Hypothyroid in pregnancy

Increase levothyroxine in pregnancy (+25-50mg)

Polycystic ovary syndrome

Endocrine disorder characterised by hyperandrogenism + insulin resistance \(\uparrow\) LH \(\downarrow\) FSH \(\rightarrow\) hyperand…

Graves' disease

Inappropriate stimulation of thyroid gland by anti-TSH auto-antibody Propanolol used to provide symptomatic relief when waiting for treatment

Pituitary Gland

Anterior: GH, LH, FSH, ACTH, TSH, prolactin Posterior: Oxytocin, ADH Almost always benign tumours, origin may be of any hormone…

Thyroid tumours

Thyroid follicular adenoma Commonest cause of solitary thyroid nodule Solid mass with fibrous capsule - normally non functioning Wide age r…

Adrenal Gland

Cortex: zona Glomerulosa - mineralocorticoids, aldosterone zona Fasciculata - glucocorticoids, cortisol zona Reticularis - androgens, DHEA …

Cushing's Syndrome

Where too much cortisol is present. Dynamic suppression test needed - dexamethasoneshould reduce ACTH and cortisol. Classic features - moon face cent…

Conn's syndrome

Hyperaldosteronism - primary and secondary Primary: adrenal cortex hyperplasia, adenoma (intrinsic) Secondary - renal artery stenosis, heart f…

Addison's Disease

Primary adrenal cortical insufficiency - not enough steroid hormones cortisol and aldosterone. Cortisol in the main issue Autoimmune is most co…

Insulinomas

F >> M most common tumour of islet of Langerhans Need paired insulin and BM levels - \(\uparrow\) peptide C also indicates

Gestational Diabetes

New in pregnancy HbA1c not recommended Similar risk factors to T2 diabetes High risks for pregnancy - macrosomia, pre-eclampsia, still birth…

Hypercalcaemia

Mild Polyuria, polydipsia Mood disturbance Nausea, fatigue constipation Anorexia Severe Abdo pain Coma Pancreatitis Card…

Parahyperthyroid adenomas

Adenomas - 85% of cases of primary HPT Glandular hyperplasia - all 4 glands enlarged, can occur sporadically or part of genetic syndromes. Medical…

Bone related biochemistry

Disease ALP Ca Phos PTH HyperPTH \(\uparrow\) \(\uparrow\) \(\downarrow\) \(\uparrow\) …

Pancreatitis

Acute - gland reverts to normal if underlying cause removed Chronic - irreversible loss of tissue Acute Relatively common - damage to exocri…

Pancreatic ductal adenocarcinoma

Most common pancreatic cancer - usually in head of pancreas ↑ risk with chronic pancreatitis, DM, alcohol Hereditary with Lynch synd…

Pancreatic cancer

Ductal adenocarcinoma Most common pancreatic cancer - usually in head of pancreas ↑ risk with chronic pancreatitis, DM, alcohol H…

Electrolyte imbalance

Electrolyte Hypo- Hyper- Sodium Range: <133mmol/L >146mmol/L   Symptoms: Con…

Diabetic Ketoacidosis

Diagnostic criteria: High BM - >11 mmol/L Ketones - >3 mmol/L Acidosis  pH <7.3 Presentation: Deep laboured b…

Hyperthyroidism

S Sweating W Weight loss E Emotional liability (irritable) A Appetite increase …

Hyperparathyroid

More PTH increases serum calcium Symptoms from hypercalcaeimia: moans, groans, stones, and bones Polydipsia, polyuria and hypertension are comm…

Hypoparathyroid

Underproduction of parathyroid hormone despite low calcium. Much rarer than hyperparathyroidism  Primary Causes DiGeorge syndrome …

Metabolic syndrome

The name for a group of health problems that increase the risk of cardiovascular disease and events A combination of 3: T2 diabetes Hypert…

Average blood glucose vs HbA1C

HbA1c depends on average blood glucose concentration and red blood cell (RBC) lifespan. Sickle-cell anaemia and other haemoglobinopathies such as her…

Diabetic Nephropathy

Complication of poorly controlled diabetes. Diffuse glomerulosclerosis - thickening of the basement membrane Nodular sclerosis - increase i…

Diabetic neuropathy

Loss of all nerve impulses Autonomic - sweating  Somatic - movement Sensory - decreased sensation in stocking distribution  …

Maturity-Onset Diabetes of the Young

Maturity-onset diabetes of the young refers to any of several hereditary forms of diabetes mellitus caused by mutations in an autosomal dominant gene…

Insulin dose changes

DKA: long-acting insulin should be continued, short-acting insulin should be stopped (to prevent hypos after the fixed rate insulin is stopped) …

Diabetes Sick Day Rules

Type 1 diabetes if a patient is on insulin, they must not stop it due to the risk of diabetic ketoacidosis check blood glucose more frequentl…

Myxoedemic coma

Severe hypothyroidism Hypothermia, hyporeflexia, bradycardia and seizures Medical emergency Thyroid hormone replacement, and glucocorticoid…

Insulin

Drug Class Peptide hormone Mechanism Lowers plasma glucose concentration: Glucose transport into fat…

Glicazide

Drug Class Sulphonylurea Mechanism Stimulates insulin production in pancreatic β cells - th…

Metformin

Drug Class Biguanide Mechanism “Increases insulin sensitivity” ↓ gluconeogenesis&nb…

Levothyroxine

Drug Class Thyroid hormone Mechanism Mimics endogenous thyroxine Typical Dose Initiall…

Carbimazole

Drug Class Anti-thyroid Mechanism Inhibits thyroid peroxidise which is necessary for thyroid synthesis …

Alendronate

Drug Class Bisphosphonate Mechanism Inhibits osteoclast bone reabsorption For optimal activity, enoug…

Colecalciferol

Drug Class Vitamin D Mechanism   Typical Dose 400-2000 units daily 400 units = 10 micrograms …

Endocrine symptoms