Endocrinology Flashcards

1
Q

Benefits of Tight Glycemic control

A
  1. Improves wounds healing
  2. Reduces rate of infection
  3. Avoids exacerbating CNS injury associated with ischemia in presence of increased serum glucose
  4. Decreases risk of dehydration 2/2 osmotic diuresis
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2
Q

Sequelae of long-term uncontrolled Diabetes

A
  1. Peripheral and autonomic neuropathy
  2. CAD
  3. HTN
  4. Increased risk of aspiration (gastroparesis)
  5. Renal insufficiency
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3
Q

What is Carcinoid Syndrome?

A

A constellation of symptoms including flushing, diarrhea, bronchoconstriction, right heart valvular disease (pulmonic stenosis, tricuspid regurgitation) and hypotension

  • D/t excessive amounts of circulating hormones (histamine, bradykinin, serotonin) in the systemic circulation
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4
Q

How is carcinoid syndrome diagnosed?

A
  • 24-hr urine levels of 5-hydroxyindoleacetic acid (5-HIAA)
  • PET/CT Scan
  • Octreoscan (Scintigraphy)
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5
Q

Why don’t all patients with carcinoid tumors develop carcinoid syndrome?

A

Most carcinoid tumors are located in GI tract
- vasoactive substances enter portal circulation and removed by liver prior to systemic circulation

Symptoms occur when substance bypass portal system

  • Metastasis to liver
  • Tumors outside GI tract (pulmonary, ovarian)
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6
Q

What’s the treatment of carcinoid crisis?

A
  1. Somatostatin analogue (Octreotide)

2. Optimize intravascular fluid volume

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7
Q

Would you use Succinylcholine in a patient with Carcinoid Syndrome?

A

No

  • Fasciculations and potential histamine release could lead to increased release of vasoactive substances
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