Endocrine

Question 1

Management of hypoglycaemia

Answer 1

ABCDE
Oral carbohydrate
Measure BSL again
IV access: glucose
No IV access: IM glucagon
Endocrine review

Question 2

DKA management

Answer 2

Rehydrate/resus with normal saline

Potassium: give if <4.5 mmol/L
Insulin: basal + meals
Dextrose: when BGL <15 mmol/L

https://aci.health.nsw.gov.au/__data/assets/pdf_file/0004/699097/ACI-Management-of-diabetic-ketoacidosis-and-hyperosmolar-hyperglycaemic-state-in-adults-in-the-ED-flow-chart.pdf

Question 3

Oral anti-hyperglycaemics mechanisms

Answer 3

SGLT2 inhibitors:
GLP-1 agonists:
DPP-4 agonists:

Question 4

Diabetes dx

Answer 4

Random BGL >11
Fasting BGL >7
HbA1c >6.5

Question 5

Addison’s disease

Question 6

Management of hyperkalaemia

Answer 6

1. Institute BLS/ALS as indicated
2. Stop potassium-containing infusions
3. Calcium gluconate 10% 10mL (slow IV push)
4. Glucose (50 ml of 50% IV bolus) and insulin (10 units of actrapid IV)
5. Monitor BSL closely
6. Sodium bicarbonate 8.4% 100 mmols IV over 30 minutes
7. Inhaled Beta2-agonist (note 25-40% patients may not respond)
8. Arrange renal replacement therapy.

Other: resonium