06/02 Flashcards
What should the results of a 9am cortisol suggest for further management?
>500= addisons unlikely 100-500= prompt for ACTH stimulation test <100= abnormal
What is Trousseau’s sign?
Indicates hypocalcaemia
Occurs 2 mins after cuff inflation above systolic pressure
Hand will spasm with wrist flexing and fingers adducting
What is the management of hyperosmolar hyperglycaemic state and why should insulin never be given?
Management is wtih fluid resuscitation
Giving insulin can lead to central pontine myelinolysis which presents as reduced consciousness, dysarthria, dysphagia and problems with balance
What are causes of lower than expected HbA1c?
Due to decreased RBC lifespan
Sickle cell
G6PD deficiency
Hereditary spherocytosis
What are causes of higher than expected HbA1c levels?
Due to increased RBC lifespan
Vitamin B12/folic acid deficiency
Iron deficient anaemia
Splenectomy
What is often seen in MEN type 1?
Parathyroid
Pituitary
Pancreatic adenoma
What is often seen in MEN type 2a?
Medullary thyroid cancer
Parathyroid
Phaeochromocytoma
What is often seen in MEN type 2b?
Medullary thyroid chance
Phaeochromocytome
Marfinoid body
Neuromas
What is thyroid storm and what is the management?
Rare but life threatening complication of thyrotoxicosis
Precipitated by things such as DKA, infection and trauma
Fever, tachycardia, confusion, N&V
Treatment with propanolol, PTU and hydrocortisone
How should the dose of levothyroxine be changed during pregnancy?
Should increase the dose by up to 50% as early in week4-6 of pregnancy
What blood gas results are shown in Cushing Syndrome?
Hypokalaemic Metabolic alkalosis
What is the management of primary hyperaldosteronism?
Spironolactone
What is first line treatment in diabetic neuropathy?
Amitriptyline, duloxetine, gabapentin or pregabalin
Tramadol for exacerbations
