HRT & progesterone

If you're prescribing HRT to someone, you should also be prescribing progesterone at the same time in the same way that you give laxatives to people on morphine.

(I don't know why - work this out at some stage)

Microalbumuria

Screening for microalbumuria in non-diabetics is a good way to screen for CV risks. The microalbumuria is caused by endothelial dysfunction.

SAAB drugs for use in acute coronary syndrome

• Statin
• Ace inhibitor
• Aspirin
• Beta blocker

Electrolyte imbalances that occur in diabetes

• Hypocalcaemia - kidney doesn't activate vitamin D -> decreased GIT absorption of Ca
  
• Hyponatraemia
• Hyperphosphataemia - it can't be excreted. Treatment is by giving a phosphate binder e.g. mylanta.

T4 during infection

Metabolism of thyroid hormones is accelerated during acute infection in man and in experimental animals. The mechanisms for this is uncertain, but activated leukocytes of the infected host have been implicated as potentially important sites of hormone degradation.

Apparently T4 can go up in infection similar to an acute pahse reactant - but I couldn't find anything on the net really backing this up!!


References:

• DeRubertis, Accelerated host metabolism of L-thyroxine during acute infection, Journal of Clinical Endocrinology & Metabolism, Vol 40, 589-600