Endo 2 Flashcards
normal blood glucose concentration
4.4-6.1
criteria for diagnosis of DKA
glucose >11
ketones >3
ph <7.3
how are fluids given in DKA
1 litre in first hour
then 1 litre every 2 hours
how is insulin given in DKA
fixed rate IV infusion at 0.1 units/kg/hr
when is a glucose infusion started in DKA
when glucose falls to <14 mmol/L
what is the normal maximum rate for insulin infusion
10 mmol/hour
macrovascular complications of diabetes
stroke
hypertension
CAD
peripheral ischaemia
microvascular complications of diabetes
peripheral neuropathy
retinopathy
kidney disease
what skin change is seen in type 2 diabetes
acanthosis nigricans- darkening and thickening of the skin at the neck axilla and groin
associated with insulin resistance
pre diabetes HbA1c
42-47 mmol/L
how often is HbA1c monitored in T2DM
every 3-6 months until stable
when are GLP-1 mimetics used in T2DM
when triple therapy fails and BMI>35
metformin moa
increases insulin sensitivity
decreases glucose production
main 2 side effects of SGLT-2 inhibitors
increased UTIs and thrush
DKA
SGLT-2 inhibitor moa
reduces glucose reabsorption in the kidney
pioglitazone moa
increases insulin sensitivity
decreases liver production of glucose
sulfonylurea moa
stimulate insulin release from pancreas
side effects of sulfonylureas
weight gain
hypoglycaemia
what is GLP-1 and what does it do
an incretin
they increase insulin release, inhibit glucagon production
what does DPP4 do
inhibit incretins like GLP-1
side effects of DPP-4 inhibitors
headaches
acute pancreatitis
rapid acting insulin lasts
4 hrs
short acting insulin lasts
8 hours
long acting insulin lasts
24 hrs or longer
start ACEi in diabetic patients with CKD when their albumin:creatinine is
> 3 mg/mmol
start SGLT-2 inhibitors in diabetic patients with CKD when their albumin:creatinine is
> 30 mg/mmoL
what is used for gastroparesis in diabetes
domperidone
metoclopramide
hyperosmolar hyperglycaemic state glucose level
> 33
what pituitary disorder is carpal tunnel often associated with
acromegaly
somatostatin analogue example
ocreotide
dopamine agonist example
bromocriptine
cabergoline
hypercalcaemia symptoms
bones
stones (kidney)
groans (abdo- nausea, vomiting, constipation)
moans (psychiatric- fatigue, depression, psychosis)
management of tertiary hyperparathyroidism
parathyroidectomy
what electrolyte does SIADH cause
euvolemic hyponatraemia
urine osmolality in SIADH
high
SIADH symptoms
headache
fatigue
muscle cramps
confusion
what medications cause SIADH
SSRIs
carbemazepine
causes of SIADH
small cell lung cancer
SSRIs
post op
lung infections
brain pathology (stroke, meningitis, head injury)
HIV
SIADH mx
fluid restriction
vasopressin receptor antagonists (tolvaptan)
what complication occurs if sodium is corrected too quickly
osmotic demyelination/central pontine demyelination
how does tolvaptan work
blocks ADH receptors
what type of diabetes insipidus does lithium cause
nephrogenic
what test is used to diagnose diabetes insipidus
water deprivation test
how is nephrogenic diabetes insipidus treated
thiazide diuretics
how is adrenaline secreted by a phaeo
in bursts usually
what are metanephrines
a breakdown product of adrenaline
alpha blocker examples
phenoxybenzamine
doxazosin
