Endocrine Flashcards
Difference between causeof T1 and T2 diabetes
T1 = Failure to produce insulin - destruction of B-cells in islets of Langerhans T2 = Insulin resistance - Due to multiple causes
Cause of T1
Autoimmune - Environmental factors acting on a genetically susceptible person
Diagnostic glucose/HbA1c levels of diabetes
Random > 11
Fasting > 7
2 hrs post Glucose Tolerance Test (GTT) > 7
HbA1c > 48
Symptoms of T1 Diabetes
Polyuria, Polydipsia, Lethargy, Weight Loss
Treatment of T1
Insulin and Education
Prevalence of T2 Diabetes in teh UK
3.5 Million
Risk factors for T2
Obesity, Poor diet, Asian/Black, Metabolic Syndrome
Components of Metabolic Syndrome
Hypertension, Hyperglycaemia, Obesity, Hypercholesterolaemia and High Triglycerides
Treatment for T2
Lifestyle changes
1st line = Metformin
2nd line = Gliclazide
Most common cause of Primary Hypothyroidism
Autoimmune - Hashimoto’s
Causes of Secondary Hypothyroidism
Hypopituitarism or Hypothalamic disorders
Symptoms of Hypothyroidism
Lethargy, Intolerance to cold, Hair Loss, Weight gain, Menorrhagia, Bradycardia, Hyporeflexia
Investigations and Treatment of Hypothryroidism
TFT’s and Levothyroxine
Is hyperthyroidism more common in men or women?
10x more common in women
Leading cause of Hyperthyroidism
Graves - Autoantibodies stimulate the thyroid causing gland hypertrophy
Other causes of hyperthyroidism
TSH secreting pituitary adenoma/ Thyroiditis
Symptoms of Hyperthyroidism
Sweating, Tremor, Irritability, Weight Loss, Palpitations, Tachcardia, Exopthalmos
What is a Thyroid Storm
Hyperthyroidism become a thyroid storm through an event such as sepsis, fever or dehydration and symptoms become much more severe and potentially life threatening.
Investigations of Hyperthyroidism
TFT’s and serology of antibodies
Treatment - Medical/Surgical
Medical = Block and replace - Carbimazole/Radioactive iodine and Thyroxine Surgical = Thyroidectomy (If thyroid eye disease)
Define Cushing Syndrome/Disease
Syndrome = Abnormalities due to chronic excess glucocorticoid production whatever the cause Disease = Excess glucocorticoid production due to inappropriate ACTH secretion from the pituitary
Symptoms of Cushings
Obese, Moon Face, Sweaty, Thin skin, Bruise easily
Investigations of cushings
48hr Dexamethasone suppressions test - should suppress plasma levels of cortisol
Corticotrophin releasing hormone tests
Treatment - Surgical and Medical
Medical - Ketoconazole
Surgical - Removal of pituitary/adrenal glands
