Endocrine Flashcards
Brief definition of Addison’s disease?
Primary adrenal insufficiency…hypocortisolism
Investigations if Addison’s is suspected?
Serum cortisol (8-9am)
<100nmol/L…admit
100-500nmol/L…refer to endocrine
U&E (Low Na; High K)
Gold Standard (in 2ndary care): ACTH stimulation test (Synacthen)
Treatment for Addison’s?
Hydrocortisone (glucocorticoid)
Fludrocortisone (mineralocorticoid)
(Also androgen replacement if necessary but unusual)
Treatment for adrenal crisis?
Hydrocortisone IM or IV
What drug is common anti-emetic?
Metoclopramide
Symptoms of adrenal crisis?
Sudden pain lower abdo/pelvis/legs Confusion Lethargy Convulsions Fever
Signs of adrenal crisis?
Hyperkalaemia Hypercalcaemia Hyponatraemia Hypoglycaemia Hypotension Hypothyroid
Conn’s syndrome definition and presentation?
Endocrine HTN
hypokalaemia
low renin, high aldosterone
due to bilateral hyperplasia or adenoma
Conn’s syndrome treatment?
Adrenalectomy
Low Na diet
Spironolactone
Cushing’s diagnosis?
Dexamethasone suppression test
ACTH levels
Cortisol levels
Hyperparathyroidism definition and presentation?
Excess PTH may be due to tumour or hypocalcaemia leading to high PTH.
Stones, groans, moans, psychic overtones.
Kidney stones
Fatigue
Ileus
Bone pain
Confusion/altered mental state
Treatment of hyperparathyroidism?
Treat cause
Primary - parathyroid surgery
Secondary/Tertiary - Vitamin D, oral calcium
(IV calcium if acute)
Hypocalcaemia presentation and causes?
Causes:
Hypoparathyroidism;
hypomagnesia;
osteomalacia
Increase neuromuscular excitability Tetany Peripheral tingling Convulsion ECG changes (prolongued QT)
Treatment of hypocalcaemia?
Vitamin D, oral calcium
IV calcium if acute
Symptoms of hypernatraemic dehydration?
Jittery movements Increased muscle tone Hyperreflexia Convulsions Drowsiness/coma
