Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RACP 2023 > ENDO > Flashcards

ENDO Flashcards

1
Q

Components of FRAX?

A

Age,sex,weight,height
Prev fracture, hip fracture
Smoking
Steroids
RA
2* osteoporosis
Alcohol

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

Testosterone metabolites?

A

DHT and estradiol

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

Testosterone formed from?

A

cholesterol –> pregnelone

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

Features of carcinoid syndrome?

A

Flushing
R sided valvular disease
Diarrhea
Mesenteric fibrosis

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

How to diagnose carcinoid syndrome?

A

5-HIAA

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

Treatment carcinoid syndrome?

A

Octreotide

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

Classic skin changes in glucagonoma?

A

necrolytic migratory erythema

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

How to diagnose neuroendocrine tumour?

A

CTCAP NOT PET (slow growing)
Somatostatin scintigraphy (>90% have somatostatin receptors)

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

General management for neuroendocrine tumours?

A

Somatostatins

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

Most common cause of Conn’s?

A

Bilateral adrenal hyperplasia

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

What causes low/high uptake in an iodine scan?

A

LOW
- Ecogenous thyroid hormone
- Ectopic thyroid tissue
- Drugs
- Excess iodine
- Thyroiditis
- Struma ovarii: teratoma
- Amiodarone
- Metastatic follicular thyroid cancer

INCR
- Graves
- TMG
- Toxic adenoma
- TSH-oma
Hydatiform mole

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

Why do you need to be cautious with a statin + hypothyroidism?

A

Can predispose to statin induced myopathy + rhabdo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cortisol mechanism of action?

A

Increased glucose levels [SLOW]

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

Low 21 hydroxylase results in?

A

Low Aldosterone and cortisol

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

Which hormones are produced from adrenal
- medulla
- cortex

A

Medulla:
- catecholamines

Cortex
- G: aldosterone
- F: cortisol
- R: DHEAS

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

Most specific sign of Cushings?

A

Skin changes = BIGGEST

weakness/myopathy
facial plethora
glucose intolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Screening tests of Cushings: which ones are best, and which ones can’t be used in certain situations

A

Urinary free cortisol: BEST
- no affected by CBG

Midnight salivary cortisol
- can’t use in shift workers

Dex suppression test

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

Cushing’s treatment

A

PITUITARY
- surgery
- radiation
- meds
ketoconazole
pasirotide
serotonin antagonists
GABA inhibitors
- last line
bilateral adrenalectomy + post op pituitary radiation (prevents Nelson’s syndrome)

GENERAL MEDS
- inhibits 11b hydroxylase + blocks steroid receptors
- metyrapone
- ketoconazole
- mitotane
- etomidate

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

Cushings disease/ ectopic ACTH causes

A

Disease
- MEN2
- USB8

Ectopic ACTH
· Small-cell lung carcinoma
· Non small-cell lung carcinoma
· Lung carcinoid tumours
· Pancreatic tumours
· Thymus tumours

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

Pheochromocytoma causes:

A
  • adrenal medulla
  • Chromaffin cells of adrenal medulla - MAJORITY
  • Abdominal sympathetic ganglia
  • Parasympathetic
  • Chest/abdo/pelvis
  • Head and neck: non secretory

Familial syndromes
○ MEN
○ Von Hippel Lindau
○ Neurofibromatosis type 1

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

Ix for pheochromocytoma?

A

Plasma free metanephrines/ normetanephrines
CTAP with contrast
MRI with contrast
PET DOTATE/ MIBG
Clonidine suppression testing

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

What antihypertensives can be used when doing a ARR?

A

Prazosin
Hydralazine
Verapamil

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

Ix done for Conns?

A

ARR
Confirm with salt suppression test
CT adrenals to see if unilateral/bilateral
Adrenal v sampling if considering management
- imaging can miss bilateral

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

Adrenal insufficiency
- autoimmune and genetic causes?

