Endocrinology

Diabetic ketoacidosis (DKA): Management

Submitted by saranya on Tue, 31/01/2012 - 23:51
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" NIKAH "

  • Normal saline infusion (0.9%)
  • Insulin
  • K (potassium replacement)
  • Antibiotics (in case of infections)
  • H (bicarbonate infusion in severe acidosis)
Normal saline infusion is done to overcome extracellular fluid deficit. If plasma Na+ is more than 155 mmol/L, 0.45% NS can be given instead of 0.9% NS.
Intracellular fluid deficit is corrected with 5% or 10% dextrose.
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Pheochromocytoma

Submitted by Jothi04 on Mon, 26/09/2011 - 07:53
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Pheochromocytoma is a tumour of chromaffin cells.

Chromaffin cells secrete catecholamines.

Rule of 10

  • 10% familial (MEN 2, Neurofibromatosis etc)
  • 10% extra adrenal (mediastinum, heart, bladder wall)
  • 10% malignant

 

Clinical Features : 5P's

1. Pounding headache

2. Palpitations

3. Perspiration

4. Paroxysmal hypertension (usually)

5. Pain (abdominal pain)

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Hypopituitarism (Simmond's disease):Clinical Features

Submitted by devarshee on Tue, 15/03/2011 - 22:31
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Hypopituitarism is otherwise known as "SIMMOND'S" disease.

There is a two-fold risk of death in patients with hypopituitarism due to untreated GH deficiency.
Houssay Phenomenon: a diminishing requirement of insulin by diabetics may be a sign of Hypopituitarism with diminished secretion of GH and ACTH (and thus corticosteroids).
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Addison's disease/ Hypoadrenalism

Submitted by devarshee on Sat, 12/03/2011 - 09:04
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Features of Addison's disease can be remembered as  "SynACTHEN"

In the acutely ill patient in whom you suspect adrenal insufficiency do not delay treatment; establish venous access and give i.v hydrocortisone 100 mg immediately.
Thyroid function abnormalities may revert to normal with satisfactory glucocorticoid replacement in Addison's disease
When present symptoms are often non-specific and the disease is sometimes only detected at post mortem leading to its description :"the unforgiving master of nonspecificity and disguise".
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