Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 3 > MedEd diabetes and pituitary > Flashcards

MedEd diabetes and pituitary Flashcards

(77 cards)

Start Studying
1
Q

What gene is T1DM associated with?

A

HLA DR3/4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is T2DM associated with?

A

Obesity
HTN
Inactivity
Dyslipidaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What state causes polyuria in T1DM?

A

Osmotic diuresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some signs of DKA?

A

Nausea and vomitting
Abdo pain
Kaussmal breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some signs of T2DM?

A

Acanthosis nigricans

Signs of peripheral disease/ complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is random glucose in diabetes?

A

> 11.1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is fasting glucose in diabetes?

A

> 7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is HbA1c in diabetes?

A

> 48

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What antibodies are associated with T1DM?

A

Anti GAD antibodies

Islet cell antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What test should you always do for T1DM in GP and what will you see?

A

Urine dip- positive glucose and ketones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is insulin given in T1DM?

A

Basal bolus regimen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the first line treatment for T2DM?

A

Lifestyle advice= diet, exercise, education

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the first line pharmacological treatment for glycaemic control in T2DM?

A

Metformin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the first line pharmacological treatment for blood pressure management in T2DM? What is second and third line

A

Ace inhibitor, if black ARB
Then add CCB or thiazide
Then ACEi/ARB with CCB and thiazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What glucose level is classed as hypoglycaemia?

A

<3.6 mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are signs of hypoglycaemia?

A

Palpitations, tremors, sweating, pallor, anxiety, drowsiness, confusion, coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is hypoglycaemia managed?

A

If conscious- eat sugary food

If consciousness is impaired - IM glucagon 1g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What triad signifies DKA?

A

Hyperglycaemia
Ketonaemia
Metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why is ketonaemia harmful?

A

Acidity causes enzyme dysfunction which can lead to coma and death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How is DKA managed?

A

Hydration with IV fluid

Insulin to reduce ketones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is HHS? How does it present?

A

Hyperosmolar hyperglycaemic state- hyperglycaemia with no ketonaemia
Dehydration, kussmaul breathing, nausea and vomitting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How can you differentiate DKA and HHS based on signs and symptoms?

A

They are the same but no abdo pain in HHS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How are DKA and HHS managed?

A

Start IV saline (and potassium chloride if K+ <5.5)
IV insulin (fixed rate) after fluids (only when K+ is not <3.5)
Include dextrose in fluids if <14
Treat underlying cause eg abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is plasma glucose in DKA?

