Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Oishi's Final year flashcards > Endo > Flashcards

Endo Flashcards

1
Q

Which type of meds does MODY typically respond well to?

A

Sulfonylureas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

MEN-1 features?

A

parathyroid (95%): hyperparathyroidism due to parathyroid hyperplasia
pituitary (70%)
pancreas (50%, e.g. Insulinoma, gastrinoma)
also: adrenal and thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How to screen for medullary thyroid cancer recurrence?

A

Serum calcitonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define impaired fasting glucose?

A

6.1 - 7mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define impaired glucose tolerance at 2 hours?

A

Fasting plasma glucose <7mmol/L

At 2 hours 7.8 - 11.1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which type of anti diabetic med is contraindicated in HF?

A

Pioglitazone (thiazolidinedione)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Severity of Graves’ eye disease? NO SPECS

A

No signs / symptoms
Only signs (e.g: upper lid retraction)
Signs & symptoms (including soft-tissue involvement)
Proptosis
Extra-ocular muscle involvement
Corneal involvement
Sight loss due to optic nerve involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

5Bs of thyroid storm tx?

A

B- B-Blockers
B- Block synthesis (thionamides - carbimazole)
B- block release (wolff-chiakoff)- iodine
B- Block T4-T3 conversion (PTU, steroids, and even amiodarone- again wolff chiakoff)
B- Block enterohepatic circulation (i.e. bile acid sequestrants)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What acid base disturbance does Cushing’s syndrome cause?

A

Hypokalaemic metabolic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Sick euthyroid syndrome findings?

A

low T3/T4 and normal TSH with acute illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

De Quervain’s thyroiditis tx?

A

Simple analgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

SEs of thiazolidinediones? e.g. piaglitazone?

A 
Weight gain
Liver impairment
Fluid retention
Increased risk of fractures
Increased risk of bladder cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If a patient is admitted with DKA, what should happen to their long acting basal insulin?

A

It should be continued alongside IV insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How to stop IV insulin in a patient admitted with DKA?

A

Make sure they eat breakfast/lunch
Inject SC prandial insulin
Stop IV insulin 30 mins later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does a high TSH but a normal fT4 suggest?

A

erratic compliance with thyroxine tx: patients who don’t take the medication regularly, but remember to take it immediately before a blood test is due

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Features of acromegaly?

A 
Diabetic retinopathy
Prognathism
Macroglossia
Cardiomegaly
Hepatosplenomegaly
Colonic polyps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Causes of pseudo-Cushings syndrome?

A

Depression
Obesity
Alcohol excess
Liver enzyme inducers - phenytoin, phenobarbital and rifampicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What should be used for alpha blockade in phaeo tx?

A

phenoxybenzamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Test for carcinoid syndrome?

A

24hr urine 5HIAA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What scan for phaeo?

A

MIBG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

DKA diagnostic criteria?

A

pH <7.3 and/or bicarbonate <15mmol/L.
Blood glucose >11mmol/L or known diabetes mellitus.
Ketonaemia >3mmol/L or significant ketonuria ++ on urine dipstick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does Alcoholic ketoacidosis present?

A

low or normal glucose levels and usually occurs due to patients being able to tolerate oral nutrition resulting in a state of starvation with associated ketoacidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

1st line mx for acromegaly? What is the alternative 1st line?

A

Trans-sphenoidal surgery

Octreotide (if surgery not suitable)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

MEN 2A features?

