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endocrine Flashcards

1
Q

Pathophysiology Diabetes mellitus

A

Glasper et al. 2021

  1. metabolic group disorder
  2. hyperglycaemia
  3. lack or non responsive insulin
  4. can cause comatose state or diabetes ketoacidosis
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2
Q

Symptoms diabetes ketoacidosis

A

Glasper et al. 2021

  1. relative to absolute deficiency of insulin
  2. 80% new diabetics
  3. loss consciousness
  4. hyperglycaemia
  5. polyuria
  6. polydispia - increased thirst
  7. abdo pain
  8. weight loss
  9. nausea and vomiting
  10. general weakness
  11. acetone - pear drop smell
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3
Q

Priorities of diabetic ketoacidosis

A
  1. doc dehydration status eg. shrunken eyes, urine
  2. Urine sample glucose (less than 11mmol/l) and ketone (less than 3mmol/l) - metabolic acidosis - NICE 2022
  3. O2 and position as required
  4. IV bolus fluids - 500ml - 10ml/kg maintain 0.9% saline until glucose under 14 - if not effective after one give another (normal people need 500-100ml)
  5. Electrolyte balance - main potassium - cause K to drop
  6. fixed rate insulin IV infusion - 0.1unit/kg/hr - target B - 4-7 A - 5-9
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4
Q

Symptoms hypothyroidism

A
  1. cold intolerant
  2. myexdema coma
  3. facial and eyelid oedema
  4. extreme fatigue
  5. extreme fatigue
  6. anorexia
  7. hair loss
  8. dry skin
  9. constipation
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5
Q

Symptoms of hyperthyroidism

A
  • Heat intolerant
  • finger clubbing
  • bulging eyes
  • face flushing
  • tachycardia
  • weight loss
  • muscle wasting
  • diarrhoea
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6
Q

What thyroxine do?

A

Control how body use energy

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7
Q

What is myexdema coma and symptoms?

A

Untreated hypothyroidism
- decrease metabolism as heart flabby
- decreased CO and perfused brain and organs
-non pitting oedema
- thick tongue
- larynx thick so husky voice
- hypoglycaemia
- coma
- resp failure
- hypotension
- hypothermia

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8
Q

Priorities of myxemema coma?

A
  1. ensure airway - O2 - thick tongue and larynx
  2. fluid balance therapy - maintain 10ml/kg 0.9% saline
  3. give levothyroxine IV and glucose IV - hypoglycaemia and replace missing thyroid hormone thyroxine for energy and growth
  4. Give crorticosteroids - associated with adrenal insufficiency via IV
  5. Monitor inc GCS
  6. keep warm - symptom hypothermia
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9
Q

State two adrenal syndromes?

A

cushing

addisons

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10
Q

Symptoms of cushing syndrome

A
  • bruises
  • personality changes
  • hyperglycaemia
  • infection
  • moon face
  • thin extremities
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11
Q

Symptoms of Addison’s

A
  • bronze pigment
  • GI disturbances
  • Weight loss
  • hypoglycaemia
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12
Q

What hormone tests do for adrenal syndromes?

A
  1. adrencortical test
  2. ACTH test
  3. ACTH stimulation test
  4. Blood glucose test
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13
Q

Priorities f adrenal syndromes

A
  1. reverse shock and restore blood circulation eg. fluid balance
  2. antibiotics as required
  3. supplement glucocorticoids - hydrocortisone bolus then maintained
  4. electrolyte balance - potassium and sodium
  5. environment - limit activity and non-stress
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14
Q

Symptoms of hyperglycaemia

A
  • thirst
  • polyuria
  • dry skin
  • hunger
  • blurred vision
  • drowsy
  • decreased healing rate
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15
Q

Priorities hyperglycaemia

A
  1. adapt diet
  2. exercise
  3. medication - real and regulated insulin

NICE 2015

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16
Q

priorities hypoglycaemia

A
  1. blood glucose check - 10-15g carbohydrate - B - 3-7 A-4-8 - NICE 2015
  2. BG check every 15-20min
  3. if glucose in range have protein meal and snack
  4. if blood over 7 snack if under treat

NICE 2015

17
Q

Guideline of target sugars

A

NICE 2015 - Diabetes in children and young people
NICE 2015 - type 1 diabetes in adults

Before - 4-7mmols
After - 5-9mmols

18
Q

Guideline Addisons Disease

A

NICE 2020

19
Q

Reference pathophysiology children

A

Glasper et al. 2021

20
Q

Reference Pathophysiology adults

A

Peate et al. 2021

21
Q

Pathophysiology hyperosmolar hyperglycaemic state

A

Life threat complication diabetes - type 2 diabetes
- hyperglycaemia - glucose too high for long period
- cause severe dehydration and confusion

22
Q

Symptoms hyperosmolar hyperglycaemic state

A
  • severe dehydration
  • commonly type 2 diabetes symptom
  • confusion
  • high blood glucose
  • loss consciousness
  • dry mouth - due to thirst
  • frequent urination
  • blurred or loss of vision
23
Q

Priorities of hyperosmolar hyperglycaemic state

A
  1. rehydrate - bolus 0.9% 500ml (NICE 2022) - maintenance - 20-35 water and electrolytes
  2. correct and monitor hyperglycaemia - insulin IV - 0.1unit/kg/hr
  3. correct electrolytes
  4. treat underlying disease eg. antibiotics
  5. monitor and support - GCS (Teasdale and Jennette, 1974) NEWS2 - NHSE 2017

MACHS (6 decks)

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