Liver Cirrhosis Liver cirrhosis is irreversible liver damage characterised by the replacement of normal hepatic architecture with diffuse bridging fibrosis and regenerative nodules. It has various causes lead to inflammation and damage to hepatocytes. Fibrosis leads to increased resistance to…
Complications of Diabetes Mellitus Complication When to tx Tx Recheck Hypertension >140/90 x 2 ACEi/ARB +/- HCTZ q 6 months Nephropathy + proteinuria ACEi/ARB q1y Hyperlipidemia LDL > 100 (2.6) Statin q1y Retinopathy Proliferative retinopathy; Non-proliferative retinopathy Symptoms; Tighter glucose…
Toxic Nodular Goiter Toxic nodular goiter can be caused by a single nodule (toxic adenoma) or multiple nodules (**toxic multinodular goiter AKA Plummer’s disease)**They are the second most common cause of hyperthyroidism. Plummer’s disease is progressive and requires ablation or…
Thyroiditis Thyroiditis is inflammation of the thyroid gland. Acute (Suppurative) Thyroiditis Acute thyroiditis is a rare bacterial infection (abscess) of thyroid tissue seen in immunocompromised patients. It can be caused by a persistent pyriform sinus fistula or trauma. The most…
Graves Disease Graves disease is an autoimmune thyroid disease caused by thyrotroping-stimulating immunoglobulins (TSIs) which stimulate TSH receptors resulting in elevated basal thyroid activity. Unlike toxic adenoma, 50% of patients with Grave’s disease undergo remission within the first year of…
Insulin Insulin formulations Formulation Examples Nota bene Rapid-acting Lispro, aspart, glulisine Typically given before meals Short-acting Regular insulin, NPH/regular preparations (75/25, 70/30, 50/50) Intermediate-acting Non-proteated Hagedorn (NPH) First-line insulin. May be prescribed along-side soluble insulin seperately or as pre-mixed solution.…
Oral Glucose Lowering Agents (OGLAs) Class Example Biguanides Metofrmin SGLT-2 inhibitors Canagliflozin, empagliflozin, dapagliflozin GLP-1 agonists Exenatide, liraglutide, semaglutide DPP-4 inhibitors Sitagliptin, linagliptin Sulfonylureas Glipizide, gliburide, chlorpropamide Thiazolidinediones Pioglitazone, rosiglitazone Prescribing OGLAs Metformin Metformin is a biguanide. It is one…
Assessment of a patient with newly diagnosed diabetes Look for evidence of: Routine Review of a known DM patient
Hypothyroidism Hypothyroidism is a deficiency of the thyroid hormones T3 and T4. The presentation of thyroid disease can be subtle and non-specific since almost all cell nuclei have thyroid receptors which affect various metabolic processes. Prognosis is good if treated…
Osteoporosis Osteoporosis is a skeletal disease characterised by low bone mineral density and microarchitectural defects. This leads to increased fragility and susceptibility to fracture. It is commonly asymptomatic until fractures happen. It is diagnosed objectively using a DEXA Scan with…