Endo Passmed Flashcards
subclinical hypothyroidism
TSH level on 2 separate occasions
3 months
if abnormal commence levothyroxine
can levothyroxine be given in a primary setting?
yes
cushings syndrome
fail dexa suppress test
increased urinary cortisol levels
low plasma acth > adrenal gland is the issue
Cushing syndrome acth dependent?
pituitary adenoma / Cushing Disease
ectopic 2^ to malignancy
ACTH independent Cushing Syndrome ?
adrenal adenoma
hypo________ metabolic _____ is seen in Cushing syndrome
hypokalaemic metabolic alkalosis
Petrosal sinus sampling of ACTH
differentiate between pituitary and ectopic ACTH secretion.
addisons test?
short synacthen test
> dose of synthetic acth given
>adrenal gland cannot respond
absence of cortisol increase
antibodies specific to T1DM?
anti-GAD
C-peptide
Which one of the following types of oral steroid has the least amount of mineralocorticoid activity?
dexamethasone
> raised intracranial pressure use
> anti-inflammatory effect (glucocorticoid) with minimal fluid retention effects (mineralocorticoid)
primary hyperaldosternosim / Conn syndrome
lethargy
headache
htn
hypokalaemia
hypernatraemia
high serum bicarb
first line for Conn?
aldosterone / renin ratio
unilateral adrenal adenoma / bilateral adrenal hyperplasia
Ix Conn/s
Hypertension with hypokalaemia
treatment resistent HTN
1) plasma aldosterone / renin ratio
2) Image CT abdo
3) adrenal venous sample
Management
adrenal adenoma:
surgery (laparoscopic adrenalectomy)
bilateral adrenocortical hyperplasia: aldosterone antagonist e.g. spironolactone
screening diabetic neuropathy?
A 10 g monofilament should be used to assess for diabetic neuropathy in the feet
