Buzzwords and Drugs

Question 1

what drugs increase prolactin- cause gynacomastiae

Answer 1

metoclopramide (+ all dopamine agonists)

chlorpromazine oestrogens

Question 2

what drugs cause hyperthyroidism

Answer 2

iodine

amiodarone

Question 3

what drugs cause hypothyroidism

Answer 3

lithium

amiodarone

Question 4

what drugs cause inappropriate ADH secretion

Answer 4

chlorpropamide

Question 5

what drugs cause hypoandrenalism

Answer 5

ketoconazole
metyrapone
aminoglutethimide

Question 6

what drugs cause ovarian and testicular failure

Answer 6

chemo

Question 7

what drugs mimic thyrotoxicosis or phaeochromocytoma

Answer 7

sympathomimetics

amphetamines

Question 8

what drugs cause increased mineralocorticoid activity

Answer 8

liquorice

carbenoxolone

Question 9

what drugs cause hypokalaemia

Answer 9

purgatives

Question 10

what drugs cause secondary hypoaldosteronism

Answer 10

ACE I

Question 11

what drugs bind to TBG- decrease total T4

Answer 11

anti convulsants

Question 12

what drugs raise TBG and CBG- increasing total T4/cortisol

Answer 12

oestrogens

Question 13

what drugs cause cushings

Answer 13

steroids

Question 14

what drugs cause diabetes

Answer 14

steroids

Question 15

what drugs cause hypercalaemia

Answer 15

vit D preparations

milk and alkali preparations

Question 16

what drugs cause hypogylcaemia

Answer 16

insulin

sulfonylureas

Question 17

Catecholamines in urine, headaches, hypertension and palpitations

Answer 17

phaeochromocytoma

Question 18

Tanned skin without being on holiday

Answer 18

addisons

Question 19

spade hands, increased shoe size, wedding ring doesnt fit

Answer 19

acromegaly

Question 20

Signs of hyperthyroidism plus eye changes, gritty eyes, smooth velvety skin

Answer 20

graves

Question 21

Moon face, proximal weakness, stretch marks, buffalo hump, abdo fat

Answer 21

cushings

Question 22

Ketones on breath (sweet smelling/pear drop breath)

Answer 22

DKA

Question 23

Deep, laboured breathing (kussmaul breathing)

Answer 23

metabolic acidosis (especially DKA)

Question 24

orphan annie nuclei

Answer 24

papillary thryoid cancer

Question 25

Bone pain, stones, abdo pain, psychiatric problems (bones, stones, groans, moans)

Answer 25

hypercalcaemia- hyperparathyroidism

Question 26

Psammoma bodiea

Answer 26

are found in papillary thyroid carcinomas

Question 27

butterfly rash

Answer 27

SLE

Question 28

heat intolerance/ palpitations

Answer 28

hyperthyroidism

Question 29

cold intolerance/ weight gain

Answer 29

hypothyroidism

Question 30

ansomnia and isolated GnRH deficiency

Answer 30

kallmans syndrome

Question 31

Trousseau sign, chovstek sign and QT prolongation (on ECG)

Answer 31

hypocalcaemia

Question 32

what is the acute management of hypocalcaemia

Answer 32

IV calcium gluconate

Question 33

Brachydactyly of 4th metacarpal

Answer 33

pseudohypoparathyroidism

Question 34

what is kallmans syndrome

Answer 34

genetic isolated gonadotropin releasing hormone deficiency often with ansomia and colour blindness failure to start puberty/ fully complete it a.k.a hypogonadotrophic hypogonadism

Question 35

what is a cranipharyngioma

Answer 35

Originates from rathke’s pouch between pituitary and 3rd ventricle floor Rare, although most common childhood intracranial tumour, present with growth failure

Question 36

how does a craniopharyngioma present (in adults)

Answer 36

``` amernorrhoea decreased libido DI hyperphagia sleep disturbance ```

Question 37

what is robson mendenhall syndrome

Answer 37

o Rare, autosomal recessive genetic trait, seen in children o Severe insulin resistance (decreased protein synthesis, glucose uptake, lipogenesis, glycogen synthesis) o Developmental abnormalities (head, face and nails), acanthosis nigricans, fasting hypoglycaemia, post prandial hyperglycaemia o Diabetic ketoacidosis

Question 38

what inheritance is MODY

Answer 38

AD

Question 39

is MODY insulin dependent

Answer 39

no

Question 40

what causes MODY

Answer 40

caused by mutations in autosomal dominant gene disrupting insulin production “Monogenic diabetes” – genetic defects of beta-cell function

Question 41

what type of diabetes is MODY

Answer 41

type 2

Question 42

what is LADA

Answer 42

latent autoimmune diabetes of adults o High blood sugar, low c peptide and raised antibodies o Insulin treatment needed

Question 43

what is gestational diabetes

Answer 43

o Hyperglycaemia during pregnancy (especially during their third trimester) o Insulin receptors don’t function properly so more glucose does to the baby

Question 44

what are the complications and treatments for gestational diabetes

Answer 44

o Neonate can develop hypoglycaemia (mother has hyperglycaemia, and the baby becomes used to high levels of sugar, therefore increased insulin production by baby’s pancreas) o 1st line treatment is insulin can also have big baby

Question 45

how do thyroid hormones affect the nervous system

Answer 45

increase responsiveness to adrenaline and sympathetic NS o Increase force and rate of heart contraction o why beta blockers are prescribed for control of sympathomimetic symptoms

Question 46

what can cause hypercalcaemia

Answer 46

primary hyperparathyroidism malignancy granulomatous disease (sarcoid, TB)

Question 47

what can cause hypocalcaemia

Answer 47

hypoparathyroidism

Question 48

what are the signs of hypocalcaemia (and treatment)

Answer 48

 Muscle cramps  Chvostek’s sign  Trosseau’s sign o Treat with calcium supplements

Question 49

what is the waist to hip ratio of central obesity

Answer 49

>0.9 in men | >0.85 in females

Question 50

what does distal neuropathy feel like

Answer 50

warm dry feet | dilated vessels and diminished ability to sweat

Question 51

what can cause optic atrophy

Answer 51

compression by a pituitary tumour

Question 52

why must insulin be given IV

Answer 52

as deactivated by GI enzymes

Question 53

what are the insulin sick day rules

Answer 53

dont stop insulin (stress hormones make BG rise)

Question 54

what will a thryoid isotope scan show in thyroid cancer

Answer 54

a cold area

Question 55

what are the BG levels for impaired fasting glucose

Answer 55

6.1-7

Question 56

what are the BG levels for impaired glucose tolerance

Answer 56

7.8-11

Question 57

what is a carcinoid tumour

Answer 57

slow growing neuroendocrine tumour found in mid gut to iluem and the respiratory tract

Question 58

what are the clinical features of a carcinoid tumour

Answer 58

flushing, diarrhoea, abdo cramps, dizziness, peripheral oedema, tricuspid stenosis

Question 59

what is the treatment for a carcinoid tumour

Answer 59

somatostatin analogues octreotide lancreotide