Endocrine Diseases I (including Diabetes Training)

• To ensure inpatient and outpatient examination and control of: • At least 50 patients with diabetes mellitus: • Patients with a high risk for diabetes mellitus • Metabolic syndrome • Changed glycaemia on an empty stomach and changed glucose tolerance (pre-diabetes) • Diabetes mellitus type 1 • Diabetes mellitus type 2 • Gestational diabetes • Diabetes mellitus in case of other problems • At least 30 patients with different thyroid pathology: • Tyreotoxicosis • 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: • Feochromocytom • Cushing syndrome • Aldosteroma • MEN syndromes • At least 10 patients with pathology of the pituitary gland: • Acromegaly • Cushing disease • Hyperprolactinemia • At least 10 patients with another 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 100 patients), Sugar load test, its performance and assessment (for at least 30 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): Work with various monofilaments Use of camertone Test of thermal sensation Sensation test with cotton wool Foot test Diabetic foot care Diabetes mellitus training principles (to participate in the training classes): Bread units Plate (portion) method Indirect ophthalmoscopy (to know the performance principles) Diabetes mellitus management during pregnancy Different medical tests: thyroid function tests adrenal function tests hypothalamic-pituitary function tests  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: Diabetes mellitus Thyrotoxicosis Hypothyreosis Feohromocitoma Cushing syndrome Acromegaly Interpretation of radiological thyroid examinations: Thyroid scintigraphy Accumulation of I131and Tc99 in thyroid I131 therapy (to know particular treatment stages and application technology) A student shall be on duty for 72 hours a month (incl. on Saturdays, Sundays and holidays) in the Admission Department of Riga East University Hospital or intensive therapy ward of the specialised department.

Assessment criteria: passed test works of seminars, b. the types and scope of the planned manipulations mastered, c. a training course of one week implemented individually in diabetes mellitus type 1 and type 2 patients, d. successful assessment of a medical resident’s clinical case analysis.