Endocrinology Flashcards
Which type of diabetes are prone to DKA?
Type 1
How does DKA typically present?
Abdominal pain Drowsiness Ketone smell on breath Polyuria, polydipsia, dehydration Kussmaul respiration (deep hyperventilation)
What is Kussmaul respiration and when is it seen?
Deep hyperventilation
Seen in DKA
What are the diagnostic features of DKA?
Acidosis (ph <7.3 and bicarb <15)
Ketosis (>3 or urinary ketones ++)
Hyperglycaemia (glucose>11)
What are the key management features for DKA?
IV saline fluid regime
IV insulin infusion started at 0.1unit/kg/hour, then 5% dextrose once glucose <15
Potassium replacement (not in first saline bolus as K+ given too quickly can lead to arrhythmias)
What are the diagnostic features of HHS?
Severe hyperglycaemia
Dehydaration
Osmolality >320mosmol/kg
(No acidosis or ketosis)
What are some clinical features of primary hyperparathyroidism?
(High calcium symptoms, bones moans groans and stones)
Bone pain/ # Peptic ulcer Constipation Renal stones Depression HTN
What is the treatment of primary hyperparathyroidism?
Removal of all 4 parathyroid glands
Which diabetes medication is useful in T2DM patients that are obese?
DDP-4 inhibitors (gliptins)
Which type of medication is exenatide?
GLP-1 agonist
How do gliptins work?
Inhibit DDP-4
So less GLP-1 is broken down
So, increased insulin secreted from beta cells, reduced glucagon secreted from alpha cells, acts on the brain for increased satiety, slows down gastric emptying, increase glucose uptake by muscles, reduces hepatic gluconeogenesis
Which T2DM drug results in weight loss?
GLP-1 agonists e.g. exenatide
Which receptor does piaglitazone agonise?
PPAR-gamma
What are some side effects of Piaglitazone?
Weight gain Liver impairment Fluid retention HF Bladder Ca Increased # risk
What is an ABG for a patient in DKA likely to show?
Metabolic acidosis with raised anion gap