A

Parathyroid hyperplasia
Medullary thyroid carcinoma
Phaeochromocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Men 2B features?
Mucosal neuroma Marfanoid appearance Medullary thyroid carcinoma Phaeochromocytoma
26
Thyroglobulin can be used as a tumour marker for which cancers?
Papillary | Follicular
27
Which thyroid cancer metastasises to lung and bone?
Follicular
28
Which thyroid cancer has orphan eyes appearance?
Papillary
29
most common cause of primary hyperaldosteronism?
Bilateral idiopathic adrenal hyperplasia
30
TD2M: What to do if a triple combination of drugs has failed to reduce HbA1c AND BMI >35?
metformin + sulfonylurea + GLP-1 mimetic is recommended, particularly if the BMI > 35
31
Causes of raised prolactin?
``` pregnancy prolactinoma physiological polycystic ovarian syndrome primary hypothyroidism phenothiazines ``` ``` Other drugs: metoclopramide domperidone chlorpromazine haloperidol very rare: SSRIs, opioids ```
32
Most common cause of primary hyperparathyroidism?
Solitary parathyroid adenoma
33
Alcoholic ketoacidosis mx?
infusion of saline and thiamine
34
What cardiac abnormalities are associated with this carcinoid syndrome?
Pulmonary stenosis and tricuspid insufficiency
35
Thyrotoxic storm tx?
beta blockers, propylthiouracil and hydrocortisone
36
Causes of gynaecomastia?
``` physiological: normal in puberty syndromes with androgen deficiency: Kallman's, Klinefelter's testicular failure: e.g. mumps liver disease testicular cancer e.g. seminoma secreting hCG ectopic tumour secretion hyperthyroidism haemodialysis drugs: spironolactone ```
37
Drug causes of gynaecomastia?
``` spironolactone (most common drug cause) cimetidine digoxin cannabis finasteride GnRH agonists e.g. goserelin, buserelin oestrogens, anabolic steroids ```
38
Tx for myxoedema coma?
IV corticosteroids + IV thyroid hormone replacement
39
MOA of gliptins?
dipeptidyl peptidase-4, DPP-4 inhibitors increase levels of incretins (GLP-1 and GIP) by decreasing their peripheral breakdown Incretins then increase insulin secretion by binding to beta cells on pancreas
40
What is likely to cause osteomalacia + hypokalaemia
type 2 renal tubular acidosis
41
Which type of renal tubular acidosis causes hyperkalaemia?
Type 4 renal tubular acidosis
42
How to tell the difference between MODY and LADA?
LADA --> decreased insulin --> increased glucagon --> increased ketones MODY --> normal insulin --> normal glucagon --> normal ketones MODY is essentially T2 in young whereas LADA is T1 in elderly
43
Risks of correcting sodium levels too quickly?
Hyponatraemia correction - osmotic demyelination syndrome | Hypernatreamia correction - cerebral oedema
44
Mx of peripheral neuropathy?
amitriptyline (don't prescribe if BPH), duloxetine, gabapentin or pregabalin
45
How often must Insulin-dependent diabetics check their blood glucose when driving?
Every 2 hours
46
How many units of insulin in most standard preparations?
100U in 1ml
47
What can can reduce the absorption of levothyroxine and how can you prevent it?
Taking iron/calcium tablets | Take them 4 hours apart
48
Diagnostic criteria for HHS?
hypovolaemia hyperglycaemia (blood sugar > 30mmol/L) without significant ketones/acidosis serum osmolality > 320mosmol/kg
49
Which conditions predispose to pseudogout?
Acromegaly | Wilson's
50
Tx for gynaecomastia?
Aromatase inhibitors | Reversible cause tx
51
Addison's patient with intercurrent illness - what to do with their dose of steroids?
double the glucocorticoids | keep fludrocortisone dose the same
52
Congenital adrenal hyperplasia biochemical abnormalities?
Increased plasma 17-hydroxyprogesterone levels Increased plasma 21-deoxycortisol levels Increased urinary adrenocorticosteroid metabolites
53
Tx for hyperparathyroidism?
1. Total parathyroidectomy | 2. Cinacalcet
54
How does Cinacalcet work?
Mimics action of calcium in parathyroid gland - reducing PTH and therefore Calcium
55
Which form of Addison's is associated with hyperpigmentation?
Primary Addison's
56
Causes of Addison's?
``` Primary causes: tuberculosis metastases (e.g. bronchial carcinoma) meningococcal septicaemia (Waterhouse-Friderichsen syndrome) HIV antiphospholipid syndrome ``` ``` Secondary causes: pituitary disorders (e.g. tumours, irradiation, infiltration) ```
57
1st line Tx of prolactinoma?
Cabergoline | Trans-sphenoidal surgery if unsuccessful
58
What to do if TSH is between 4 - 10mU/L and the free thyroxine level is within the normal range?
<65 years + symptomatic: trial of levothyroxine - if no improvement in symptoms, stop levothyroxine Older people (especially >80 years): 'watch and wait' strategy - generally avoid tx Asymptomatic: observe and repeat TFTs in 6 months
59
What to do if TSH is > 10mU/L and the free thyroxine level is within the normal range?
<=70: start tx even if asymptomatic | Older (especially >80): 'watch and wait'
60
Features of thyroid storm?
hyperthermia tachycardia jaundice altered mental status
61
Indications for surgery in primary hyperparathyroidism?
Elevated serum corrected Calcium >0.25mmol/L above normal Hypercalciuria > 400mg/day Creatinine clearance < 30% compared with normal Episode of life threatening hypercalcaemia Nephrolithiasis Age < 50 years Neuromuscular symptoms Reduction in bone mineral density of the femoral neck, lumbar spine, or distal radius of more than 2.5 standard deviations below peak bone mass (T score lower than -2.5)
62
Hypercalcaemia mx?
IV fluids | If Ca >3: + IV bisphosphonate
63
osteoporosis guidelines if a postmenopausal woman has a fragility fracture?
put on bisphosphonates (there is no need for a DEXA scan)
64
What to prescribe alongside bisphosphonates?
vitamin D and calcium supplementation should be offered to all women unless confident they have adequate calcium intake and are vitamin D replete
65
Investigation findings in Kallman syndrome?
hypogonadotropic hypogonadism Low testosterone Low/inappropriately normal FSH and LH
66
Investigation findings in Klinefelter's syndrome?
hypergonadotropic hypogonadism Low testosterone High FSH and LH
67
How to determine cause of Cushing's?
If low dose doesn't suppress cortisol - CUSHING SYNDROME High dose helps determine specific cause Cortisol and ACTH suppressed = pituitary adenoma Cortisol NOT SUPPRESSED, ACTH SUPPRESSED = adrenal adenoma Neither suppressed = Ectopic
68
Breastfeeding women with hyperthyroidism. Tx?
PTU
69
What is Nelson's syndrome?
enlargement of an adrenocorticotropic hormone-producing tumour in the pituitary gland due to loss of negative feedback, following surgical removal of both adrenal glands in a patient with Cushing's disease

Oishi's Final year flashcards (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions