Respiratory Flashcards
Define type 1 diabetes mellitus
A disease where the pancreas stops producing insulin.
Presentation of T1DM
Often diabetic ketoacidosis
Polyuria
Ploydipsia
Weight loss
Recurrent infections
Investigations in TIDM
FBC, UE, glucose
Blood cultures
HbA1c
Thyroid
Anti-TTG
Insulin antibodies
Management of TIDM
Background and short acting insulin
Hypoglycaemia management
2mg/kg bollus of 10% dextrose
5 mg/kg/hour infusion
Triad of diabetic ketoacidosis
hyperglycaemia
Acidosis
Ketosis
Presentation of diabetic ketoacidosis
Polyuria
Polydipsia
Nausea and vomiting
Weight loss
Acetone smell to breath
Dehydration
Altered consciousness
Symptoms of trigger - sepsis?
Management of DKA
Correct dehydration over 48 hours
Fixed rate insulin infusion
Define adrenal insufficiency
Adrenal glands do not produce enough steroid hormones - cortisol and aldosterone
Features of adrenal insufficiency in babies
LEthargy
Vomiting
Poor feeding
Hypoglycaemia
Jaundice
Failure to thrive
FEatures of adrenal insufficiency in children
Nausea and vomiting
Poor weight gain
Weight loss
Abdominal pain
Muscle cramps or weakness
Developmental delay
Bronze hyperpigmentation
Investigations in adrenal insufficiency
UEs
Blood glucose
Short synacthen test
Cortisol
ACTH
Aldosterone
Renin
Hormone levels in Addisons disease
Low cortisol
High ACTH
Low aldosterone
High renin
Hormone levels in secondary adrenal insufficiency
Low cortisol
Low ACTH
Normal aldosterone
Normal renin
Management of adrenal insufficiency
Hydrocortisone
Fludrocortisone
Monitor growth
Blood pressure
Glucose
Bone profile
Vit D
Sick day rules
Define congenital adrenal hyperplasia
Congenital deficiency of 21-hydroxylase enzyme - causes underproduction of cortisol and aldosterone and over production of androgens
Presentation of congenital adrenal hyperplasia
Ambiguous genitalia
Enlarge clitoris - high testosterone
Hyponatraemia
Hyperkalaemia
Hypoglycaemia
Poor feeding
Vomiting
Dehydration
Arrhythmias
Phenotype of congenital adrenal hyperplasia
Female
Tall for age
Facial hair
Absent periods
Deep voice
Early puberty
Male
Tall for age
Deep voice
Large penis
Small testis
Early pubert
Hyperpigmentation
Management of congenital adrenal hyperplasia
Cortisol replacement - hydrocortisone
Aldosterone replacement - fludrocortisone
Females - genital surgery
Define growth hormone deficiency
Results from the disruption of the growth hormone axis at the hypothalamus or pituitary gland
Presentation of growth hormone deficiency
Micropenis
Hypoglycaemia
Severe jaundice
Older
Poor growth
Short stature
Slow development
Delayed puberty
Investigations in growth hormone deficiency
Growth hormone stimulation test - glucagon, insulin
Thyroid
MRI
Genetic
Xray
Management of growth hormone deficiency
Sub cut growth hormone
Monitoring !
Define congenital hypothyroidism
Child born with underactive thyroid gland - as a result of underdevelopment or faulty gland
Presentation of congenital hypothyroidism
Heel prick test
Prolonged jaundice
Poor feeding
Constipation
Increased sleeping
Reduced activity
Slow growth and development
MAnagement of congenital hypothyroidism
Levothyroxine
