Endocrinology problems

Question 1

Blood sugar ranges, fasting and postprandial/random

Answer 1

Fasting: <5.6 normal, 5.6-6.9 impaired, >7 on two = diabetes

Postprandial: <7.8 normal
7.8-11 impaired
>11 diabetes

Question 2

WHO definition of T1DM

Answer 2

• Fasting glucose >7 or
• Random/post prandial 11.1 or
• HbA1c> 48 and

-Insulin deficiency
Clinical signs (polydipsia, polyuria, weight loss, ketoacidosis)

Question 3

Calculation of effective osmolality *exam??

if hyperosmolar, can indicate a pseudohyponatraemia

Answer 3

2 x measured sodium + glucose

Question 4

Mineralocorticoid deficiency

Answer 4

Hyponatraemia: Sodium loss, and water at same rate, but volume depleted; after 10% volume loss, ADH secretion, diluting salt, hyponatraemia
Hyperkalaemia: Less K+ excretion
Hypotension: Volume loss
Metabolic acidosis: K+ and H+ retention due to sodium loss, meaning no transepithelial potential

Question 5

Glucocorticoid deficiency

Answer 5

Hyponatraemia: Loss of vascular tone, loss of GFR, body retaind water thinking volume depletion, dilutes
Hypoglycaemia: Cortisol needed for hepatic gluconeogenesis
Hypotension: Loss of tone