Diabetes And Endocrinology Flashcards
What is diabetes?
High blood sugar
What is the WHO classification of diabetes?
Normal- fasting plasma glucose <6.0, 2hr post prandial plasma glucose <7.8
Diabetes- fasting plasma glucose >7.0, 2hr post prandial >11.1
Impaired glucose tolerance- fasting <7.0, 2hr post prandial 7.8-11.1
Impaired fasting glucose- fasting 6.0-6.9, 2hr post prandial <7.8
How is diabetes diagnosed?
HbA1c (average blood glucose)
What are the types of diabetes?
Type 1 Type 2 Gestational diabetes Drug-induced diabetes Genetic Secondary- pancreatitis, Cushing’s syndrome, acromegaly
What is the difference in type 1 and type 2 diabetes?
Type 1- autoimmune destruction of the pancreatic beta cells
Type 2- insulin resistance +/- pancreatic failure
What are the symptoms of type 1 diabetes?
Polyuria
Polydipsia
Weight loss
Ketosis
What are the symptom of type 2 diabetes?
May be asymptomatic
Hyperglycaemic symptoms
Fatigue
Complications of diabetes
What is the management of type 1 diabetes?
Insulin- rapid acting (novorapid), short acting, intermediate acing, long acting (levemir)
What is the management of type 2 diabetes?
Diet and lifestyle changes
Drug therapy- metformin, thiazolidinediones
What are some common emergencies in diabetes?
Diabetic ketoacidosis
Hyperosmolar hyperglycaemic state
Hypoglycaemia
What is hypothyroidism?
Underactive thyroid glands- low fT4, high TSH
What are the symptoms and signs of hypothyroidism?
Fatigue Weight gain Heavy periods Cold intolerance Lethargic appearance Dry skin Dry and brittle hair Outer eyebrows lost Bradycardia Slow relaxing reflexes Goitre
What is hyperthyroidism?
Over active thyroid gland- high fT4 (thyroxine), low TSH
What are the signs and symptoms of hyperthyroidism?
Fatigue Weight loss Light periods Heat intolerance Tremor Warm sweating palms Goitre Pressure of speech Emotional lability Tachycardia
What is Grave’s disease?
An immune system disorder that results in the over production of thyroid hormones
What is the treatment of Grave’s disease?
Drugs- carbimazole
Radioactive iodine therapy
Surgery
What are the signs of thyroid cancer?
Cervical lymphadenopathy
Thyroid nodule hard
Goitre
Hoarseness
What is the treatment for thyroid cancer?
Surgery
Radioactive iodine therapy
What hormones does the pituitary gland secrete?
Anterior- Follicle stimulating hormone Lutenising hormone Growth hormone Thyroid stimulating hormone Adrenocorticotropic hormone Prolactin Posterior- Antidiuretic hormone Oxytocin
What is acromegaly?
A hormonal disorder that develops when your pituitary gland produces too much growth hormone during adulthood
What are the symptoms of acromegaly?
Headache
Sweating
Loss of peripheral viison
What are the signs of acromegaly?
Prognathism
Separation of teeth
Coarse facial features
Doughy skin cancer
What is the diagnosis of acromegaly?
Oral glucose tolerance test
What is the treatment of acromegaly?
Surgery
Somatostatin analogues
What is Cushing’s syndrome?
A condition caused by having too much cortisol in your body
What are the symptoms of Cushing’s syndrome?
Weight gain
Muscle weakness
Amenorrhoea
What are the signs of Cushing’s syndrome?
Buffalo hump Striae Cervical fat pad Osteoporosis Proximal myopathy
How is Cushing’s syndrome diagnosed?
24 hour urinary free cortisol
Dexamethasone suppression test
Differential- imaging, vein sampling
What is the treatment for Cushing’s syndrome?
Ketonazole
Mitotane
What is paechromocytoma?
Tumour of the adrenal glands
What are the signs and symptoms of phaeochromocytoma?
Headaches Palpitations Sweating Tachycardia Hypertension Family history Pale Clammy Neuromas on the tongue and around the mouth
What is Addison’s disease?
Where the adrenal glands don’t produce enough hormones?
What are the signs and symptoms of Addison’s disease?
Weight loss Postural dizziness Neuroglycopenia Family history Low BP Pigmentation
What is the treatment of Addison’s disease?
Glucocorticoid- hydrocortisone 15mg
Mineralocorticoid- fludrocortisone
