Metabolic and Endocrine Flashcards
Symmetrical dermatitis on sun-exposed skin
Diarrhoea and depression
Recently started on anti-TB treatment
What nutritional deficiency does he have?
Vitamin B6 deficiency
Coeliac disease results in malabsorption of the fat-soluble vitamins, which are…
Vitamins A, D, E, K
Patient on TPN (total parenteral nutrition) presents with red crusted lesions around the nostrils and corner of the mouth
What nutritional deficiency do they have?
Zinc deficiency
Type 1 diabetes
Hyperlipidaemia
Mild hyponatraemia
What is the most likely cause for the sodium balance disorder?
Pseudohyponatraemia
Low plasma sodium concentration caused by hyperlipidaemia/hyperproteinaemia
Back pain
Weight loss
Elevated ESR
Marked excretion of immunoglobulin chains in the urine
Myeloma
Hypercalcaemia in a patient after renal transplant
Secondary or tertiary hyperparathyroidism?
Tertiary hyperparathyroidism
Physiological hypertrophy of the parathyroid glands in response to hypocalcaemia.
Plasma calcium is usually low or normal
Causes include Vitamin D deficiency and chronic renal failure
Secondary hyperparathyroidism
Autonomic parathyroid hyperplasia
Plasma calcium and phosphate are raised
Tertiary hyperparathyroidism
45-year-old woman with diabetes presents with shiny areas on her skin with a yellowish colour and overlying telangiectasia
Necrobiosis lipoidica
85-year-old man with type 2 diabetes
Painful wasting of the quadriceps muscle of the right leg with absent knee reflex
Area is very tender
Amyotrophy
Treatment of diabetes
Type 2 diabetes patient presents with HONK
Blood glucose 40mmol/L
0.9% saline, insulin, heparin
Treatment of diabetes
First-line treatment for 19-year-old with diabetes and metabolic ketoacidosis
0.9% saline, IV heparin, prophylactic heparin
Treatment of diabetes
Type 1 diabetes patient brought to A&E
Unconscious with blood glucose level of 1.0mmol/L
IV 50% dextrose
Vitamin deficiency
Prolonged bleeding
Vitamin K
Vitamin deficiency
Malnourished, bleeding gums
Vitamin C
Vitamin deficiency
Night-blindness
Vitamin A
Vitamin deficiency
Bowed legs (rickets)
Vitamin D
Vitamin deficiency
Nystagmus, ophthalmoplegia, ataxia
Vitamin B1 (thiamine)
Vitamin deficiency
Diarrhoea, dementia, dermatitis
Nicotinic acid
Vitamin deficiency
Sore red tongue, peripheral neuropathy
Vitamin B12
Cardiac arrhythmias
ECG: tall T waves
Hyperkalaemia
Muscle weakness, tetany
ECG: small T waves, prominent U wave
Hypokalaemia
Carpopedal spasm, perioral anaesthesia
Positive Trousseau’s, Chvostek’s sign
Hypocalcaemia
Abdominal pain, constipation, vomiting
Depression
Increased incidence of renal stones
ECG: reduced Q-T interval
Hypercalcaemia
Endocrine symptoms
Change in facial appearance, visual problems
Acromegaly
Endocrine symptoms
Weight gain, hirsutism, menstrual problems, depression
Cushing’s syndrome
Endocrine examination signs
Buccal/palmar crease hyperpigmentation, postural hypotension
Addison’s disease
Endocrine examination signs
‘Moon-shaped’ face, centripetal obesity, proximal myopathy, purple striae, hypertension, diabetes mellitus
Cushing’s disease
Endocrine examination signs
Macroglossia, spade-like hands and feet
Acromegaly
Endocrine examination signs
Bradycardia, dry thin hair, goitre, loss of outer third of eyebrow, slowly relaxing reflexes
Hypothyroidism
