Endo Flashcards
what investigation is needed if trying to identify Conn’s, and CT abdo is inconclusive?
Adrenal venous
- bilaterally increased aldosterone in adrenal veins = bilateral hyperplasia
- unilaterally increased aldosterone = Conn’s syndrome
what does radioactive nuclear scintigraphy show for toxic multinodular goiter
patchy uptake
what is definitive management for primary hyperparathyroidism (regardless of whether is is a single adenoma / bilat adenomas / hyperplasia)
TOTAL parathyroidectomy
causes of raised Prolactin
pregnancy prolactinoma polycystic ovarian syndrome primary hypothyroidism phenothiazines (antipsychotics), metoclopramide, domperidone physiological
how do you manage primary aldosteronism (CONNS) if solitary / bilateral adrenal enlargement
SOLIITARY > spironolactone /eplerenone > surgery
BILATERAL > spiro only (NOT SURGERY, or you would make them addisonian)
sick day rules for T1DM
continue normal insulin regimen
check BP regulary (at least every 4 hours)
drink 3L of water min
change to sugary drinks if struggling to eat (this will maintain carb intake)
features of papillary thyroid cancer
young women
excellent prognosis
spreads to LN early
Young women go dancing with men in papillons (PAPILLARY thyroid cancer) and they look happy (good prognosis)
features of follicular thyroid cancer
aggressive, associated with NHL (in FOLLICLES that contain lymph)
features of medullary thyroid cancer
MEDULLARY > MEN2a/2b
MEN are unhappy > poor prognosis
features of anaplastic thyroid cancer
very FAST GROWING
not treatment responsive
can cause pressure sx
what is important to measure if a patient presents as SEVERELY HYPOGLYCAEMIC
their C PEPTIDE levels
If C PEPTIDE HIGH: endogenous cause (e.g. insulinoma) / sulphonylurea
C PEPTIDE LOW: exogenous (e.g. injection of insulin)
what is primary polydipsia
ADH system functions normally
but person just drinks lots of water > pees out lots of water
explain 2 types of diabetes insipidus
CRANIAL: low ADH secretion by pituitary , caused by head trauma / tumour / infection /inflamm
NEPHROGENIC: kidneys are irresponsibe to ADH
causes of nephrogenic diabetes insipidus
electrolyte imbalance (hypercalcaemia, hypokalaemia)
Lithium
Genetic
Intrinsic Kidney dsease
what is presentation of diabetes insipidus
cannot concentrate their urine, so:
polydipsia, polyuria
dehydration
postural hypotensiion
what electolyte finding occurs in DI and why
hypERnatraemia
because you cant drive water back into the blood, the blood is thick and very concentrated essentially
when do you add metformin in T1DM mx
if BMI >25
what are important side effects to excessive levothyroxine therapy (overcompensating)?
osteoporosis
AF
worsening of angina
hyperthyroidism
how do you investigate a phaeo
24 hou urinary metanephrines (have replaced catecholamine collection=
what is pheo associated with
MEN2
neurofibromatosis
von Hippel Lindau
which drug could you give to mx phaeo that blocks both alpha and beta receptors
LABETALOL (lABetalol)
which alpha blocker is given as first tx of phaemo
Phenoxybenzamine
what is another name for de quervains thyroiditis
subacute thyroidittis
how does de quervains thyroiditis present in the first stage
hyperthyroidism
painful goiter
raised ESR
