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Medicine > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What is the difference pathologically between T1 and T2 diabetes?

A

T1-absolute lack of insulin due to autoimmune destruction of beta cells in pancreas

T2-decreased insulin secretion +/- increased insulin resistance

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2
Q

Give a definition of diabetes?

A

Symptoms of hyperglycaemia AND high venous glucose detected once (fasting >7mmol/L or random >11.1mmol/L)

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3
Q

What are the symptoms of T1 diabetes?

A

Polydipsia
Polyuria
Weight loss
?Ketosis

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4
Q

What are the symptoms of T2 diabetes?

A

Asymptomatic/complications eg. MI

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5
Q

Suggest 2 tests you could do to confirm T1 diabetes?

A

Random glucose level
Fasting glucose level
Oral glucose tolerance test
Urine dip for ketones

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6
Q

Give 2 possible drug treatments for T2 diabetes?

A

Biguanides-metformin
Sulphonylureas-gliclazide
Insulin

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7
Q

Give 3 lifestyle changes for diabetes?

A 
Lose weight
Increase exercise
Stop smoking
Reduce alcohol intake
Low fat diet
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8
Q

How can you monitor long term diabetes control? What is it measuring?

A

HbA1c levels

Glycosylated haemoglobin over approx. 60 days

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9
Q

Name 3 systems that need to be monitored in patients with diabetes?

A

Eyes
Feet
Kidneys
CVS

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10
Q

What is the ideal BP in T2 diabetics?

A

140/80

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11
Q

Define hypoglycaemia?

A

Plasma glucose <3mmol/L

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12
Q

Give 5 symptoms of hypoglycaemia?

A 
Sweating
Dizziness
Palpitations
Confusion
Drowsiness
Seizures
Coma
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13
Q

How do you treat a hypoglycaemic attack?

A

Oral sugar and long acting starch

If unable to swallow the IV glucose

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14
Q

Give 3 symptoms of DKA?

A 
Vomiting
Drowsiness
Dehydration
Lethargy
Ketotic breath
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15
Q

Give 2 triggers of DKA?

A 
Infection
Surgery
MI
Wrong insulin dose/noncompliance
Chemotherapy
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16
Q

What are the 3 parameters used to diagnose DKA?

A

Acidosis
Hyperglycaemia
Ketosis

17
Q

What makes HONK different from DKA?

A

Longer history
Marked dehydration, glucose >35mmol/L
Acidosis absent

18
Q

Name the first 3 steps in management of neuropathic pain?

A

Paracetamol
Amitrypitilline
Gabapentin

19
Q

What is the initial management of DKA?

A

Set up IV access
Aggressive fluids whilst monitoring potassium
Soluble insulin IV
Add potassium when urine output is >30ml/hr

20
Q

Give 2 triggers of HONK?

A

Infection
MI
Drugs (steroids, beta blockers)

21
Q

Give 3 symptoms of HONK?

A

Malaise
Confusion
Drowsiness
Polydipsia

22
Q

Name a complication that can develop from HONK?

A

Thrombosis
Seizures
Focal CNS signs

23
Q

How do you treat HONK?

A

Rehydrate with saline over 48hrs

Replace K+ when urine starts flowing

24
Q

What can precipitate a thyrotoxic storm?

A

Recent thyroid surgery
Infection
MI
Trauma

25
Q

If a patient is unconscious from hypoglycaemia, how might you administer treatment and with what?

A

Glucose gel-Buccal
Dextrose-IV
Glucagon-IM

26
Q

What is the skin condition caused by insulin resistance?

A

Acanthosis Nigricans

27
Q

How is diabetic retinopathy classified?

A

Background
Preproliferative
Proliferative
Advanced

28
Q

How can you treat diabetic nephropathy?

A

ACE i

29
Q

What is the typical presentation of diabetic neuropathy?

A

Glove and stocking distribution of tingling and pain. Worse at night.

30
Q

What is the most common cause of Cushing’s syndrome and name 3 other causes?

A

Oral steroids

Cushing’s disease- pituitary adenoma
adrenal hyperplasia
Ectopic ACTH production-lung cancer

Adrenal cancer

31
Q

Give 5 symptoms of Cushing’s syndrome?

A 
Weight gain
Mood changes (depression, irritability)
Proximal weakness
Gonadal dysfunction (irregular menses, hirtutism)
Acne
Recurrent Achilles' tendon rupture
32
Q

Name 4 signs seen in Cushing’s syndrome?

A 
Central obesity
Moon face
Buffalo neck hump
Purple striae
Bruises
Skin & muscle atrophy
33
Q

Why may random plasma cortisol levels mislead when trying to test for Cushing’s syndrome?

A

Illness, time of day and stress (being in hospital) can influence the results.

34
Q

What is the diagnostic test for Cushing’s syndrome?

A

Dexamethasone suppression test

35
Q

Give 5 side effects of corticosteroid therapy?

A 
Hyperglycaemia
Osteoporosis
Cataracts
Depression
Hypertension
Weight gain 
Amenorrhea
36
Q

Name 4 symptoms of hyperthyroidism?

A 
Diarrhoea
Weight loss
Increased appetite
Over active 
Heat intolerance
Palpitations
Tremor
37
Q

Suggest 4 symptoms of hypothyroidism?

A 
Tired
Lethargic
Low mood
Cold intolerance
Weight gain
Constipation
Hoarse voice
38
Q

What value of HbA1c should diabetics be aiming for?

A

<7%

39
Q

Name 4 actions of cortisol?

A

Increase plasma glucose
Immunosuppressive
Slows bone formation
Catabolism

Medicine (17 decks)

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