Endo Flashcards
Management of hypercalcaemia?
Initially - rehydrate with IV saline
Following rehydration bisphosphonates may be used. They typically take 2-3 days to work with maximal effect being seen at 7 days
Management of hypothyroidism?
Levothyroxine 50-100mcg od
(25mcg od for patients with ischaemic HD, severe hypothyroidism, or patients over 50 years)
check TFT after 8-12 weeks
therapeutic goal is ‘normalisation’ of TSH
What is nephrogenic DI and how would pt respond to water deprivation test?
Renal insensitivity to ADH preventing the concentration of urine.
Pt - polyuria, nocturia and chronic thirst
Urine osmolality after fluid dep: low
Urine osmolality after desmopressin: low
What is cranial DI and how would pt respond to water deprivation test?
Insufficient ADH release, leading to an inability to concentrate urine even if patient is hypovolaemic. Kidneys are unaffected though so they’ll respond to desmopressin
Urine osmolality after fluid dep: low
Urine osmolality after desmopressin: high
Diabetic neuropathy pain management
First line: amitriptyline, duloxetine, gabapentin or pregabalin
- if the first doesn’t work, try one of the other three
Tramadol can be used as ‘rescue therapy’
Topical capsaicin may be used for localised neuropathic pain
Addison’s disease
Primary cause = autoimmune
Features: lethargy, weakness, anorexia, nausea + vomiting, weight loss, ‘salt-craving’
hyperpigmentation (esp palmar creases), vitiligo, loss of pubic hair in women, hypotension, hypoglycaemia
hyponatraemia and hyperkalaemia may be seen
crisis - collapse, shock, pyrexia
