Category: Endocrinology

Adrenal Crisis & Hypocortisolism

Cortisol is the body’s natural steroid (glucocorticoid) which helps maintain blood pressure, blood glucose, sodium balance and suppress inflammation. It is a critical hormone which if not replaced when needed could result in life-threatening adrenal crisis. In this article, we discuss diagnosis, emergency management and discuss steroid-induced adrenal suppression.

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Hypoglycaemia

Management of low blood sugar in conscious & unconscious patients, finding common causes, adjusting medications & when to refer.

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Hypercalcaemia

Serum calcium concentration is tightly regulated between 2.1-2.6mmol/L. Severe hypercalcaemia is a life-threatening electrolyte emergency requiring prompt recognition and urgent treatment.   Classification Mild (2.65 – 3.00 mmol/L): Patient is often asymptomatic Moderate (3.01-3.40 mmol/L): Can be asymptomatic or symptomatic Severe (>3.40 mmol/L): Risk of dysrhythmia and coma Serum calcium is found in 2 forms

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Medications in Diabetes

In this article, we’ll cover the treatments used in Diabetes Mellitus. We’ll look at key things you need to know about each therapy, when you might start it & common adverse effects. This article isn’t comprehensive or a guideline – you should still look up information & a guideline before starting any treatment. Introduction Type

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Fluid Balance

Almost every patient admitted to hospital receives IV fluids at some point in their journey. However, the body manages this, without the need for careful medical assessment and adjustment, as fluid balance is one of its core functions. Despite this, there are many situations where we need careful and controlled management. These include: Electrolyte disturbance

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Thyroid Disease

As a junior, you will frequently see patients who potentially have thyroid dysfunction. The problem is these patients often present with quite generalised symptoms and you may struggle to know when to send TFTs and what to do when they’re abnormal. Thyroid dysfunction is incredibly common (about 2.5% of the population) with the majority of

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Diabetic Foot Ulcers

Introduction: Diabetic foot ulcerations are a significant complication of diabetes and often precede minor (below the ankle) or major (above or below the knee) amputation. At least 2% of people with diabetes experience new foot ulcers annually, and of these, one in 400 undergoes amputation (Kerr, M. 2019)

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DKA and HHS

You’ve found a patient is hyperglycaemic & either they are ketotic or have significant hyperglycaemia (>30mmol/L) and so you suspect DKA or HHS respectively. Diabetic Ketoacidosis (DKA) DKA is defined as the biochemical triad of: Ketonaemia ≥3 mmol/L (on ketone meter) OR significant ketonuria (≥2+ on standard urine sticks) Blood glucose ≥ 11mmol/L OR known diabetes mellitus*

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Hyperglycaemia

Hyperglycaemia is something you will encounter frequently. In this article, we focus on how to approach hyperglycaemia and identify diabetic emergencies. If your patient is ketotic or has significant hyperglycaemia (>30mmol/L), consider DKA or HHS respectively which are covered in a separate article. Introduction Hyperglycaemia may be the first indication that a patient is unwell.

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Hypertension in Hospital

As a junior doctor, you will often be called about patients with raised blood pressure (BP) in secondary care. This differs from chronic hypertension in primary care for which the treatment is summarised expertly by NICE. Here we look at the assessment and management of hypertension in acute care, with a focus on hypertensive emergencies

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