Endocrinology Flashcards
What cells do Pheochromocytoma originate in?
Chromaffin cells in Adrenal medulla
If a patient has T2DM and has an increased risk of CVD, what medication should you start?
SGLT-2 inhibitor
How to tell insulinoma on a blood test?
High insulin, high c-peptide
Bloating + Vom + erratic blood glucose + T1DM diagnosis - what do you think?
Gastroparesis
low Na + high K
Addisons
How to treat HHS?
- Fluid replacement –> given at 0.5-1 L/hour
- Insulin (if fluids has reduced blood sugar levels)
- VTE prophylaxis
Management of gastroparesis in patients with T1DM?
Metoclopramide
How to manage a patient’s regular insulin regime if they are T1DM and present to A&E with DKA?
continue long acting but stop short acting
What to prescribe if patient cannot tolerate metformin therapy?
SGLT-2
What is the infusion rate of insulin in DKA?
0.1 unit/kg/hour
What do you use to test for diabetic neuropathy on examination?
10g monofilament
Hypertension + hypoK
Conns
What should be given with a new diagnosis of Graves prior to seeing endocrinologist?
propranalol
What are the sick day rules for Addisons?
double hydrocortisone
same fludrocortisone
What is the karyotype for Kleinfelters?
47 XXY
What are the LH and testosterone results for Kleinfelters?
low testosterone
high LH
First line investigation for acromegaly
serum IGF-1
What thyroid cancer is associated with raised calcitonin?
Medullary
What should you look at when patient comes in with normal PTH and hyperCa?
HyperCa should produce low PTH
so PTH is inappropriately high
What is the EGFR cut off for patients on metformin?
less than 30 stop
What medication is used for neuropathic pain in diabetic neuropathy?
Duloxetine
What parameter do you monitor in patients with HSS?
serum osmolality
Sick day rules for T2DM medications
Metformin –> Stop if Kidneys not good & if risk of dehydration
SGLT2 –> increased risk of ketoacidosis ( euglycaemic)
GLP-1 –> stop if risk of dehydration as AKI
Management of Subclinical hypothyroidism
TSH>10 and Free T4 normal –> 2 occasions 3 months apart–> Levothyroxine
TSH 5.5-10 and free t4 normal –> and symptoms–> 6 month trial of levothyroxine
What are the target BM values in patients with T1DM when waking and pre meal?
fasting : 5-7
plasma before meals: 4-7
