Diabetes & Endocrinology Flashcards
List some symptoms of diabetes
Lethargy
Thirst
Polyuria
Weight loss
List some risk factors for diabetes
Family history of diabetes
Family history of autoimmune diseases
Pancreatitis
Obesity
High alcohol intake
Existing cardiovascular disease
Cardiovascular risk factors
Describe restrictions on employment people with diabetes may face
Can’t be in the army, navy or air force with type 1 diabetes
People who operate heavy machinery/lorries etc may have to take time off
The DVLA needs to be informed if you are diagnosed with diabetes or your medication changes (true/false)
True
Why is diabetes knowledge important in pregnant women?
Uncontrolled diabetes in pregnancy can lead to miscarriage or congenital abnormalities
What tests (and which results) would be one to diagnose diabetes?
1) Random blood glucose (>11.1 = diabetes)
2) OGTT (>11)
3) Fasting glucose (>7)
4) HbA1c (>48) - but iron deficiency anaemia can raise HbA1c
How many tests are needed to confirm a diagnosis of diabetes?
1 test & symptoms OR 2 separate tests
What does annual diabetes screening entail?
Weight/BMI check BP Foot screen Eye screen CVS examination Injection sites - looking for lipohypertrophy HbA1c U&E LFT Lipid profile ACR \+/- TFT, coeliac screen
Mechanism of action of statins
HMG CoA-reductase inhibitor
Side effects of statins?
Muscle aches
Mechanism of action of Metformin
Iguanide - improves insulin sensitivity (may work via AMP kinase or micro biome)
Side effects of Metformin?
Diarrhoea - limited by taking with food
Mechanism of action of Gliclazide
Sulphonylureas
Side effects of sulphonylureas
Weight gain
Hypoglycaemia
Mechanism of action of Liraglutide
GLP-1 agonist - act in stomach to reduce appetite and enhance insulin release
Side effects of Liraglutide
Weight loss
Mechanism of action of Dapagliflozin
SGLT2 antagonist - acts on transporter in kidney to increase glucose excretion
Side effects of Dapagliflozin
UTI
Weight loss
Mechanism of Lisinopril
ACE inhibitor
Side effects of ACE inhibitors
Cough
Mechanism of Amlodipine
Calcium channel antagonist
Side effects of calcium channel antagonists
Ankle swelling
Side effects of thiazide diuretics
Hypokalaemia
List some symptoms of thyrotoxicosis
Weight loss Heat intolerance Palpitations Increased appetite Shortness of breath on exertion Lethargy Insomnia Diarrhoea Oligomenorrhoea Exophthalmos Thyroid eye disease Proximal myopathy Goitre
What should you look for during a general examination in a patient with suspected thyroid disease?
Weight loss Bulging eyes Sweaty/warm Agitated, can't sit still Pressured speech
What should you look for during a hand examination in a patient with suspected thyroid disease?
Nails - onycholysis Sweaty/warm palms Palmar erythema Fine flapping tremor Tachycardia, arrhythmia's
What should you look for during a neck examination in a patient with suspected thyroid disease?
Goitre
Swollen lymph glands
Size and consistency of thyroid
Thyroid bruit (listen with stethoscope)
What should you look for during a eye examination in a patient with suspected thyroid disease?
Proptosis
Lid lag
Swelling around eye
Eye movement - double vision/blurred vision