A

APS1: Addisons, candida, hypoparathyroidism
APS2: Addisons, DM, thyroiditis

X linked adrenoleukodystrophy
- demyelinating disease
- ABCD1 gene mutation –> accumulation LFCAs
- spastic paraparesis, neurogenic bladder, sexual dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Symptoms of acute/chronic adrenal insufficiency
Acute: abdominal pain, shock, hypovolemia *CAN MIMIC SEPSIS* Chronic: hyper/hypo pigmentation
26
Tests for adrenal insufficiency
Plasma ACTH, cortisol Short synacthen * Adrenal antibodies ○ 21-hydroxylase antibodies =AI Addisons * VLCFA ○ X linked adrenoleukodystrophy * mutation in 21 hydroxylase --> 17-OH progesterone increased + low alodsterone/ cortisol ○ CAH
27
Tests for adrenal insufficiency
Plasma ACTH, cortisol Short synacthen * Adrenal antibodies ○ 21-hydroxylase antibodies =AI Addisons * VLCFA ○ X linked adrenoleukodystrophy * mutation in 21 hydroxylase --> 17-OH progesterone increased + low alodsterone/ cortisol ○ CAH
28
How does CAH affect adrenal hormones?
mutation in 21 hydroxylase --> 17-OH progesterone increased + low alodsterone/ cortisol; high DHEAS
29
How to diagnose CAH?
17-hydroxyprogesterone elevated Failed short synacthen
30
How to differentiate adenoma vs carcinoma/pheo on imaging?
BENIGN Density < 10 Not vascular > 50% washout at 10minutes Small (however mets can be small too) Homogenous Smooth margins
31
Adrenal carcinoma prognosticator? Treatment
Ki67 > 10% Management - Mitotane - chemo - surgical removal
32
Relative steroid potency of - Hydrocortisone - Pred - Methylpred - Dex
1 - Hydrocortisone 4 - Pred 5 - Methylpred 25 - Dex
33
Pancreas tissue functions? Acini Islet of langerhands - Alpha - Beta - Delta
Acini Islet of langerhans: digestive juices - Alpha: glucagon - Beta: insulin - Delta: somatostatin
34
Glucagon effects?
Increases gluoconeogenesis Increases glycogenolysis Increases energy expenditure Increases ketogenesis/ lipolysis
35
Testing for T1DM
GAD, IA2, ZnT8 C peptide
36
Risks of DM if: - affected mother - affected father - both parents affected - sibling - dizygotic twins - monozygotic twins
- affected mother 2-4% - affected father 5-8% - both parents affected 30% - sibling 5% - dizygotic twins 8% - monozygotic twins 50%
37
Converting Hba1c to fructosamine?
HbA1c 6% is equivalent to 42 mmol/mol then for every 1% increase in HbA1c there is an 11 mmol/mol increase i.e. 6% = 42 mmol/mol, 7% = 53 mmol/mol, 8% = 64 mmol/mol and 9% = 75 mmol/mol and so on.
38
What can affect Hba1c?
INCREASE - anemia - alcoholism - renal failure DECREASE EPO/Fe/B12/CLD administration Aspirin Vitamin C,E Decreased lifespan: hemoglobinopathies, splenomegaly hypertriglyceridemia
39
Risks for T1DM
Other AI diseases HLA DR3 and 4 --> risk HLA DR2 --> protection
40
Features of LADA?
Become more insulin dependent quickly; initially responsive to OHA's No C peptide Antibodies (+)
41
Genetic risk factor for T2DM?
TCFL72
42
Effects of incretin?
Suppresses appetite Inhibits gluneogenesis Decreases glucagon Increases insulin synthesis
43
MODY definition?
Family history of onset < 25 years No ketosis Impaired insulins secretion Hyperglycemia corrects without insulin for 2 years
44
MODY types, gene association and clinical features
Check notes
45
Penetrance of PCKD? What causes more severe disease: truncating or non truncating?
Complete penetrance Non truncating cause stronger disease as affects proteins, than truncating disease
46
Genes assoc with PCKD?
PKD1 PKD2: less severe POLYCYSTIN 1
47
Clinical features of PCKD?
KIDNEY Flank pain Bloating UTI Proteinuria, haematuria HTN OTHER Ovarian cysts Cerebral aneurysms Cardiac valvular disease Hepatic/ pancreatic cysts
48
Diagnosis and classification of PCKD?
DIAGNOSIS - Family history (+): > 3 cysts total or 2 in each kidney - Family history (-): ? 10 cysts in each kidney + bilateral renal enlargement CLASSIFICATION - htKV + age
49
Management PCKD
ACEI/ARB: improves CV mortality, reduces eGFR/TKV decline Tolvaptam (vasopressin blocker) - earlier start = more benefit CTA/MRA
50
AKI defined by?
Decr urine output Decr Cr
51
AI poly endocrine syndrome: describe type 1 and 2
1 - candidiasis mucocutaneous, addisons, hypoparahtyroid - AI recessive 2
52
AI poly endocrine syndrome: describe type 1 and 2
1 - candidiasis mucocutaneous, addisons, hypoparahtyroid - AI recessive 2 - addisons - t1dm - thyroiditis - polygenic
53
MOST COMMON INITIAL SITE OF OA?
MOST COMMON INITIAL SITE: MEDIAL TIBIOFEMORAL CARTILAGE
54
DI: results for neurogenic, nephrogenic and primary polydipsia post fluid deprivation and post desmopressin
Check notes
55
How does lithium affect thyroid function>
Hypothyroidism
56
How does amiodarone affect thyroid function?
Jod Basedow effect Wolf Chaikoff effect: Hyper/hypothyroidism
57
How does heparin affect TFT?
TFTs appear to be secondary hyperthyroidism
58
How does CMZ/Phenytoin affect TFT/s
Appears to be hypothyroidism primary
59
Iodine uptake scan: increased and decreased uptake?
INCR - Graves - MNG - Adenoma - TSH-oma - Hydatiform mole DECR - Struma ovarii - Ectopic thyroxine - Iodine excess - Thyroiditis - Amiodarone - Metastatic follicular cancer
60
What substances do these parts of the testes produce? Theca cells Granulosa cells Leydig Sertoli
Theca cells - Ovarian androgens, mostly androstenedione and some testosterone, are produced in the theca cells, which respond to LH. The androgens diffuse across the basement membrane to the granulosa cells. Granulosa cells - in response to stimulation by FSH, produce aromatase, which converts the androgen precursors to estrone and estradiol. Leydig - testosterone Sertoli - spermatogenic substances - Inhibin
61
What substances do these parts of the testes produce? Theca cells Granulosa cells Leydig Sertoli
Theca cells - Ovarian androgens, mostly androstenedione and some testosterone, are produced in the theca cells, which respond to LH. The androgens diffuse across the basement membrane to the granulosa cells. Granulosa cells - in response to stimulation by FSH, produce aromatase, which converts the androgen precursors to estrone and estradiol. Leydig - testosterone Sertoli - spermatogenic substances - Inhibin: inhibits FSH
62
Maximal time for GnRH production? Water of lipid soluble?
GnRH: pulsatile Water soluble

RACP 2023 (17 decks)

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