Endocrine Flashcards
“WHIPPLES TRIAD
•Blood glucose measured at <70mg/dl
•Confusion, irritability, fatigue, anxiety, sweating, irregular heart rhythm, perioral paresthesia
•Signs and symptoms resolve with appropriate glucose elevation
NEUROGLYCOPENIC
•Alterations in consciousness, lethargy, confusion, combativeness, agitation and unresponsiveness
NEUROGENIC
•Anxiety, nervousness, irritability, nausea, vomiting, palpitations, tremors”
Hypoglycemia
- Impaired fasting glucose (100-125mg/dl)
- Borderline Hgb-A1C elevation (5.7-6.4%)
- 2 hour post-prandial glucose (140-199mg/dl)
- Usually will NOT produce polyuria or polydipsia seen in Diabetes Type I or II
Prediabetes
- Plasma glucose of 126mg/dl or higher after an overnight fast, documented on more than one occasion
- Ketonemia/ketonuria
- Polyuria, polydipsia, fatigue, polyphagia, unexplained weight loss, poor wound healing, blurred vision, higher prevalence of certain infections especially candidal vaginitis and balanitis, recurrent UTIs, skin infections and malignant otitis externa
Diabetes Type I
- Plasma glucose of 126mg/dl or higher after an overnight fast, documented on more than one occasion
- Ketonemia/ketonuria
- Polyuria, polydipsia, fatigue, polyphagia, unexplained weight loss, poor wound healing, blurred vision, higher prevalence of certain infections especially candidal vaginitis and balanitis, reccurent UTIs, skin infections and malignant otitis externa
HOWEVER;
•Ketones are less likely to accumulate in the blood
•Pancreas is able to compensate for insulin receptor resistance
**MEDEVAC**
Diabetes Type II
•Same as Type II Diabetes; only occurs in pregnant women and can develop even after delivery
Gestational Diabetes
•Hyperglycemia >250mg/dl
•Acidosis with blood pH <7.3
•Serum bicarbonate <15mEq/L
•Serum positive for ketones
•Commonly occurs with Type I diabetics with history of poor compliance
•May begin with a day or more of polyuria, polydipsia, marked fatigue, nausea, vomiting, mental stupor that can progress to coma
•Rapid deep breathing and a ““fruity”” breath odor of acetone
**MEDEVAC**
Diabetic Ketoacidosis
•Weakness, cold intolerance, constipation, depression, menorrhagia, hoarseness, dry skin, bradycardia
•Delayed return of DTR’s
•Low T4 (Thyroxine)
•Elevated TSH
**MEDEVAC**
Hypothyroidism
•Sweating, weight loss, heat intolerance, menstrual irregularity, tachycardia, tremor, stare (exopthalmos)
•Goiter (in Grave’s disease), opthalmopathy
•May have fine, thinning hair
•Low TSH
•T4 sometimes normal but T3 elevated
**MEDEVAC**
Hyperthyroidism
•Most of the time the only sign and symptom is the nodule/goiter
•Toxic multinodular goiters and hyperfunctioning nodules can cause hyperthyroidism; sweating weight loss, anxiety, loose stools, heat intolerance, tachycardia, tremors
•Large retrosternal multinodular goiters can cause dyspnea due to tracheal compression
•Malignancy is suggested by hoarseness, vocal chord paralysis, solitary, firm, large, or adherent to trachea or strap muscles
**MEDEVAC**
Thyroid Nodule/Goiter
•Weakness, abdominal pain, fever (>105), confusion, vomiting, hyperpigmentation
•Low blood pressure, dehydration
***MEDEVAC**
Acute Adrenal Crisis
•Menstrual disorders, infertility, hirsutism, acne, insulin resistance, metabolic syndrome, dyslipidemia, perinatal complications
Polycystic Ovarian Syndrome
•Fatigue, decreased strength, poor libido, hot flashes, erectile dysfunction, small testes, gynecomastia, infertility
Hypogonadism
•Sub-areolar glandular hyperdensity which may be unilateral or bilateral, and may be painful or non-painful
RED FLAGS
•Asymmetry, density located away from subareolar region, nipple retraction, nipple bleeding or discharge, unusual firmness
Gynecomastia
CONSTELLATION OF 3 OR MORE
•Abdominal Obesity
•Triglycerides 150mg/dl or higher
•HDL <40mg/dl for men or 50mg/dl for women
•Fasting glucose of 110mg/dl or higher
•Hypertension
Metabolic Syndrome
