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PRIYA ENDO > endo treatments > Flashcards

endo treatments Flashcards

1
Q

T1 DM

A

long acting insulin once daily eg glargine

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2
Q

diabetic ketoacidosis

A

replace losses

  • fluid (0.9% saline –> when glucose falls to 15, dextrose)
  • insulin (short acting insulin)
  • potassium (>10mmol / hour)

FIGPICK

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3
Q

T2 DM

A
  1. metformin
  2. SUR, SGLT2i, DPP4i, TZD
    • another
  4. add GLP-1 agonist

all patients >40 give 40mg simvastain + 10mg atorvastatin

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4
Q

peripheral neuropathy

A

amitryptaline / gabapentin

topical capsican cream

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5
Q

autonomic neuropathy

A
  • promotility drugs (metoclopramide)
  • anti-nausea (prochloperaxine)
  • serotonin antagonists (ondansetron)
  • abdo pain (NSAIDS)

for sweat glands –> topical glycopyrrolate, clonidine, botox

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6
Q

nephropathy

A
  1. measure protein / creatine levels (ACR vs PCR)

2. treat with ACE / ARB

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7
Q

retinopathy

A

laser
virectomy
anti-VGEF inhibitors
ranibizumab

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8
Q

MODY

A

glucokinase –> diet

transcription –> SURs

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9
Q

permanent neonatal MODY

A

SURs

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10
Q

gestational diabetes

A

short acting insulin

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11
Q

congenital hyperinsulism

A

diazoxide

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12
Q

HHS

A
  1. 0.9% saline

2. low dose IV inuslin (0.05 units)

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13
Q

alcohol induced keto acidosis

A

IV pabrinex = high dose vitamins
IV dextrose
IV anti-emetic

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14
Q

lactic acidosis

A

remove offending medication eg metformin

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15
Q

hypothyroidism

A 
young = levothyroxine 50-100ug 
>65 = levothyroxine 25-50ug
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16
Q

hashimotos

A

levothyroxine

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17
Q

multi-nodular goitre

A

surgery if >50% mass is in the middle

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18
Q

hyperthyroidism

A
  1. carbimazole
  2. propylthiouracil (in 1st trimester of pregnancy)
    * B blockers can also be used*
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19
Q

grave’s disease

A

anti-thyroid drugs

20
Q

relapsed grave’s

A

radioiodine

21
Q

differentiated thyroid cancer - low AMES

A

thyroid lobectomy with ishumsectomy

22
Q

differentiated thyroid cancer - high AMES

A

sub total / total thyroidectomy

23
Q

papillary carcinoma

A

total thyroidectomy

radioiodine to ensure removal of all neoplastic cells

24
Q

follicular carcinoma

A

minimally invasive - thyroid lobectomy

radioiodine

25
Q

medullary carcinoma

A

screen for MEN 2
total thyroidectomy
radioiodine

26
Q

hypercalcaemia

A
  • fluids - 0.9% saline 4-6L in 24 hours
  • loop diuretics (furosemide)
  • bisphosphonates
27
Q

hyperparathyroidism

A

primary

  • surgical removal of parathyroid gland
  • if unfit = cincalcet

secondary

  • treat underlying cause
  • treat with phosphate binders, calcium + vit supplements
28
Q

hypoprathyroidism / pseudo / pseudopseudo

A
  • calcium supplement

- vitamin D tablets

29
Q

non-functionin gpituitary adenoma

A

transsphenoidal surgery and adenoma removal

30
Q

prolactinoma

A
  1. cabergoline
  2. transspenoidal surgery
  3. sellar radiotherapy
31
Q

acromegaly

A
  1. trans nasal pituitary surgery
  2. somatostatin analouges, larenotide, octerotide
  3. radiotherapy
32
Q

cushing’s

A

pituitary

  • hypophysectomy
  • biltareal adrenolectomy

adrenal
- adrenalectomy

drug

  • metyrapone
  • ketoxonazole
  • pasireotide
33
Q

hypopituitarism

A

replacement therapy

34
Q

diabetes insipidus

A

desmospray/ desmopressin tablets

35
Q

adrenal insufficiency

A

primary

  • hydroxortisonw 2x daily
  • fludrocortisone (aldosterone replacement)

secondary
- hydrocortisone (not fludrocortisone)

36
Q

addisons

A

hydrocortisone and fludrocortisone

37
Q

addisonian crisis

A

hydrocortisone

38
Q

primary aldosteronism (conns)

A

surgical
- unilateral laparoscopic adrenalectomy

medical (in bilateral adrenal hyperplasia)
- MR antagonists eg spironolctone

39
Q

phaeochromocytoma

A
  • alpha blockers (phenoxybenzamine)

- beta blockers (propranolo)

40
Q

SIADH

A

vasopresisn receptor antagonist

41
Q

group 1 hypothalamic pituitary failure

A
  1. weight >18.5

2. pulsatile GnRH + gonadotrophin injections

42
Q

group 2 hypothalamic pituitary dysfunction (PCOS)

A
  1. BMI <30
  2. folic acid 400ug / 5mg daily
  3. ovulation induction (clomifene citrate, gonadotrophin injections, laparoscopic ovarian diathermy)
43
Q

group 3 - ovarian failure

A

hormone replacement

egg donation

44
Q

male hypogonadism

A

(if testosterone <8 on 2 mornings)

give testosterone replacement

45
Q

endometriosis

A

symptomatic

46
Q

MEN1

A

parathyroid hyperplasia - parathyroidectomy
pituitary adenoma - surgery / medical
pancreatic tumours - insulinomas can be treated with diazoxide, gastinomas with PPI

47
Q

MEN2a

A

prophylactic thyroidectomy

PRIYA ENDO (8 decks)

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