10/01 Flashcards
What is the treatment of diabetic neuropathy?
1st line= amitriptyline, duloxetine, gabapentin or pregabalin
If one drug does not work then try any of the other 3
Tramadol can be used as rescue therapy in exacerbations
Topical capsacin could be used for localised pain
What is subacute thyroiditis?
Occurs post viral infection and often results in hyperthyroidism
What are the 4 stages of acute thyroiditis?
1= lasts 3-6wks, hyperthyroidism, painful goitre, raised ESR
2=1-3wks, euthyroid
3=weeks-months, hypothyroid
4=thyroid structure and function returns to normal
What is the management of acute thyroiditis?
Normally self limiting
Aspirin or NSAIDs for the pain
Steroids in severe cases particularly for hypothyroidism
What are sick day rules in diabetes?
Good fluid intake 3 litres
Increase frequency of blood glucose measurements
If struggling to eat then sugary drinks
Continue oral diabetic medication as normal and continue normal insulin regime
What drugs cause gynaecomastia?
Spironolactone Digoxin Cannabis GnRH agonists e.g. goserelin oestrogens
What form of metabolic disturbance does Cushing Syndrome form?
Hypokalaemic metabolic alkalosis
What is an indicator that diabetic medication should be stepped up from just metformin therapy?
HbA1c >58mmol/L
What are symptoms of prolactinomas?
Excess prolactin in women
- amenorrhoea
- infertility
- galactorrhoea
- osteoporosis
Excess prolactin in men
- impotence
- loss of libido
- galactorrhoea
Other features
- headache
- bitemporal hemianopia
- symptoms and signs of hypopituitarism
What is Conn’s Syndrome?
Hyperaldosteronism
What are features of Conn’s syndrome?
Hypokalaemia
Hypertension
Alkalosis
Normal clinical examination
How can T1DM and T2DM be differentiated?
C peptide
It is low in T1DM and normal or high in T2DM
How can impaired fasting glucose be diagnosed?
Fasting glucose 6.1-6.9mmol/L
On two separate occasions if asymptomatic
What cancer is Hashimoto’s thyroiditis associated with?
MALT lymphoma
