Endocrine Flashcards
At what HbA1c should you add in another agent to treat diabetes?
What is the target range? And what is the target range if you’re on a drug which can cause hypos (e.g sulphonylureas?)
HbA1c >58
Note HbA1c 48 is the target
53 if you’re on a drug that can cause hypos
What are the criteria for pre diabetes?
HbA1c 42-47
Fasting glucose 6.1-6.9
What’s the criteria for impaired fasting glucose?
6.1-7
What’s the criteria for impaired glucose tolerance?
Fasting glucose <7
2 hour tolerance 7.8-11.1
What is the most likely adverse effect from radioiodine therapy?
Hypothyroidism
What is the mainstay of treatment for Addison’s?
Hydrocortisone (glucocorticoid replacement) and fludrocortisone (mineralocorticoid)
In intercurrent illness > double the hydrocortisone but leave the fludrocortisone the same
What conditions can give a falsely low HbA1c reading and why?
Sickle cell anaemia and haemoglobinopathies
Due to decreased FBC lifespan
Mechanism of action of the sulfonylureas?
Increase pancreatic insulin secretion (only work if there are functional B cells)
What condition can cause a falsely high HbA1c reading and why?
Splenectomy - increased RBC lifespan
What test is used to diagnose Addison’s?
Short synacthen test
How do you manage De Quervain’s thyroiditis?
Conservative management with ibuprofen, sometimes steroids in more severe cases
What are the causes of primary hyperaldosteronism?
Adrenal adenoma in 20-30% of cases
Bilateral adrenal hyperplasia in 60-70% of cases
Unilateral hyperplasia
Familial hyperaldosteronism
Adrenal carcinoma
How does primary hyperaldosteronism present?
Hypertension
Hypokalaemia
Metabolic alkalosis
What would the aldosterone/ renin ratio show in primary hyperaldosteronism?
High aldosterone levels
Low renin levels
How is primary hyperaldosteronism managed?
Adrenal adenoma > surgery
Bilateral hyperplasia > spironolactone (aldosterone antagonist)
