100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached
logo-home
Summary Endocrinology and Diabetes £9.29   Add to cart

Summary

Summary Endocrinology and Diabetes

 22 views  0 purchase

High yield comprehensive revision notes on Endocrinology. Written by a top decile Cambridge University Student. It will be covering: - Diabetes Mellitus - Thyroid Disorders - Pituitary Axis - Adrenal Gland - Blood Pressure control - Calcium metabolism

Preview 4 out of 58  pages

  • No
  • Endocrinology
  • April 23, 2021
  • 58
  • 2020/2021
  • Summary
book image

Book Title:

Author(s):

  • Edition:
  • ISBN:
  • Edition:
All documents for this subject (10)
avatar-seller
cambridgemedic
Endocrinology
Diabetes 1. Type I Diabetes Mellitus
Mellitus 2. Type II Diabetes Mellitus
3. Diabetic Emergencies
a. Diabetic Ketoacidosis
b. Hyperosmolar Hyperglycaemic state
c. Hypoglycaemia
4. Complications of Diabetes
Pituitary Gland 1. Hypopituitarism
Disorders 2. Pituitary Adenoma
3. Pituitary apoplexy
4. Pituitary Hypersecretion Syndromes
a. Hyperprolactinaemia
b. Acromegaly and gigantism
c. Cushing’s Disease
5. Thirst Axis
a. Diabetes Insipidus
b. SIADH
Thyroid Axis 1. Hypothyroidism
2. Hyperthyroidism
3. Graves’ Disease
4. Thyroid Crisis
5. Myxoedema Coma
6. Goitre
7. Thyroid Malignancy
Glucocorticoid 1. Adrenal Gland
Axis 2. Addison’s Disease (Primary Hypoadrenalism)
3. Secondary hypoadrenalism
4. Congenital Adrenal Hyperplasia
5. Cushing’s Syndrome
Endocrinology of 1. Primary hyperaldosteronism
Blood Pressure 2. Phaeochromocytoma
Control 3. Multiple endocrine neoplasia
Disorders of 1. Hyperparathyroidism
Calcium 2. Hypoparathyroidism
Metabolism
Disorders of 1. Male hypogonadism
Male 2. Loss of libido and erectile dysfunction
Reproduction 3. Gynaecomastia
Presentations 1. Fatigue

Diabetes Mellitus
1. Type I Diabetes Mellitus
See Paediatrics
Overview
- Autoimmune destruction of pancreatic beta cells

,Associations
- Autoimmune thyroid disease
- Addison's disease
- Pernicious anaemia
- HLA-DR4
- Cystic fibrosis (CFTR channels)
- Haemochromatosis (toxic iron deposition)
- MEN / autoimmunity

Presentation
Symptoms
- Polydipsia
- Polyuria
- Lethargic
- Weight loss
- Recurrent infections
- Blurred vision
- Nausea and vomiting

Signs
- Necrobiosis lipoidica diabeticorum – shiny, painless areas of
yellow/red. Associated with telangiectasia.

Complications
- Diabetic ketoacidosis
- Macrovascular
o Ischaemic heart disease
o Cerebrovascular disease
o Peripheral vascular disease
- Microvascular
o Retinopathy
o Neuropathy e.g. glove and stocking, autonomic dysfunction,
mononeuritis multiplex
o Nephropathy (nephrotic syndrome)

Pathology
- Autoimmune condition
o Reduction in pancreatic B cells and lack of insulin synthesis
o Antiglutamic acid decarboxylase (GAD) autoantibodies
found in large amount of patients
o Some evidence it may follow an environmental trigger e.g.
virus

Investigations
GP may take urinalysis / capillary glucose

WHO guidelines:
- Fasting plasma glucose >7mM

, - Plasma glucose >11.1 mM when take 2 hours after ingesting 75g of
glucose (oral glucose tolerance test)

HbA1c
- Should be monitored every 3-6 months
- Target of 48mmol/mol or lower

Management
Conservative
- Self-monitoring of blood glucose
o 4x per day, before each meal and bed
o More frequent if: hypoglycaemic episodes, during period of
illness, surrounding sport, planning pregnancy, during
pregnancy, breastfeeding
o Targets:
 5-7mmol/l on waking
 4-7mmol/l before meals

Medical
- Typical Insulin Regime
o Basal/background – 1-2 injections per day/insulin pump e.g.
twice-daily detemir. Second-line: once-daily glargine
o Bolus – to cover sugar/carbohydrate in food e.g. aspart,
lispro, glulisine
- Alternative
o Twice-daily mixed insulin regime – 1-3 daily injections of short
+ intermediate acting insulins mixed.
- Consider metformin if BMI >25

2. Type II Diabetes Mellitus
Overview
- Most common cause of diabetes in the developed world
- Relative deficiency of insulin due to excess of adipose tissue
- Prediabetes
o People who haven't yet met T2DM criteria but are likely to
develop the condition over the next few years
o Require close monitoring/lifestyle interventions e.g. weight
loss

Presentation
Often picked up routinely in blood tests

Other signs:
- Polydipsia
- Polyuria

Investigations
Diagnosis

, - Symptomatic patients:
o Fasting glucose >/= 7mmol/l
o Random glucose >/= 11.1 mmol/l (or after 75g oral glucose
tolerance test)
- Asymptomatic patients - above demonstrated on two separate
occasions
- HbA1c
o >/= 48mmol/mol is diagnostic of diabetes mellitus (6.5%)
o Misleading Hb1Ac can be caused by increased red cell
turnover:
 Haemoglobinopathies
 Haemolytic anaemia
 Untreated iron deficiency anaemia
 Suspected gestational diabetes
 Children
 HIV
 Chronic kidney disease
 Medications causing hyperglycaemia




Manage
ment
Conservative
- Monitoring and treating for complications related to diabetes
- Modifying cardiovascular disease risk factors
- Dietary advice
o High fibre, low glycaemic index sources of carbohydrates
o Low-fat dairy products and oily fish
o Control intake of foods containing saturated fats
o Weight loss

Medical
- First-line is metformin
o Stop during intercurrent illness - increased risk of lactic
acidosis
o CI: CKD (stop if eGFR <30); iodine-containing contrast; alcohol
abuse
- Second-line drugs include sulfonylureas, gliptins and pioglitazone
- If oral medication is not controlling blood glucose - insulin is used

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through credit card for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller cambridgemedic. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for £9.29. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

72042 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy revision notes and other study material for 14 years now

Start selling
£9.29
  • (0)
  Add to cart