Endocrine Flashcards
Pre-diabetes diagnostic criteria:
A. Fasting plasma glucose
B. 2 hour 75 g oral glucoses tolerance test (OGTT)
C. HbA1c
A. 6.1-6.9 mmol/L
B. 7.8-11.0 mmol/L
C. 6.0-6.4%
T or F: those diagnosed as pre-diabetic often become diabetic
False: 50-80% revert to normal glucose tolerance (with weight loss and lifestyle modifications)
Diabetes mellitus
Hyperglycemia due to impairment of insuline secretion (type 1), defective insulin action (type 2) or both
Microvascular and macrovascular complications with diabetes mellitus
Micro: affects eyes, kidneys, nerves
Macro: cardiovascular, stroke, peripheral vascular disease
Diabetes mellitus diagnostic criteria A. Fasting plasma glucose B. 2 hour 75 g OGTT C. Random plasma glucose D. HbA1c
You need ONE of the following to qualify for DM A. > 7.0 mmol/L B. > 11.1 mmol/L C. > 11.1 mmol/L D. > 6.5%
You need a confirmatory test done on another day IF you DON’T have other DM symptoms
diabetic ketoacidosis
Acute complication of T1D (or T2D in severe cases)
Polyuria, -dypsia, -phagia, marked fatigue, dehydration, LOC, fruity breath, kussmaul’s respiration
Hyperosmolar hyperglycemic state
Acute complication of T2D
Insideous onset preceded by weakness, polyuria and -dypsia, LOC, dehydration
Hypoglycemia: blood glucose levels
<4.0 mmol/L
hypoglycemic clinical features
- palpitations and tachycardia
- sweating
- anxiety
- tremor
Whipple’s triad and hypoglycemiA
- fasting hypoglycemia with symptoms (dizzy, headache, cloudy vision, mental dullness, fatigue, confusion)
- blood glu <2.5 mmol/L (men) and <2.2 mmol/L (women)
- giving glucose improves symptoms
With primary hyperthyroidism, you would see [ ] T3/4 and [ ] TSH A. Increased, decreased B. Increased, increased C. Decreased, decreased D. Decreased, increased
A–> it’s an issue with the thyroid gland itself (thus producing too much T3/4). The pituitary gland is like “oh shit we gotta chill with stimulating the thyroid” so the TSH levels are decreased
With secondary hyperthyroidism, you would see [ ] T3/4 and [ ] TSH A. Increased, decreased B. Increased, increased C. Decreased, decreased D. Decreased, increased
B–> it’s a pituitary issue, thus producing too much TSH leading to high T3/4 levels
Thyrotoxicosis (primary and secondary hyperthyroidism): clinical picture
Thyroid hormones basically make you an ideal human (improved GI function, good cardiac output, appearance, etc), so elevated T3/4 takes it to an extreme
- fatigue, heat intolerance, irritable
- weight loss, increased appetite, IBS
- tachycardia and palpitation
- decreased bone mass
- fine hair, sweaty skin, pruritis
Grave’s disease
an autoimmune disorder that is caused by hyperthyroidism and is characterized by goiter and/or exophthalmos
-low TSH, increased T3/4
Subacute thyroiditis
Acute inflammatory disorder of thyroid gland
Hyperthyroidism –> hypothyroidism –> then euthyroidism (normal thyroid functioning)
Hashimoto’s thyroiditis
an autoimmune disease in which the body’s own antibodies attack and destroy the cells of the thyroid gland
-low T3/4, high TSH
Growth hormone excess in kids
Gigantism
Growth hormone excess in adults
Acrogemaly
Hypogonadotropic hypogonadism
FSH and LH are low (pituitary issue), leading to deficient/defective gonads (ovaries/ovaries)
Hypergonadotrophic hypogonadism
FSH and LH levels are normal, but there’s an impaired response of the gonads, leading to deficient/defective gonads
Turner’s syndrome
Born with a single X chromosome. (short, webbed neck, different physical sexual development.)
Klinefelter syndrome
A chromosomal disorder in which males have an extra X chromosome, making them XXY instead of XY.
Cushing’s syndrome
caused by prolonged exposure to high levels of cortisol
Too much ACTH (pituitary issue or exogenous glucocorticoids))
- weakness
- insomnia
- easy bruising
- moon face
- buffalo hump
- hirsutism and acne
- hyperpigmentarion
- stretch marks
Diagnosing cushing’s syndrome
- Complete drug history
- 24 hour urine free cortisol
- Dexamethasone suppression test
- Late night salivary cortisol
Addison’s disease
occurs when the adrenal glands do not produce enough of the hormones cortisol or aldosterone
Low cortisol, high ACTH
- dark skin
- high potassium, low sodium
- arthralgia, hypotension, myalgia
- salt craving
Secondary hypocortisolism
Low cortisol and Low ACTH (issue with pituitary gland)
- pale skin
- normal potassium, low/normal sodium
Primary hyperparathyroidism
High PTH and high serum calcium
Due to parathyroid adenoma, lithium therapy, PT carcinoma
Secondary hyperparathyroidism
High PTH and low serum Ca2+
Due to partial resistance to PTH in patients with renal failure and osteomalacia
Tertiary hyperparathryoidism
High pth and high serum Ca2+ (same as in primary HPTH)
Increased parathyroid activity after a long period of secondary hyperparathyroidism
Hyperparathyroidism: clinical picture
Bones (pain, arthralgia, fracture): due to Ca2+ extraction (?lol that’s not the right word, whatever)
Stones (nephrolithiasis)
Abdominal groans: pain, nausea, vom
Psychiatric undertones: fatigue, depression, anxiety, sleep disturbanced
