Endocrine disease Flashcards
What is endocrine disease
Endocrine glands secrete hormones into blood which act on other organs. Diseases arise from excessive or insufficient levels of hormones.
What is the most common endocrine disease
Diabetes mellitus affects 7% of the uk population
What % of diabetes suffer from type 1
8%
What does type 1 diabetes cause
Weight loss, tiredness, polyuria, polydipsia (acute onset)
What % of people with diabetes have type 2
90%
What does type 2 diabetes cause
Increased weight (onset may be insidious and long term)
How do you diagnose diabetes
Using blood glucose levels
What blood tube do you use for glucose testing and why
The grey topped tube as it has fluoride which ingots metabolism of glucose by the blood cells.
What is the normal fasting plasma glucose level
Greater than or equal to 7 mmol/L
What is the normal random plasma glucose level
Greater than 11.1 mmol/L
Sometimes a glucose tolerance test is required, how is this done
- measure fasting plasma glucose
- give 75g of glucose orally
- measure plasma glucose after 2 hours
What is the difference of in glucose tolerance tests for normal and diabetes
Diabetes- has a high rise and slowly decreases
Normal- medium rise and quick decrease
What is insulin excess called
Insulinoma
How is insulin excess diagnosed
By prolonged fasting and measuring proinsulin, insulin and c-peptide when hypoglycaemic
What is hypothyroidism
Problem with thyroid gland itself
What are symptoms of hypothyroidism
Everything is slow
T4 and T3 will be low
TSH increased
What are symptoms of hyperthyroidism
Everything is fast
T4 and T3 increase
TSH decreased
What are functions of the adrenal cortex
Hormones secreted are essential for life
Cortisol maintains blood pressure and volume
Cortisol also stimulates breakdown of protein and fat
What causes primary adrenal insufficiency. Or Addison’s disease
Lack of cortisol, due to damage of adrenals
What are clinical features of Addison’s disease
Lethargy
Weight loss
Pigmentation of creases on hand and feet
Abdominal pain
Dehydration
How do you diagnose addisons
1 measure cortisol and serum electrolytes
2 short synacthen test
What is the normal response to a short synacthen test
0 min cortisol = >225nmol/L
30 min cortisol = >500 nmol/L
What is the Addison’s disease response to a short synacthen test
0 min cortisol = <225nmol/L
Little to no increased at 30 mins
ACTH elevated
What is Cushing’s syndrome
Excess cortisol
What are clinical features of Cushing’s syndrome
Hypertension
Truncal obesity (abdomen)
Thinning skin
Muscle weakness
Easy brushing
Moonface
What test is used to diagnose Cushing’s
Dexamethasone suppression test
What is the normal level for dexamethasone supression tests
Cortisol is <50 nmol/L
What is the Cushing response to dexamethasone supression tests
> 50 nmol/L cortisol
What is agromegaly
A growth hormone excess that causes gigantism
