Endocrine

Two different failures of insulin — one autoimmune, one acquired — converge on the same toxic endpoint: glucose the cells cannot use, damaging vessels everywhere.

No insulin means the body burns fat into acid — and the treatment sequence (fluids → potassium → insulin → dextrose) is the exam’s favorite trap.

Blood glucose in the 600s-plus with almost no ketones — the type 2 crisis where dehydration, not acidosis, is what kills.

The whole body runs slow when thyroid hormone runs low — and the lab pattern (TSH up, free T4 down) plus one lifelong replacement drug make it a favorite exam target.

Excess thyroid hormone floors the body’s accelerator — and its lethal extreme, thyroid storm, kills 8–25% even with treatment.

Too much cortisol for too long — and the most common cause is a prescription. The face rounds, the trunk fills, the limbs waste, and the adrenal glands quietly stop working.

The adrenal cortex stops making cortisol — and in primary disease, aldosterone too. The onset is so gradual that half of patients are diagnosed only when they arrive in shock.

One hormone, one water channel, two opposite failures. Too much ADH dilutes the patient into a seizure; too little pours water out until the sodium climbs — and correcting either one too fast injures the brain.

Four pea-sized glands set the calcium level that every nerve, muscle and heartbeat depends on — too much gives stones, bones, groans and a short QT; too little, usually after neck surgery, gives tingling lips, a spasming hand and a threatened airway.

A rare adrenal tumour that pours out adrenaline and noradrenaline in bursts — pounding headache, drenching sweat, racing heart and a blood pressure that resists several drugs — and whose most dangerous moments are a pressing hand on the abdomen and a beta-blocker given too soon.

Obesity is a chronic disease defined by a BMI of 30 or greater (overweight 25 to 29.9; class 3 at 40 or more). Fat stored around the waist drives insulin resistance, which clusters with high blood pressure, high triglycerides, low HDL and high fasting glucose as metabolic syndrome — diagnosed when 3 or more are present. Care starts with lifestyle change and intensive behavioral programs, then weight-management medicines such as GLP-1 receptor agonists (with a boxed thyroid C-cell warning, pancreatitis, gallbladder and kidney risks, and no use in pregnancy), then bariatric surgery with its leak, dumping and lifelong-nutrition risks.