Endocrinology Flashcards
4 complications of acromegaly
Colorectal cancer
hypertension
diabetes (>10%)
cardiomyopathy
Gold standard test for acromegaly.
Serum IGF-1 levels have now overtaken the oral glucose tolerance test (OGTT) with serial GH measurements as the first-line test. The OGTT test is recommended to confirm the diagnosis if IGF-1 levels are raise
What happens to Na+ and K+ in Addisons disease?
Hyponatraemia and Hyperkalaemia
Also generally hypoglycaemic
3 primary causes of hypoadrenalism ?
TB
HIV
Metastases
Anti phospholipid syndrome
Secondary cause of hypoadrenalism ?
Pituitary causes
How do distinguish primary to secondary addison’s?
Primary you get hyperpigmentation.
What is the Gold standard test for Addison’s disease?
ACTH stimulation test (i.e. short synacthen test)
What is a complication of carbimazole?
Agranulocytosis
Who is carbimazole given to?
management of thyrotoxicosis. It is typically given in high doses for 6 weeks until the patient becomes euthyroid before being reduced.
What can steroids do to a FBC?
Cause neutrophilia
When should you have a gradual withdrawal of systemic steroids?
- received more than 40mg prednisolone daily for more than one week
- received more than 3 weeks of treatment
- recently received repeated courses
What can cause ectopic ACTH production
SCLC
What happens to K+ and ph in cushing’s disease?
You get hypokalaemia and metabolic alkalosis and impaired glucose tolerance
How do you diagnose cushing’s disease
You do an overnight dexamethasone suppression test . Those with cushing’s diseases will not have their morning cortisol level suppressed.
If you have an ectopic ACTH syndrome will you get cortisol suppresion on dex supression test ?
NO
