Endocrine Flashcards
Follow up investigations for Cushings
BP Dipstick urine for glucose Visual fields 24 free urinary cortisol Overnight/low dexamthesone supression test
Causes of Cushings Syndrome
Cushings disease (pituitary adenoma producing ATCH) Steroid use Ectopic ATCH (small cell lung cancer) Adrenal adenoma
Questions to ask Cushingoid patient
Have you noticed any change in your appearance? Mood? Periods?
What is a differential for Cushing spotter?
Hypothyroidism
Questions for acromegaly patient
Have you noticed a change in your appearance? Do you sweat excessively? Do you suffer from high blood pressure? Have you changed shoe size?
Symptoms of acromegaly
Headaches Visual problems Pins and needles Back ache Muscle weakness Bigger hands and feet
How is acromegaly diagnosed?
GH response to OGGT test, if not suppressed then acromegaly
What follow does acromegaly need?
Colonoscopy from age 40
Treatment of acromegaly
Transphenoidal surgery Radiotherapy (not great) Bromocriptine (pre-op)
Symptoms of DKA
breath ketones low HR high RR (Kussmaul) low BP Vomiting/abdo pain
Symptoms of hypoglycaemia
(Adrenergic/sympathetic overdrive) Sweaty Cold and Clammy high HR, BP Myoclonic jerks/seizure
Diagnostic triad of ketoacidosis
Hyperglycaemia + Ketonuria + Acidosis
Tx of DKA
PANICS Potassium Acidosis - ABG, ketones Normal Saline Insulin by Insulin Catheter and Cultures Stomach Aspiration
Why do you get deformity in diabetic neuropathy?
Because light touch and sensation are lost first, so loss of protective sensation
Graves disease triad
Goitre + eyes signs + thyrotoxicosis
