Buzz words: Endocrinology

Question 1

Centripetal obesity, bruises, darkened
palmar creases, recent onset DM
Syndrome = ectopic ACTH
Disease = pituitary cause
Pseudo = alcoholic cushing’s ↑GGT

Answer 1

Cushing’s

Question 2

Polyuria, polydipsia
Pituitary tumour, trauma
Lack of vasopressin ∴replace with
desmopressin

Answer 2

Central diabetes insipidus

Question 3

Hereditary, hypercalcaemia, lithium

Thiazide Diuretic

Answer 3

Nephrogenic DI

Question 4

Assoc. with schizophrenia
Urine osm same with fluid deprivation &
after desmopressin

Answer 4

Psychogenic Polydipsia

Question 5

Generalised weakness, hyporeflexia,
ataxia, lethargy, confusion
Hyponatraemia, high urine osm, hypoosmolality
(Opposite of DI)

Answer 5

SIADH

Question 6

Isolated hypogonadotrophic
hypogonadism
Anosmia/hyposmia, colour blindness, cleft
palate

Answer 6

Kallmann’s Syndrome

Question 7

Course features, widely spaced teeth,
rings stuck on fingers, slanting forehead,
protruding jaw
Growth hormone-secreting pituitary
tumour

Answer 7

Acromegaly

Question 8

Adrenal insufficiency
GI disturbance, weight loss, postural htn
High K and low Na (lack aldosterone)

Answer 8

Addison’s Disease

Question 9

Aldosterone-producing adenoma
Low K, high Na, high HCO3
High aldosterone, low renin
Metabolic alkalosis

Answer 9

Conn’s Syndrome

Question 10

Parathyroid tumour
Pitutary adenoma
Pancreatic tumour (Zollinger-Ellison
Syndrome)

Answer 10

MEN1 (3 Ps)

Question 11

Phaeochromocytoma
Amyloid-producing thyroid tumour
Primary hyperparathyroidism

Answer 11

MEN 2a (2Ps, 1T)

Question 12

Phaeochromocytoma, amyloid-producing thyroid tumour, Marfan’s syndrome, organ fibrosis

Answer 12

MEN 2b

Question 13

Insomnia, palpitations, weight loss,

increased appetite

Answer 13

Hyperthyroidism

Question 14

Exopthalmos, pretibial myxoedema

Autoimmune à stimulation of TSH-R

Answer 14

Grave’s Disease

Question 15

Exopthalmos, pretibial myxoedema

Autoimmune à stimulation of TSH-R

Answer 15

Grave’s Disease

Question 16

Exopthalmos, pretibial myxoedema

Answer 16

Grave’s Disease

Question 17

Weight gain, lethargy, constipation
Most common cause of hypothyroidism in
western world
Diffusely enlarged thyroid
Anti-thyroglobulin, anti-microsomal, antithyroid
peroxidease, anti-TSH-R

Answer 17

Hashimoto’s

Question 18

Flu-like illness (influenza, coxsacchie,
mumps) à inflammation and T3/4 release
Hyperthyroid à hypothyroid à euthyroid
Pain worse with swallowing, fever
↑ESR

Answer 18

De Quervain’s Thyroiditis

Question 19

Slow growing, hard, immobile, enlarged
Biopsy: fibrotic tissue
Difficulty breathing and swallowing

Answer 19

Riedel’s Thyroiditis

Question 20

Rare, elderly, die within 1 year
Hard, rapidly enlarging
Fixed to skin

Answer 20

Anaplastic Carcinoma

Question 21

Adolescents and young adults
Orphan Annie Eyes, psammoma (sandy)
bodies
Lymphadenopathy

Answer 21

Papillary Carcinoma

Question 22

Middle aged

Spread to lung/bone

Answer 22

Follicular Carcinoma

Question 23

Calcitonin tumour marker

MEN2

Answer 23

Medullary Carcinoma

Question 24

Lumpy, irregular thyroid
Plummer’s syndrome
Autonomous hyperfunctioning nodules

Answer 24

Toxic Multinodular Goitre

Question 25

Enlarged thyroid | Iodine deficiency/pregnancy/puberty

Answer 25

Simple Colloid Goitre

Question 26

Bones, stones, moans, groans Polyuria, polydipsia ↑PTH

Answer 26

1° Hyperparathyroidism

Question 27

Bones, moans, stones, groans Hyperparathyroidism, malignancy, vitamin D intoxication or sarcoidosis

Answer 27

Hypercalcaemia

Question 28

CKD, parathyroid failure, DiGeorge syndrome, post-thyroidectomy, hypomagnesaemia

Answer 28

Hypocalcaemia

Question 29

Target cell resistance to PTH | Low Ca and high PTH

Answer 29

Pseudohypoparathyroidism

Question 30

Trousseau’s sign (BP cuff) Weakness, cramps Chvostek’s sign (face twitch)

Answer 30

Hypoparathyroidism

Question 31

Low serum Ca | CKD

Answer 31

2° Hyperparathyroidism

Question 32

Prolonged 2° hyperparathyroidism | Loss of feedback --> hypercalcaemia

Answer 32

3° Hyperparathyroidism

Question 33

Lung Ca --> ectopic PTH secretion | Hypercalcaemia + bone breakdown

Answer 33

PTHRP Secretion

Question 34

Ischaemic necrosis of pituitary (postpartum) | Hypopituitarism e.g. amenorrhoea

Answer 34

Sheehan’s Syndrome

Question 35

Bilateral adrenalectomy + Cushing’s

Answer 35

Nelson’s Syndrome

Question 36

Weight loss, fatigue, polyuria, polydipsia Pear-drop breath Ketoacidosis + kussmal breathing

Answer 36

T1DM

Question 37

Hyperglycaemia, ketoacidosis, ketonuria Dehydration, confusion, abdo pain Nausea, vomiting, sweet-smelling breath

Answer 37

DKA

Question 38

Neuroglycopenia --> irritable, tired, drowsy

Answer 38

Hypoglycaemia