Endocrinology Flashcards
underlying pathology of Cushing’s syndrome
excessive cortisol
causes of Cushing’s syndrome (4)
1- Exogenous steroids
2- Pituitary Adenoma
3- Adrenal Adenoma
4- Paraneoplastic (e.g. Small Cell Lung Cancer)
Conditions that can be caused by Cushing’s syndrome (4)
1- Hypertension
2- T2DM
3- Depression
4- Osteoporosis
Diagnostic test for Cushing’s syndrome
Dexamethasone Suppression Test
Primary Adrenal Insufficiency- pathology
damaged adrenal glands cause decreased secretion of Cortisol and Aldosterone
Secondary adrenal insufficiency- pathology
decreased ACTH from the pituitary causes decreased steroid secretion
tertiary adrenal insufficiency
decreased CRH from the Hypothalamus causes decreased ACTH secretion from the pituitary which causes decreased steroid secretion from the adrenal glands
clinical features specific to Grave’s disease (3)
1- Exopthalmos (pictured)
2- diffuse goitre (no nodules)
3- Pretibial Myxoedema
Symptomatic treatment of Grave’s disease
Propranolol
- First line treatment option for Grave’s disease
- Other treatment options
- Carbimazole
- Propylthiouracil
- Radioactive Iodine
- Surgery
antibodies associated with Hashimoto’s Thyroiditis
Anti-TPO Antibodies (antithyroid peroxidase)
Antithyroglobulin antibodies
medications that can cause hypothyroidism
Lithium
Amiodarone
Bromocriptine / Ocreotide
treatment of hypothyroidism
Levothyroxine
criteria for acute diagnosis of ketoacidosis
1- Ketones (<3)
2- hyperglycaemia (<11)
3- Acidosis (pH<7.3)
Initial management of ketoacidosis
FIG PICK
Fluids
Insulin (fixed rate 0.1 units/kg/hr)
Glucose (monitor blood glucose and add dextrose if below certain level e.g. 14mmol/l)
Potassium (monitor 4hrly and correct as required)
Infection (treat underlying causes like infection)
Chart fluid balance
Ketone monitoring (monitor ketones or blood bicarbonate if ketones are unavailable)
initial blood test for Acromegaly
Insulin-like growth factor (IGF-1)