Endocrine

Question 1

Defintion of HSS (hyperosmolar, hyperglycaemic state)

Answer 1

Glucose of 30 or more, with ketones <3, pH >7.3, bicarb >15
Dehydrated
Osmoloality usually >320

Question 2

Define SIADH

Answer 2

All of the following:
Low serum osmolality <275
High urine osmolality >100
High urine sodium >40
Euvolaemia
Normal thyroid & adrenal function
No recent diuretic use

Question 3

Hypercalcaemia ECG changes

Answer 3

short QT
osborn/J waves
bradycardic
https://litfl.com/hypercalcaemia-ecg-library/

Question 4

Calculate osmolality

Answer 4

(2 x Na) + glucose + urea, all in mmol/L

Question 5

Treat SIADH

Answer 5

Stop precipitating drug
fluid restrict, aim -500ml each day
total intake 0.5-1L

Question 6

Hyponatraemia severity? (NICE)

Answer 6

Mild 130-135
Mod 125-130
severe <125

Question 7

When to admit hyponatraemia? (NICE)

Answer 7

Mild asymptotic-GP
Moderate asymptomatic-ask endocrine
Severe-admit
symptomatic-admit

Question 8

How quickly to Tx hyponatraemia

Answer 8

Aim to increase by 1mmol/hr, 10mmol in 24hrs, safe >120-needs to be checked

Question 9

Adrenal crisis blood resulsts?

Answer 9

Hyponatraemia
Hyperkalaemia
Hypoglycaemia
Normochromic anaemia
+/- lymphocytosis,/eosinophillia

Question 10

Birch wartofsky scale for thyrotoxicosis

Answer 10

Points for:
AF
High HR
altered mental state
gastro-hepatic dysfunction
temp
precipitating event

Question 11

Aim of DKA Mx

Answer 11

Reduce ketones by 0.5/hr
Reduce glucose by 3mmol/hr
Increase bicarb by 3 mol/hr