Endocrinology Flashcards

1
Q

Type 1 Diabetes mellitus

A

Features: chronic polydipsia, polyuria and weight loss with ketonemia/ketonuria + hyperglycaemia
Differentiate T2 – body habitus, age, insulin resistance signs, FH
Ix: RFPG, OGGT, anti-GAD antibodies (not present in 15%)
Mx: patient education, nutrition, exercise, psychosocial, immunizations
Insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
Diabetic ketoacidosis
(Ix + Mx)
A

Ix: serum glucose, corrected Na, K, Ca
Mx: ABC + continuous cardiac monitoring
Fluid challenge 0.9% saline
Insulin infusion + K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Type 2 Diabetes mellitus management

A

Conservative: Patient education, diet modification, physical exercise, optimise other cardiac risk factors, eye and foot examinations
Medical:
1. Metformin
2. Add sulphonylurea or gliptin or pioglitazone or SGLT-2 inhibitor
3. Gliptin+sulphonylurea or pioglitzone+sulphonylurea or sulphonylurea+SGLT-2 inhib or pioglitzone+SGLT-2 inh
4. Consider GLP1 memtic if BMI >35 kg/m2 or occupational implications of insulin
5. Insulin therapy
Surgical: Bariatric surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Type 2 DM complications

A

Microvascular:
• Diabetic retinopathy
• Diabetic nephropathy
• Peripheral neuropathy

Macrovascular:
• Coronary heart disease
• Peripheral vascular disease/diabetic foot
• Cerbrovascular accident
Other:
Hyperosmolar hyperglycaemic state (HONK)
Necrobiosis lipodica dibeticorum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Adrenal Crisis

A

Features: Shock + anorexia, N+V, ab pain, weakness, fatigue, lethargy, confusion
Rarer feature: hypoglycaemia, fever, hyperpigmentation/vitiligo
Ix: serum cortisol/ACTH, aldosterone/renin, Hyponatraemia, hyperkalaemia, azotemia, hypercalcaemia, eosinophilia. Other autoimmune endocrine deficiency
Precipitation: acute stress/infection, vomiting/GI disturbance, adrenal infarction, Pituitary infarction, abrupt steroid withdrawal
Mx: ABC. Resus IV 0.9% saline or 5% dextrose (hypoglycaemia)
4mg IV bolus of dexamethasone + treat cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Osteoarthritis Mx

A
Conservative: See other card
Medical:
•	Analgesia: Paracetamol + topical NSAIDs, Short course NSAIDs + PPI, Codeine 
•	Intra-articular steroid injection
Surgical:
•	Arthroscopic washout
•	Realignment osteotomy 
•	Arthroplasty 
•	Arthrodesis (fusion)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cushings syndrome complications

A
Centripetal obesity
Facial plethora
Glucose intolerance
Weakness and proximal myopathy
Hypertension
Psychological changes – depression, psychosis
Easy brusing
Hirsuitism
Oligomenorrhea or amenorrhea
Impotence
Acne/oily skin	
Abdominal striae 
Ankle oedema
Backache, vertebral collapse, fracture – osteoporosis 
Polydipsia, polyuria
Rneal calculi
Hyperpigmentation 
Headache
Exophthalmos
Immune deficiency – tine versicolor 
Abdo pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly