Corrections 2 Flashcards
What can be used for diagnosis of T2DM in adults?
1) HbA1c
or
2) Plasma glucose
What plasma glucose is diagnostic of T2DM in patients that are symptomatic?
1) Fasting glucose ≥7.0 mmol/l
or
2) Random plasma glucose ≥11.1 mmol/l
What HbA1c is diagnostic of T2DM?
≥48 mmol/mol
in patients without symptoms, the test must be repeated to confirm the diagnosis
What are some conditions where HbA1c may not be used for diagnosis of T2DM?
1) haemoglobinopathies
2) haemolytic anaemia
3) untreated iron deficiency anaemia
4) suspected gestational diabetes
5) children
6) HIV
7) chronic kidney disease
8) people taking medication that may cause hyperglycaemia (for example corticosteroids)
What does the presence of an elevated prolactin level along with 2ary hypothyroidism & hypogonadism indicate?
Pituitary stalk compression –> consistent with a non-functioning pituitary adenoma.
What investigation is required to confirm the diagnosis of acromegaly if a patient is shown to have raised IGF-1 levels?
OGTT with serial GH measurements
(raised blood glucose should stop the body from producing GH)
What effect should the administration of insulin have on c-peptide levels?
Should cause c-peptide levels to fall (will NOT fall in the case of an insulinoma)
What are the 3 features of MEN 1?
1) Parathyroid involvement:
- hyperparathyroidism due to parathyroid hyperplasia
2) Pituitary tumour:
- e.g. prolactinoma
3) Pancreatic tumour:
- e.g. gastrinoma (leading to recurrent peptic ulceration)
- e.g. insulinoma
Most common presentation of MEN 1?
Hypercalcaemia
What gene is involved in MEN 1?
MEN1 gene
What gene is involved in MEN 2?
RET oncogene
mechanism of prochlorperazine?
D2 receptor blocker
What type of medication is prochlorperazine?
1st generation antipsychotic (typical)
What medication can lead to proximal myopathy?
Steroids
What class of medication is chlorpromazine?
Antipsychotic
