Endocrinology Flashcards
Primary hyperaldosteronism: manage with –
Primary hyperaldosteronism: manage with spironolactone
Cushing’s syndrome = hyp-kalaemic metabolic a-
Cushing’s syndrome - hypokalaemic metabolic alkalosis
Management DKA
—replacement:
most patients with DKA are deplete around 5-8 litres. – is used initially.
–: an intravenous infusion should be started at 0.1 unit/kg/hour.
Once blood glucose is < – mmol/l an infusion of 5% – should be started
correction of –
long-acting insulin should be continued, short-acting insulin should be stopped
Management
fluid replacement: most patients with DKA are deplete around 5-8 litres. Isotonic saline is used initially. Please see an example fluid regime below.
insulin: an intravenous infusion should be started at 0.1 unit/kg/hour. Once blood glucose is < 15 mmol/l an infusion of 5% dextrose should be started
correction of hypokalaemia
long-acting insulin should be continued, short-acting insulin should be stopped
– is a specific feature of Grave’s disease rather than generic hyperthyroidism
Exophthalmos is a specific feature of Grave’s disease rather than generic hyperthyroidism
Features seen in Graves’ but not in other causes of thyrotoxicosis:
– signs (30% of patients)
exophthalmos
ophthalmoplegia
pretibial myxoedema
thyroid acropachy, a triad of:
digital–
soft tissue swelling of the –
– formation
Autoantibodies
- antibodies (90%)
- antibodies (75%)
Features seen in Graves' but not in other causes of thyrotoxicosis eye signs (30% of patients) exophthalmos ophthalmoplegia pretibial myxoedema thyroid acropachy, a triad of: digital clubbing soft tissue swelling of the hands and feet periosteal new bone formation
Autoantibodies
TSH receptor stimulating antibodies (90%)
anti-thyroid peroxidase antibodies (75%)
–and — account for 90% of hypercalcaemia cases
Malignancy and primary hyperparathyroidism account for 90% of hypercalcaemia cases
Hypoglycaemia with impaired GCS: give IV –if there is access
Hypoglycaemia with impaired GCS: give IV Glucose if there is access
Tertiary hyperparathyroidism is characterised by extremely high – with moderately raised –
Tertiary hyperparathyroidism is characterised by extremely high serum PTH with moderately raised serum calcium
Phaeochromocytoma typically present symptomatically with a triad of –, –, and –
Phaeochromocytoma typically present symptomatically with a triad of sweating, headaches, and palpitations
Women with hypothyroidism may need to – their thyroid hormone replacement dose by up to –% as early as 4-6 weeks of pregnancy
Women with hypothyroidism may need to increase their thyroid hormone replacement dose by up to 50% as early as 4-6 weeks of pregnancy
Associated electrolyte abnormalities are seen in around one-third of undiagnosed Addison's patients: hyp--kalaemia hyp--natraemia hyp--glycaemia metabolic --
Associated electrolyte abnormalities are seen in around one-third of undiagnosed patients: hyperkalaemia hyponatraemia hypoglycaemia metabolic acidosis
SGLT-2 inhibitors have been linked to necrotising fasciitis of the – or– (– Gangrene)
SGLT-2 inhibitors have been linked to necrotising fasciitis of the genitalia or perineum (Fournier’s Gangrene)
– is recommended in the treatment of Turner’s syndrome
Growth hormone is recommended in the treatment of Turner’s syndrome
Impaired hypoglycaemia awareness occurs due to neuropathy of parts of the –
Impaired hypoglycaemia awareness occurs due to neuropathy of parts of the autonomous nervous system
Tertiary hyperparathyroidism is characterised by extremely high – with moderately raised –
Tertiary hyperparathyroidism is characterised by extremely high serum PTH with moderately raised serum calcium
