydroxylase enzyme
This causes a decrease in the production of cortisol and aldosterone from progesterone and an overproduction of testosterone from progesterone.
What signs + symptoms in CAH?
Female: ambiguous genitalia
After birth: Hypoglycaemia, hyponatraemia and hyperkalaemia.
Could see bronzing from increased ACTH due to cortisol decrease.
What is the pathophysiology of Growth Hormone Deficiency?
Damage to anterior pituitary which stimulates the release of ILGF-1 by the liver.
