Endo Flashcards
Causes of cranial DI (3)
Cranial: pituitary tumour, infection (meningitis), sarcoidosis
Causes of nephrogenic DI (5)
↑ Ca, ↓ K, lithium, inherited (AVPV2 gene), idiopathic
Presentation of DI
Presentation:
Polyuria (including nocturia) – UO often >3L
Polydipsia
Symptoms of hypernatremia: lethargy, irritability, confusion
What are symptoms of hypernatraemia (3)
lethargy, irritability, confusion
Ix for DI
General: U&Es (Ca, Na, K), glucose (to exclude DM)
Water deprivation test
What is the water deprivation test
Water is restricted for 8 hours
Plasma and urine osmolality are measured every hour
After 8 hours, give desmopressin and measure urine osmolality
Mx of cranial DI
Cranial: intranasal desmopressin
Mx of nephrogenic DI
Nephrogenic: thiazide diuretic or NSAIDs
Signs of DKA (5)
N&V, abdo pain, Kussmaul breathing, sweet breath
Which genes involves in DM
HLA DR3/4
RF of DMT2 (5)
Obesity, FH, ethnicity, endocrine, drugs
Diagnosis criteria of DM
Blood glucose measurement
Fasting ≥7 mmol/L
Random >11.1 mmol/L
Mx of DKA
Fluids, correct Na K
1st line and 2nd line treatment of T2DM
1st line = diet and lifestyle
2nd line = metformin
+/- sulphonylurea +/- insulin
Main 3 causes of hypovolaemic hyponatraemia
Diarrhea
Vomiting
Diuretics
Main 3 causes of euvolaemic hyponatraemia
Hypothyroidism,
Hypoadrenalism,
SIADH (pneumonia/cancer)
Main 3 causes of hypervolaemic hyponatraemia
HF
Cirrhosis
Nephrotic syndrome
Ix for hypovolaemic hyponatraemia (1)
- Clinically hypovolaemic
- Low urine sodium kidneys will detect volume and hang on to salt
(measure off diuretics)
Ix for euvolaemic hyponatraemia (6)
TFTs
Short synACTHen: ACTH injection (cortisol will not rise)
Drug review, breast examination, CXR, brain MRI
Ix for hypervolaemic hyponatraemia (2)
Fluid overloaded
Low urine sodium aldosterone secretion –> retention of Na
Signs of severe hyponatraemia (2)
seizures/↓ consciousness
Causes of hypernatraemia (4)
vomiting, diarrhea, diabetes insipidus, primary aldosteronism
Presentation of hypernatraemia (7)
lethargy, irritability, thirst, signs of dehydration, confusion, coma, fits
Mx of hypernatraemia
Drink water/IV fluids
Mx of hypervolaemic hyponatraemia
fluid restrict and treat cause
Mx of euvolaemic hyponatraemia
fluid restrict and treat cause
Mx of hypovolaemic hyponatraemia
Saline
Why do you hyperprolactinaemia in hypothyroidism
TRH stimulates prolactin release
Causes of hyyperprolactinaemia (4)
Pituitary prolactinoma (commonest)
Hypothyroidism
Drugs e.g. metoclopramide, antipsychotics (DA antagonists)
Physiological! Pregnancy, breast feeding
Drug causes of hyperprolactinaemia (2)
Metoclopramide, antipsychotics