Endocrine Flashcards
normal t3 and t4, but high TSH
what is this?
what is the appropriate course of action?
subclinical hypothyroidism
Repeat thyroid function tests in 3-6 months
For adults with type 2 DM with lifestyle management & a single drug, what is the target HbA1c ACC to NICE?
48 mmol/ mol
diagnosis of type 2 DM = symptomatic + one of the following:
- random blood glucose?
- fasting blood glucose?
- 2 hr glucose tolerance?
- HbA1c?
If symptomatic one of the following results is sufficient:
Random blood glucose = 11.1mmol/l
Fasting plasma glucose = 7mmol/l
2 hour glucose tolerance = 11.1mmol/l
HbA1C =48mmol/mol (6.5%)
If the patient is asymptomatic two results are required from different days.
1st line ix for Addisons disease
morning serum cortisol (b/w 8 am & 9am)
in an emergency (addisonian crisis) , do not wait for blood test results, administer IV hydrocortisone
what are the TSH, T3 and T4 findings in:
- primary hypothyroidism
- secondary hypo
- subclinical hypo
- primary hyperthyroidism
- secondary hyper
- subclinical hyper
primary hypo
high TSH, low T3, low T4
secondary hypo
low TSH, low T3, low T4
subclinical hypo
high TSH, normal T3 & T4
primary hyper
low TSH, high T3 & T4
secondary hyper
high TSH, high T3, high T4
subclinical hyper
low TSH, normal T3 & T4
acute abdo pain, vomiting, confusion, recent weight loss, deep and laboured breathing, bed wetting and high glucose reading in a child- dx?
diabetic ketoacidosis
deep & laboured breathing - kussmaul breathing
rash in graves - location + what is it called?
pretibial myxoedema - occurs in 1 to 2% of graves disease cases
dizziness, fatigue, diarrhoea, sweating, flushing, normal BP but widespread wheeze - ix to confirm dx?
carcinoid syndrome - 24 hr urinary 5HIAA
MEN1 affects which organs?
Caused by mutation in the MEN 1 gene
Parathyroid: hyperplasia/adenomas
Pancreas: gastrinoma, insulinoma
Pituitary: prolactinoma
controlling BP to __/__ leads to the greatest reduction in mortality in uncomplicated diabetes
140/90 ( no more and no less than)
first-line treatment of type 1 diabetes
basal bolus insulin
first-line treatment of type 2 diabetes
metformin
management of hyperthyroidism -
- symptomatic relief
- medical
- propranolol for symptomatic relief
2. carbimazole/ propylthiouracil for medical management ( pregnant- carbimazole)
1st line diagnostic test for phaeochromocytoma
24 hr urine collection for free metadrenaline & normetadrenaline
What is the advised initial hormone replacement therapy in patients with confirmed hypopituitarism?
cortisol - to overcome the lack of ACTH
