Metabolic and Endocrine disease Flashcards
What are antibodies associated with type 1 DM?
Islet cell antibodies(90%)
Glutamic acid decarboxylase antibodies GAD (78%)
Insulin antibodies
Tyrosine phosphatase antibodies
What is the duration of action of insulin glargine?
24 hours
What is the treatment of choice in T1DM?
Insulin
Basal bolus regime
1 Long acting at night plus 3 short acting with meals
How can T1DM be monitered?
Monitoring 3-6 monthly HbA1c And daily blood glucose monitoring(4 types a day in adults and 5 types in children and more if sick)
How can morning hypoglycemias be prevented in someone on basal bolus insulin?
reduce basal bolus
What is the most serious side effect of metformin
lactic acidosis
What is the mechanism of action of Liraglutide?
Glucagon like peptide agonist-promote weight loss
Indication-triple therapy infective and BMI greater than 35
What is the earliest sign of Diabetic nephropathy
Increase ACR > 3-30
warrant start of ACEI or ARB
How can T2DM be monitored?
HBA1C-3-6 monthly(aim for 48nmmol or 53 if risk of hypoglycemias)
Yearly review-Retinal screening, foot assessment,U&E, lipids, bp, urine
Education and lifestyle-Physical activity, dietary advice, medication education
CVS risk prevention-smoking cessation, statins,bp control
What are the causes of Dupyutren Contractures?How can it be managed?
Aging Trauma Chronic liver disease Alcohol use Smoking Antileptic medication eg- phenyoin
TX-(reduce pain)Injection cholinergase,steriods
Surgery
What are the common tumour markers
Pancreas-CA 19-9 Ovary-ca 125 HCC-AFP Colorectal-CEA Thyroid-Calcitonin Testicular cancer-HCG,LDH
What drugs need to be stopped in AKI?
DAMN
Diuretics(renal hyopoperfusion, hyperK)
ACE1
Metformin(risk of lactic acidosis)
NSAIDS
