Metabolic Flashcards
When to get DEXA if underweight? (BMI <18.5)
Child - 1 year
Adult - 2 years
Sooner if recurrent fractures or bone pains
Most common secondary cause of HTN? Blood results? Test to request?
Conn’s (primary hyperaldosteronism)
Hypokalaemia + HTN
Renin - aldosterone ratio
Refeeding syndrome hallmarks
Low K
Low PO4
Low Mg
Low thiamine
Drug that is a risk factor for osteoporosis
SSRI
Causes of hypervolaemic hyponatramia
Failures:
thyroid
heart
liver
kidney
Duchenne Muscular Dystrophy inheritance pattern
X-linked recessive - ie mother passes it on
1/3rd caused by de novo mutations
Turner’s syndrome (45X) common endocrine condition
Hypothyroidism (also DM)
Starting dose levothyroxine in under 65s
1.6micrograms per kilogram
Rounded to nearest 25
Hba1c target prior to surgery
Under 69
Age to consider screening for fracture risk in patients without risk factors (men and women)
Men 75
Women 65
Kallman’s vs Klinefelter’s
LH/FSH and testosterone levels
Key features
Kallman’s - LH/FSH low/normal, T low. Anosmia
Klinefelter’s - LH/FSH raised, T low
T2DM and established CVD Rx
Metformin and uptitrate
Add SGLT-2 regardless of diabetic control
2 x bloods showing subclinical hypothyroidism TSH >5.5
6 month trial of levothyroxine
Familial hypercholesterolaemia inheritance pattern
Autosomal dominant
Osteoporotic fracture - age cut-off for DEXA vs start bisphosphonate
<75 —> DEXA
>75 —> treat
When to increase statin dose
If non-HDL cholesterol has not improved by 40%
Diabetes drugs that cause cholestasis
Sulphonylureas
Commonest causes of drug-induced cholestasis
Steroids
Antibiotics
Contraceptives
When to treat subclinical hypothyroidism
When TSH >10
First-line Rx in MODY
Glickazide (sulphonylurea)
Gout uric acid target
360
Standard Rx for men with osteoporosis
Alendronic acid
(Risedronate if high risk fracture)
