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Phase 2 Medicine > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

What do the beta cells of the Islets of Langerhans secrete?

A

Insulin

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2
Q

What do the alpha cells of the Islets of Langerhans secrete?

A

Glucagon

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3
Q

What do the delta cells of the Islets of Langergans secrete?

A

Somatostatin

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4
Q

What is the function of insulin?

A

To lower blood glucose levels

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5
Q

How does insulin lower glucose levels?

A
  1. Stimulates glucose uptake into insulin-dependent tissues
  2. Stimulates glucagon synthesis and suppresses gluconeogenesis
  3. Stimulates cellular uptake of potassium
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6
Q

What is the normal range for blood glucose?

A

3.5-8.0 mmol/L

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7
Q

How is glucose taken into cells?

A

Via GLUT receptors

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8
Q

How is hypoglycaemia defined?

A

Blood glucose levels < 3.0mml/L

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9
Q

What are the symptoms of hypoglycaemia?

A

Dizziness, confusion, hunger, convulsions, coma, sympathetic activation

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10
Q

What is the treatment for hypoglycaemia?

A

Rapidly absorbed carbohydrate taken orally if possible

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11
Q

What is the definition of Diabetes Mellitus?

A

A disease of chronic hyperglycaemia due to insulin deficiency, resistance or both

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12
Q

What is the normal level for a fasting blood glucose?

A

< 5.5 mmol/L

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13
Q

What is the prediabetic level for a fasting blood glucose?

A

5.5-7.0 mmol/L

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14
Q

What is the diabetic level for a fasting blood glucose?

A

> 7.0 mmol/L

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15
Q

What is the cause of Type 1 DM?

A

Insulin deficiency from autoimmune destruction of beta cells of the Islets of Langerhans

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16
Q

What is the inheritance pattern of T1DM?

A

Polygenic

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17
Q

What are the symptoms of T1DM?

A

Polydipsia, polyuria, fatigue, weigh loss, polyphagia

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18
Q

What do undiagnosed type 1 diabetics often present to hospital with?

A

Diabetic ketoacidosis

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19
Q

What is the treatment for T1DM?

A

Replacement of deficient insulin and careful diet control

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20
Q

What is the cause of Type 2 Diabetes Mellitus?

A

Insulin resistance and deficiency

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21
Q

What are the risk factors for developing T2DM?

A

Obesity, Fhx, male sex, lack of exercise, hyperlipidaemia, hypertension, excess alcohol consumption, stress, African and Caribbean ancestry

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22
Q

What are the acute symptoms of T2DM?

A

Polyuria, polydipsia, weight loss

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23
Q

What are the subacute symptoms of T2DM?

A

Lethargy, visual blurring, pruritas vulus

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24
Q

What are the complications of T2DM?

A

Retinopathy, polyneuropathy, ED, arterial disease

25
Q

What is the treatment for T2DM?

A

HOLISTIC - education, management of long term complications, hypoglycaemic agents

26
Q

Which drugs are used in T2DM?

A

Metformin, statins and BP lowering drugs, sulphonylureas

27
Q

What are the microvascular complications of T2DM?

A

Retinopathy, neuropathy, nephropathy

28
Q

What are the macrovascular complications of T2DM?

A

Increased risk of IHD, MI and cerebrovascular disease. Diabetic foot ulcers.

29
Q

What are the symptoms of diabetic ketoacidosis?

A

Nausea, vomiting, abdominal pain, polydipsia, polyuria, dehydration, drowsiness, ketone smell in breath, Kussmaul breathing.

30
Q

What is the treatment for diabetic ketoacidosis?

A
  1. Fluid resus with 0.9% saline
  2. 50u rapid action IV insulin
  3. Assess for K+ replacement
31
Q

What is the aim of treatment for diabetic ketoacidosis?

A

Aim for fall of ketones by 0.5 mmol/L/hr

32
Q

What is a hyperosmolar hyperglycaemic state?

A

Severe hyperglycaemia without significant ketosis

33
Q

What are the symptoms of a hyperosmolar hyperglycaemic state?

A

Hyperglycaemia, dehydration, alteration of consciousness and serum osmolarity of > 320 mosm/kg

34
Q

What are the actions of thyroid hormone?

A
  1. Increases metabolic rate
  2. Beta adrenergic action on heart and gut motility
  3. CNS activation
  4. Bone demineralisation
35
Q

What are the signs of hyperthyroidism?

A

Tremor, sweating, restlessness, wasting, hyperreflexia, palmar erythema

36
Q

What are the symptoms of hyperthyroidism?

A

Weight loss, increased appetite, heat intolerance, palpitations, oligomenhorrea, diarrhoea, polyuria, polydipsia

37
Q

What are the causes of hyperthyroidism?

A

Grave’s disease, toxic multinodular goitre, toxic adenomas, thyroiditis, TSH-secreting pituitary tumours

38
Q

Which drugs can be used to manage hyperthyroidism?

A

Carbimazole or propylthiouracil

39
Q

How is hyperthyroidism managed?

A

Drugs, radioactive iodine, thyroidectomy

40
Q

How can the risk of thyroid eye disease be reduced?

A

Smoking cessation as smoking is the main risk factor

41
Q

What are the primary causes of hypothyroidism?

A

Hashimoto’s thyroiditis, primary atrophic hypothyroidism, post surgery for hyperthyroidism, congenital

42
Q

What are the secondary causes of hypothyroidism?

A

Iodine deficiency and secondary to pituitary failure

43
Q

What are the signs of hypothyroidism?

A

Dry nails and hair, bradycardia, macroglossia, hyporeflexia, hoarse voice, alopecia

44
Q

What are the symptoms of hypothyroidism?

A

Weight gain, cold intolerance, menorrhagia, fatigue, constipation and carpal tunnel syndrome

45
Q

What is used to manage hypothyroidism?

A

Thyroxine

46
Q

What is the action of vasopressin (ADH)?

A

Increase aquaporins in collecting duct, therefore increasing water retention

47
Q

What are the functions of vasopressin?

A

Decrease urine production, increase blood pressure, decrease sweating

48
Q

What increases ADH?

A

Hypovolaemia, hypotension, anaemia, nicotine and adrenaline

49
Q

What decreases ADH?

A

Hypertension, ethanol and a-adrenergic stimuli

50
Q

Cranial aetiology of DI?

A

Familial, tumours, infection, trauma post-surgical

51
Q

What is Diabetes Insipidus?

A

ADH deficiency or insensitivity

52
Q

Nephrogenic aetiology of DI?

A

Renal disease or drugs

53
Q

Investigations and positive results for DI?

A
  1. Osmolality - shows low urine osmolality
  2. U+E - shows hypernatraemia
  3. 24h urine volumes - shows high urine volumes
  4. Water deprivation tests
54
Q

What is the treatment for cranial causes of DI?

A

1st line ADH analogue

55
Q

What is the treatment for nephrogenic causes of DI?

A

Thiazide diuretics

56
Q

Symptoms of Syndrome of Inappropriate ADH?

A

Confusion, nausea and irritability then fits and coma at late stage

57
Q

Aetiology of SIADH?

A

Tumours: SCLC, prostate, thymus and lymphomas
Metabolic: alcohol withdrawal, porphyria
Pulmonary: TB, pneumonia, lung abscess
CNS: meningitis, head injury
Drugs: SSRIs, anti epileptics and sulfonylureas

58
Q

Investigations and positive results for SIADH?

A
  1. U+E - shows dilutional hyponatraemia
  2. Osmolality - shows low plasma osmolality
  3. Urinalysis - shows urinary Na+ secretion

Phase 2 Medicine (1 decks)

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