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DKA Precipitating Factors : "5 I's"
Infection
Ischemia (cardiac, mesenteric)
Infarction
Ignorance (poor control)
Intoxication (alcohol)

Diabetes mellitus Complications : "NIKE Shoes [are] Valuable"
N - Neuromuscular; Peripheral neuropathy
I - Infective: TB, recurrent UTIs
K - Kidney( Nephropathy)
E - Eye disease: retinopathy and cataracts
S - Skin: Necrobiosis lipoidica diabeticorum, granuloma annulare, diabetic dermopathy
V - Vascular: coronary artery disease, cerebrovascular disease, peripheral vascular disease
Alternatively
"KNIVES"
K - Kidney (nephropathy)
N - Neuromuscular (peripheral neuropathy, mononeuritis, amyotrophy)
I - Infective (UTIs, TB)
V - Vascular ( coronary/cerebrovascular/peripheral artery disease)
E - Eye (cataracts, retinopathy)
S - Skin ( lipohypertrophy/lipoatrophy, necrobiosis lipoidica)

Acromegaly symptoms : "ABCDEF"
Arthralgia/ Arthritis
Blood pressure raised
Carpal tunnel syndrome
Diabetes
Enlargemed organs
Field defect

Adrenal glands , Causes of Addison's Disease : "ADDISON"
A - Autoimmune (90% cases)
D - Degenerative (amyloid)
D - Drugs (ketoconazole)
I - Infections (TB, HIV)
S - Secondary (low ACTH); hypopituitarism
O - Others adrenal bleeding
N - Neoplasia (secondary carcinoma)

Cushing syndrome : "CUSHING"

C - Central obesity/ Cervical fat pads/ Collagen fiber weakness/ Comedones (acne)

U - Urinary free corisol and glucose increase
S - Striae/ Suppressed immunity

H - Hypercortisolism/ Hypertension/ Hyperglycemia/ Hirsutism

I - Iatrogenic (Increased administration of corticosteroids)
N - Noniatrogenic (Neoplasms)
G - Glucose intolerance/ Growth retardation

Diabetes Insipidus ; Diagnosing Subtypes : After a desmopression injection
Concentrated urine = Cranial.
No effect = Nephrogenic.

Diabetes Medication - Oral Hypoglycaemics: "BAGS"

Biguanides : e.g. metformin - reduces insulin resistance, S/E GI upset, lactic acidosis.

Alpha-glucosidase inhibitors : e.g. acarbose inhibits carbohydrate digestion so reduces intestinal glucose reabsorption, S/E bloating, diarrhoea.

Glitazones (thiazolidinediones) : e.g. pioglitazone, risoglitazone-insulin-sensitising agents causing transcription of Glut-1 receptors, S/E hepatotoxicity.

Sulphonylureas : e.g. gliclazide, tolbutamine-stimulate insulin production from pancreatic beta-cells, S/E weight gain and hypoglycaemia.

Causes of Diabetic Keto Acidosis (DKA): "DKA"
D - Dehydrated
K - Ketoacidosis
A - Acetone breath By Chris B

Diabetic ketoacidosis I vs. II : ketONE bodies are seen in type ONE diabetes.

Diabetic Ketoacidosis Management : "FUCKING"
F - Fluids (crytalloids)
U - Urea (check it)
C - Creatinine (check it)/ Catheterize
K - K+ (potassium)
I - Insulin (5u/hour. Note: sliding scale no longer recommended in the UK)
N - Nasogastic tube (if patient comatose)
G - Glucose (once serum levels drop to 12)

Causes of Goitre : 1)Diffuse :
"Some People Have Goitres"
Subacute e.g. de Quervain"s thyroiditis (painful)
Physiological
Hashimoto’s thyroiditis
Graves’ disease
2) Nodular :
"Many Are Cancerous"
Multinodular goitre
Adenoma
Carcinoma

Causes of Gynecomastia : "SALaD"
S - Sertoli cell tumors
A - Alcohol
L - Leydig cell tumors
D - Digitalis

HISTAMINE Features: "HISTAMINE"
H - HCL production
I - Inflammation
S - Strong vasodilator
T - Therapeutic value none
A - Allergy
M - Mast cells
N - Neurotransmitter/ Narrow airways
I - IgE

Hypercalcemia differential : "VITAMIN TRAPS"
V - Vitamin A and D intoxication
I - Immobilization
T - Thyrotoxicosis
A - Addisons disease / Acidosis
M - Milk-alkali syndrome
I - Inflammatory disorders
N - Neoplastic disease
T - Thiazides, other drugs
R - Rhabdomyolysis
A - AIDS
P - Pagets disease/ Parenteral nutrition/ Parathyroid disease
S - Sarcoidosis

Hyperthyroidism symptoms : "SWEATING"
S - Sweating
W - Weight loss
E - Emotional lability
A - Appetite is increased
T - Tremor/Tachycardia due to AF
I - Intolerance to heat/Irregular menstruation/Irritability
N - Nervousness
G - Goitre and Gastrointestinal problems (loose stools/diarrhoea)

Hypoglycaemia Causes: In the non-diabetic:
"EXPLAIN"

E - EXogenous medication e.g. insulin, oral hypoglycaemics, alcohol, aspirin overdose, IGF-1

P - Pituitary insufficiency
L - Liver failure
A - Addisons disease
I - Islet cell tumours (e.g. insulinoma)
N - Non-pancreatic neoplasm e.g. fibrosarcoma
Precipitating factors in a diabetic:
"MINE"
M - Missing a meal
I - Insulin overdose (accidental)
N - Non-accidental overdose
E - Exercise (increased activity)

Hypokalaemia clinical features: "TIMID CHIMP"
T - Tetany
I - Increases paralytic ileus (aggravates)
M - Muscle weakness
I - Increases possibility of hepatic encephalopathy
D - Digoxin toxicity
C - Cardiac arrythmias
H - Hypotonia
I - Increases P-R interval, T wave and prominent U wave
M - Muscle cramps
P - Polyuria

Hypothyroidism Symptoms : Hypothyroidism is 10 times more common in females(mom) & occurs mainly in middle life.
"MOM iS SO TIRED"
M - Memory loss
O - Obesity
M - Malar flush/Menorrhagia
S - Slowness
S - Skin and hair become dry
O - Onset is gradual
T - Tired
I - Intolerance to cold
R - Raised blood pressure
E - Energy levels are low
D - Depressed

Pheochromocytoma Common Symptoms : "5 Ps"
Paroxysmal rise in BP
Palpitations
Perspiration
Pain in abdomen
PMV in urine

Pituitary Anterior Hypophysis Hormones : "FLAT PG"
F - FSH
L - LH
A - ACTH
T - TSH
P - Prolactin
G - GH

Pituitary hormones : "TOP FLAG"
T - Thyroid stimulating hormone
O - Oxytocin
P - Prolactin
F - Follicle stimulating hormone
L - Lutinizing hormone
A - Adrenocorticotropin hormone
G - Growth hormone

SIADH (Syndrome of Inappropriate Diuretic Hormone) Diagnostic: "Syndrome of INAPPropriate Anti-Diuretic Hormone"
Increased
Na (sodium)
PP (urine)
SIADH is characterized by increased urinary sodium

SIADH (Syndrome of Inappropriate Diuretic Hormone): Causes : "SIADH"
S - Surgery
I - Intracranial: infection, head injury, CVA
A - Alveolar: Ca, pus
D - Drugs: opiates,antiepileptics, cytotoxics, anti-psychotics
H - Hormonal: hypothyroid, low corticosteroid level

Short Statue Causes : "RETARD HEIGHT"
R - Rickets
E - Endocrine (cretinism, hypopituitarism, Cushings)
T - Turner syndrome
A - Achondroplasia
R - Respiratory(suppurative lung disease)
D - Down syndrome
H - Hereditary
E - Environmental (postirradiation, postinfectious)
U - IUGR
G - GI (malabsorption)
H - Heart (congenital heart disease)
T - Tilted backbone (scoliosis)

Thyroid storm characteristics : "Storm HITS girls cAMP"
Thyroid storm is due to:
H - Hyperthyroidism
I - Infection or Illness at childbirth
T - Trauma
S - Surgery
girls - Thyroid storm more common in females.
cAMP - Tx involves high dose of beta blockers (beta receptors work via cAMP)

Thyroid storm initial management : "PCPS"
P - PTU - 1 gm po
C - Corticosteroids
P - Propranolol
S - SSKI

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