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FCM > Endocrine and Metabolic > Flashcards

Endocrine and Metabolic Flashcards

1
Q

What condition has the following symptoms: Fatigue, cold intolerance, myalgia, Menstrual irregularities, infertility, dry skin, hoarseness, goitre,

A

Hypothyroidism

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2
Q

What is subclinical hypothyroidism?

A

TSH levels are above normal reference range.

FT4 is below the normal reference range.

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3
Q

What is serum thyroid peroxidase antibodies (TPOAb)

A

autoimmune thyroid disease - raised levels in Hashimoto’s disease.

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4
Q

TSH high
T4 Low
T3 Low/Normal

A

Primary Hypothyroidism

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5
Q

TSH low
T4 High
T3 High

A

Hyperthyroidism

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6
Q

TSH Low
T3 Low
T4 Low

A

Secondary hypothyroidism

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7
Q

What are neurogenic symptoms of hypoglycemia VS neuroglycopenia symptpoms?

A
  1. palpitations, anxiety, sweating, hunger, trembling

2. Confusion, difficulty speaking and vision changes, drowsy, dizzy, weakness,

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8
Q

How do you diagnose diabetes

A

Glucose tolerance test
fasting >7
random > 11
after two hours > 11

Hba1c can also be used to diagnose > 48 with symptoms
> 48 not symptomatic, repeat within 2 weeks.
Note - cannot be for under 18s, or for diabetes type 1, gestinational diabetes or pancreatic trauma.

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9
Q

A sugar level of less than 4 is considered what?

A

Hypoglycemia, if less that 2.5 severe! and can loose conciousness

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10
Q

What condition is the following - Hyperpigmentation, Gi symptoms - abdominal pain, early saiety, loss of appetitie, CRAVING SALT
Muscle weakness, pain, cramps
postural dizziness- hypotensive
loss of pubic hair and increased thirst?

A

Addisons disease.

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11
Q

How is addisons disease investigated?

A
  1. serum cortisol levels at 8-9am if over 525, negative result.
  2. glucose - low or normal (Coristol helps increase glucose levels)
  3. urea and electrolytes - Hyponaturemia and hyperkalemia (hypotensive)
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12
Q

How is addisons disease diagnoised?

A

Synacthen test -
in addisons diease you have maximum ACTH released from the pitutary to try and stimulate the adrenal glands. But adrenal glands are broken so do not produce cortisol.
the test offers a synthetic form of ACTH if the coritsol levels increase - you do not have Addisons diease. If it remains low after 30-60 minutes, you have the disease.

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13
Q

What is hypokalemia

A

Low levels of potassium

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14
Q

What are they symptoms for hypocalcemia?

A 
CAT N
convulsions
arrhythmia 
tetany 
Numbness
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15
Q

Polydipsia, polyuria, polyphagia, weight loss, blurred vision, acanthas nicgrans?

A

Diabetes II

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16
Q

What is the pathophysiology of Diabetes type 2?

A

Pancreas beta cells releases insulin.
Insulin which is a hormone causes uptake of glucose from blood into adipose tissue, liver and muscle. For storage and energy.
It also increases the amount of transporters on cells.
Increase glucose causes insulin resistance - and thus reduced uptake of glucose. this becomes glucosuria and with it takes water - thus polydipsia and polyuria.
It also takes with it electrolytes thus hyperosmolar state - emergency.

17
Q

How do you diagnoise Diabetes II

A

Fasting Plasma glucose test >7mmol/l
Hba1c (>48mmol/l PLUS Symptoms)
Glucose tolerance test

18
Q

What are

A
19
Q

what are reversible causes of hyperglycemia?

A

Infection
steroids
pancreatic trauma

20
Q

can you use HBA1c to diagnoise patients under 18 years of age?

A

NO

21
Q

can you use Hba1c to diagnose patients who have diabetic symptoms for less than 2 months?

A

NO

22
Q

Can you diagnose diabetes in patients who are 2 months post partum

A

NO

23
Q

When reading HbA1 when should you be weary?

A

RBC disorders (anemia, sickle cell, thalassemia)

24
Q

Recurrent infections, unintentional weight loss, nocturia and polydipsia and tiredness? are signs of what condition

A

Diabetes

25
Q

Abdominal pain, nausea and vomiting, altered mental state and dehydration are due to what problem?

A

DKA

26
Q

Why do you get abdominal pain, nausea and vomiting in DKA

A

Inflammatory cytokines that are released from lipolysis (glycerol and fatty acids) used to gluconeogenesis in the liver, irritates the gastrointestinal tract

27
Q

Why do you get altered mental state in DKA?

A

Ketones (produced from abundance of glucose) in diabetes type 1 - is acidic - this causes metabolic acidosis which can cause altered mental state and arrythmias.

28
Q

what are some clinical signs of DKA

A

Fruity smelling breath
kaussmal breathing - Tachnypnoea, and acidotic
Tachycardia
Shock - Hypotension, reduced urinary output, high HR.

29
Q

How do you test for ketones

A

Urinary or Blood - you should measure this even if blood glucose is normal. For urine dipstick the ketones must be read within 15 seconds.

30
Q

Why do you get DKA?

A

body is under stress, and more energy is needed than insulin available.
I.E Infection
hypothyroidism or pancreatitis
Corticosteroids use

31
Q

What do you give for DKA management?

A

IV Fluids & Insulin

Potassium and glucose potentially if electrolyte imbalance - hypokalemia and hypoglycemia.

32
Q

What is the difference between DKA and HHS

A

DKA - Hyperglycemia, Ketonemia, acidosis

HHS - Hyperglycemia, hypovolemia, hyperosmalality

FCM (13 decks)

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