Endo Flashcards by Edmund Whelan

What test can be done for primary adrenal insufficiency / to diagnose Addison’s?

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What levels of aldosterone do you see in primary, secondary and tertiary adrenal insufficiency?

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What hormones are low in secondary and tertiary adrenal insufficiency?

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Give two drugs that can be given for adrenal insufficiency.

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What are the symptoms of an Addisonian crisis?

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What hormones are released by the posterior pituitary?

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Most common site for carcinoid tumours to metastasise?

Liver

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Where do carcinoid tumours mostly affect?

GI tract
(Carcinoid tumour = neuroendocrine tumour = cancer of nerves/glandular cells)

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Key side effect of spironolactone?

Gynacomastia
(Use eplerenone if happens)

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Difference between primary and secondary hyperaldosteronism

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Three symptoms of hypokalaemia?

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What levels of calcium do you see in primary, secondary and tertiary hyperparathyroidism?

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What are the causes of primary, secondary and tertiary hyperparathyroidism?

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What does PTH act on to do what?

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In which two ways does the kidney maintain calcium levels?

Vitamin D activation acts to increase calcium levels –> CKD = hypocalcaemia
PTH stimulates kidneys to reabsorb calcium –> CKD = hypocalcaemia

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Give three side effects of metformin.

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Give two examples of sulphonylureas and two side effects.

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Give two side effects of pioglitazone

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Give two examples of DPP-4 inhibitors and a side effect.

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Give four symptoms of low ACTH

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Give two examples of DPP-4 inhibitors and a side effect.

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Give two examples of SGLT-2 inhibitors and two potential side effects.

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Give the diagnostic criteria for TIIDM.

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How much glucose is given in OGTT?

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Two investigations for acromegaly?

1st line = Serum IGF-1 2nd line = OGTT 3rd line = Pituitary function test 4th line = MRI

What syndrome is acromegaly associated with and which nerve roots are associated with it?

Give three classes of drug that can be used to treat acromegaly?

Give an example of a somatostatin analogue.

Give an example of a GH antagonist.

Give an example of a dopamine agonist.

What's the mnemonic for remembering the symptoms of Addison's?

Investigations for hyperaldosteronism? Which is first line?

How would you test for Cushing's syndrome?

How would you test for Cushing's disease and what result would you look for?

How would you test for adrenal Cushing's and what result would you look for?

How would you test for ectopic ACTH Cushing's and what result would you look for?

Give an example of an alpha blocker that could be used to manage pheochromocytoma?

Give an example of a mineralocorticoid.

Give an example of a glucocorticoid.

Which layer of the adrenal cortex are androgens produced?

Where in the adrenal glands is adrenaline produced?

What are the layers of the adrenal cortex and what's produced in each layer?

Give two diagnostic tests for pheochromocytoma. Which one is gold standard?

First, second and third line treatment for DKA?

Diagnostic criteria for DKA?

What anion gap is seen in DKA?

What electrolyte do you need to closely monitor in DKA?

What should you think of if you see low sodium and high glucose in DKA?

What serum osmolality would confirm pseudohyponatraemia in DKA?

What's the medical term for heavy menstrual bleeding and is it associated with hyper or hypothyroidism?

Difference between endocrine and exocrine glands?

- Endocrine: hormones/substances secreted directly into bloodstream - Exocrine: hormones/substances secreted into a ductal system usually leading to an epithelial surface

Other than Addison's, give three causes of primary adrenal insufficiency.

Other than long term steroid use, give three causes of secondary adrenal insufficiency.

How does hyperglycaemia lead to increased insulin production on a cellular level?

- Increased glucose uptake by beta cells (GLUT2 receptors) - Increased ATP production due to glucose metabolism - K+ channels shut due to increasing ATP, causing cell membrane depolarisation - Ca2+ channels open, influx - Exocytosis of insulin containing vesicles

Give two microvascular and two microvascular complications of TIIDM.

Micro - retinopathy, nephropathy, neuropathy Macro - cardiovascular disease, cerebral vascular disease, PAD

What three antibodies are found in Grave's disease?

Three most common types of thyroid cancer?

Give five causes of hypothyroidism.

What antibodies are found in Hashimoto's thyroiditis?

What do C-cells in the thyroid secrete?

What's a key red flag side effect of carbimazole?

- Sign of infection, commonly sore throat (Carbimazole suppresses bone marrow production so may lower WBC count)

Give four treatments of Grave's

What can be given to treat hypothyroidism?

Synthetic levothyroxine / T4

What's the most common antibody type in autoimmune diseases?

IgG

Apart from bones, stones, moans, groans what are three other symptoms of hypercalcaemia?

- polydipsia - polyuria - malaise

What test can be done for carcinoid syndrome?

What's the gold standard for diagnosis of carcinoid syndrome?

- Serum chromogranin-A + octreoscan

Is pre-tibial myxoedema pitting or non-pitting?

Non-pitting

Normal serum potassium range?

What epithelium lines the vas deferens?

pseudostratified columnar epithelium with stereocilia

Give two causes of hypercalcaemia other than MM and hyperparathyroidism.

Pre-diabetic HBA1c range?

42-47

Most common cause of iodine deficiency in developing vs developed countries?

Developed - Hashimoto's Developing - Iodine deficiency

Main electrolyte imbalance caused by SIADH?

Hyponatraemia

Drug used to treat hyperthyroidism and its MOA?

- Carbimazole - Inhibits TPO

Two signs present in hypocalcaemia?

- Chovstek's sign (tap facial nerve) - Trousseau’s sign (blood pressure cuff <20mmHg above systolic, 5 minutes, claw hand forms)

Gold standard for diagnosis of carcinoid syndrome?

Serum chromogranin A + octreoscan

Micro and macrovascular complications of TIIDM?

Micro - retinopathy, neuropathy, nephropathy Macro - CVD, CVD, PAD (2nd CVD stands for cerebral vascular disease)

First line investigation for hyperaldosteronism?

Difference between a direct and indirect Comb's test?

- Direct comb's test detects antibodies stuck to the surface of RBCs (autoimmune haemolytic anaemia) - Indirect comb's test tests for antibodies against foreign RBCs. Used before blood transfusions.