Endocrine Diseases II

To ensure inpatient and outpatient examination and control of at least 30 patients with diabetes mellitus: • Patients with high risk for diabetes mellitus • Metabolic syndrome • Impaired fasting glycaemia and impaired glucose tolerance (pre-diabetes) • Diabetes mellitus type 1 • Diabetes mellitus type 2 • Gestational diabetes • Diabetes mellitus in case of other disorders At least 20 patients with various thyroid pathologies: • Thyreotoxicosis • Hypothyreosis • Nodular goiter • Autoimmune thyroiditis • Subacute thyroiditis • Acute thyroiditis • Thyroid cancer • Primary, secondary and tertiary hyperparathyreosis • Thyroid lesion in case of MEN syndromes At least 15 patients with adrenal pathology: • Pheochromocytoma • Cushing syndrome • Aldosteroma • MEN syndromes At least 10 patients with pathology of the pituitary gland: • Acromegaly • Cushing disease • Hyperprolactinemia At least 10 patients with other endocrine pathology: • PCO • Hypoaldosteronism • Osteoporosis • Rare endocrine syndromes Interpretation skills of hormone and antibody tests. Calculation of the body mass index and waist circumference (for at least 50 patients). Glucose load test, its performance and assessment (for at least 20 patients). To learn to work with different devices for insulin administration – injectors (pens) (available in Latvia). To acquire an insulin pump operation (available in Latvia), replacement or filling of insulin reservoir, setting insulin concentration. Work with glucometers of different companies (available in Latvia) and test strips for detection of glycaemia, ketone bodies, cholesterol. 24-hour glucose measurement and analysis with a computer. Test of the neurological condition in patients with diabetes mellitus (of all the patients with diabetic polyneuropathy): o Work with different monofilaments o Use of camertone o Test of thermal sensation o Sensation test with cotton wool o Foot test Diabetic foot care Diabetes mellitus training principles (to participate in the training classes): o Bread units o Plate (portion) method Indirect ophthalmoscopy (to know the performance principles) Management of diabetes mellitus during pregnancy Different medical tests: o Thyroid function test o Adrenal function test o Hypothalamic-pituitary function test X-ray and ultrasound densitometry principles and data interpretation Vertebral radiographic assessment (semi-quantitative X-ray examination of the vertebrae) Ability to assess the arterial pressure and orthostasis (to measure in each patient) 24-hour ambulatory blood pressure monitoring(ABPM) Ability to interpret radiographic, computed tomography and magnetic resonance imaging of hypothalamus and the pituitary gland Preparation principles of patients for operations in patients with: o Diabetes mellitus o Thyrotoxicosis o Hypothyreosis o Pheochromocytoma o Cushing syndrome o Acromegaly A student shall be on duty for 72 hours a month in the Admission Department of Riga East University Hospital.

a. Passed test works of seminars, b. The ability to diagnose, examine and apply therapy to the patients with endocrine diseases individually is demonstrated, by focusing on the complications of chronic diabetes mellitus , thyroid pathology, metabolic bone diseases and adrenal diseases, c. The types and scope of the planned manipulations mastered, d. Successful assessment of a medical resident’s clinical case analysis.