A

> 11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is plasma glucose in HHS?
>30
26
What are the 4 stages of retinopathy?
``` 1= background retinopathy= blot and dot haemorrhage/ hard exudates 2= pre prolif= background and cotton wool spots 3= proliferative= non proliferative and new vessels on disk (neovascularisation) 4= maculopathy= hard exudates and near macular ```
27
What is neovascularisation associated with?
Retinal detachment with retinal detachment and vitreoud haemorrhage with visual loss
28
How is retinopathy managed?
Backgorund= improve glycaemic control Pre proliferative and proliferative= pan retinal laser photocoagulation Maculopathy= anti VEGF injections
29
How does diabetic nephropathy present?
Oedema, polyuria, lethargy, hypertension
30
What is the first line investigation for diabetic nephropathy? What will you see?
Urinalysis | Will show a high albumin: creatinine due to microalbuminuria
31
How is diabetic retinopathy managed?
ACEi/ARB | Improve glycaemic control
32
What causes diabetic neuropathy?
Blockage of the vasa vasorum (blood vessels that supply the vasa vasorum)
33
What distribution is associated with diabetic peripheral neuropathy?
Glove and stocking
34
What are some signs and symptoms of diabetic neuropathy?
Loss of sensation (especially feet) Loss of ankle reflex Injuries to foot Fractures
35
What are the 3 types of diabetic neuropathy?
Peripheral Autonomic Mono
36
How will autonomic diabetic neuropathy present?
``` GI tract symptoms= difficulty swallowing, bladder dysfunction, delaye dgastric emptying Postural hypotension (collpase on standing) Cardiac autonomic supply ```
37
How will diabetic mononeuropathy present?
Sudden motor loss eg wrist drop, foot drop, 3rd nerve palsy
38
What is seen on third nerve palsy?
Eye down and out | Pupil responds to light
39
What is diabetes insipidus?
Inadequate secretion or sensitivity to vasopressin/ADH causing production of dilute urine
40
What are causes of cranial diabetes insipidus?
Pituitary tumor, infection, sarcoidosis, TB
41
How will someone with diabetes insipidus present?
Polyuria Nocturia Polydipsia Dehydration (tachycardia, dry mucous membranes)
42
What are first line investigations for DI? What will you see?
UEs (ca/k for cause) Glucose Water deprivation test
43
How is the water deprivation test carried out?
Restrict them of water for 8 hours | Then give desmopressin and monitor UEs every hour
44
What will be the result of water deprivation test in a normal person, cranial and nephrogenic DI?
Normal- no change in urine osmolality after desmopressin is given and no more water to reabsorb Cranial- rapid rise in urine osmolarity Nephrogenic- urine remains unconcentrated
45
How is diabetes insipidus managed?
``` Cranial= Intranasal desmopressin and tell them not to drink lots of water Nephrogenic= thiazide diuretic, low salt and protein diet ```
46
What is SIADH?
Excess ADH secretion causing too much water absorption
47
What happens to serum Na, urine osmolality and urina na in SIADH?
Serum na= low Urine osmolality= high Urine na= high
48
What are causes of SIADH?
``` CNS= subarachnoid haemorrhage, tumor, TB Pulmonary= pneumonia, bronchiectasis Malignancy= small cell lung cancer Drugs= carbamazepine, SSRI Idiopathic ```
49
How is SIADH managed?
Treat cause eg surgery for tumor Immediate fluid restriction for hyponatreamia If ineffective oral demeclycycline/IV vaptans
50
What is normal sodium?
135-145 mEq/L
51
What are the 3 types of hyponatreamia?
Hypovolemic Euvolemic Hypervolemic
52
What are causes of hypovolemic hyponatreamia? How is it managed
Vomitting Diarrhoea Diuretics Manage with IV fluid
53
What is urine sodium in hypovolemia hyponatreamia?
Low (<20)
54
What are causes of euovolemic hyponatreamia? How is it managed
SIADH Hypothyroidism Adrenal insufficiency Manage= Fluid restrict
55
What are causes of hypervolemic hyponatreamia? How is it managed
Liver, kidney or heart failure Manage by restricting fluid
56
How do you treat severe hyponatreamia?
Slow IV saline
57
What happens if IV saline is given too fast?
Central pontine myelionylysis
58
Why is SIADH euvolemic?
Posterior pituitary produces lots of ADH Lots of BNP is produced This BNP prevents ADH from making you hypovolemic
59
What is fluid intake restricted to when treating hyponatraemia?
1 litre/ day
60
What range is hypernatreamia?
>145 mEq/L
61
What are causes of hypernatreamia?
Unreplaced water loss eg GI loss, sweating Renal loss eg HHS, DI Sodium overload eg cushings, primary aldosteronism, iatrogenic
62
How will hypernatreamia present?
``` Lethargy Irritability Thirst Signs of dehydration Confusion Coma Fits ```
63
How is hypernatreamia treated?
5% dextrose to correct water deficit | 0.9% saline- correct ECF volume depletion
64
What sodium imbalance is more common?
Hyponatraemua
65
What stimulates prolactin production? What inhibits it?
``` Stimulates= TRH Inhibits= dopamine ```
66
What are causes of hyperprolactinaemia?
``` Pregnancy Breast feeding Prolactinoma Pituitary adenoma Primary hypothyrodism ```
67
How does hyperprolactinaemia present?
Men=Loss of libido, erectile dysfunction, infertility Women=Galactorrhea, secondary amenorrhea, loss of libido, infertility Mass effects= headache, visual field defect
68
What are the investigations for hyperproloactinaemia? What will you see
Pregnancy test- may be positive TFTs- may be low if from hypothyroidism Basal serum prolactin- if crazy high most likely tumor MRI to image
69
How is prolactinoma managed? Give first and second line treatment
First line= dopamine receptor agonist eg cabergoline, bromocriptine Second line= trans sphenoidal surgery
70
How is hyperglycaemia in T2DM managed?
First line lifestyle advice Second line metformin if Hba1c is over 48 Third line add pioglitazone, SGLT2 inhibitor, DPP4 inhibitor or sulphonylurea Fourth line add another drug or try insulin based treatment
71
How are lipids in T2DM managed?
Atorvastatin 20mg OD if risk of cardiovascualr event in next 10 years is above 10% Atorvastatin 80mg OD if they have IHD/CVD/peripheral arterial disease
72
How is hypertension in T2DM managed?
First line ACEi, ARB if black Second line add CCB or thiazide Third line ACEi/ARB + CCB + thiazide
73
How is hyper and hypokalemia managed in T2DM?
Hyperkalemia (>4.5)= beta blocker | Hypokalemia (<4.5)= spironolactone
74
What antiplatelet medication and what dose is given to diabetics with IHD/CVD/PAD?
Aspirin 75 mg
75
What needs to be managed in a patient with diabetes?
``` Hyperglycaemia Hypertension Dyslipidaemia Hyper/hypokalemia Coagulopathy ```
76
What 2 molecules are in excess in DKA, what effect does each of them have and how are they reduced?
Excess glucose causes dehydration, this is treated with IV fluids Excess ketones causes acidosis and enzyme dysfunction, this is treated with insulin
77
What will ketones, plasma glucose and pH be in DKA vs HHS?
DKA: pH= low/acidic, ketones=high (over 3), plasma glucose high (over 11) HHS: pH= normal, ketones=normal, plasma glucose high (over 30)

Year 3 (104 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions