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Year 4 Mine > Endo > Flashcards

Endo Flashcards

1
Q

Levothyroxine risks

A

osteoporosis
arrhythmias

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2
Q

Cushings Syndrome causes

A

Cushing’s disease
Adrenal adenoma
Paraneoplastic syndrome
Exogenous steroids

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3
Q

Cushing’s disease

A

Pituitary adenoma secreting ACTH

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4
Q

Prolactinoma symptoms

A

In women: oligomenorrhoea or amenorrhoea, galactorrhoea, infertility, vaginal dryness
In men: erectile dysfunction, reduced facial hair
Both: headache, visual field defects

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5
Q

Prolactinoma investigations

A

MRI brain: microadenoma appears as lesions in the pituitary; macroadenoma appears as a space-occupying tumour
Serum prolactin

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6
Q

most common pituitary tumour

A

Pituitary adenoma - benign, non-secreting

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7
Q

Pituitary adenoma features

A

Headache
Visual field defects

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8
Q

Pituitary adenoma investigations

A

MRI brain
maybe hormone tests

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9
Q

Pituitary adenoma management

A

Neurosurgery: usually performed trans-sphenoidal
Radiotherapy: for residual tumour after surgery, or for recurrence

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10
Q

Most common hormone secreting tumour of the pituitary

A

prolactinoma

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11
Q

What hormones does anterior pituitary secrete

A

GH,
LH/FSH,
TSH,
ACTH
prolactin

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12
Q

What hormones does posterior pituitary secrete

A

ADH
oxytocin

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13
Q

Hashimotos thyroiditis associated with what cancer

A

MALT lymphoma

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14
Q

hypertension
headaches
palpitations
sweating
anxiety

A

phaeochromocytoma

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15
Q

Phaeochromocytoma investigations

A

24 hr urinary collection of metanephrines

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16
Q

Phaeochromocytoma management

A

surgery
stabilise first with:
alpha-blocker (e.g. phenoxybenzamine), given before a
beta-blocker (e.g. propranolol)

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17
Q

Sick euthyroid syndrome

A

low T3/T4 and normal TSH with acute illness

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18
Q

What is important to monitor in HHS

A

serum osmolality

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19
Q

Diabetic neuropathy management

A

amitriptyline, duloxetine, gabapentin or pregabalin
Try another if doesn’t work
tramadol as exacerbation therapy
capsaicin cream

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20
Q

Most common cause primary hyperaldosteronism

A

bilateral idiopathic adrenal hyperplasia

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21
Q

Conn’s syndrome

A

adrenal adenoma

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22
Q

Primary hyperaldosteronism features

A

hypertension
hypokalaemia e.g. muscle weakness
metabolic alkalosis

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23
Q

Primary hyperaldosternosim investigations

A

plasma aldosterone/renin ratio is the first-line investigation - should be high aldosterone low renin in primary
CT
if the CT is normal adrenal venous sampling (AVS) can be used to distinguish between unilateral adenoma and bilateral hyperplasia

24
Q

Conn’s syndrome management

A

surgery

25
Q

bilateral adrenal hyperplasia management

A

spironolactone

26
Q

Grave’s disease autoantibodies

A

TSH receptor stimulating antibodies (90%)
anti-thyroid peroxidase antibodies (75%)

27
Q

Orlistat mechanism of action

A

inhibits gastric and pancreatic lipase to reduce the digestion of fat

28
Q

What antibodies in Hashimoto’s thyroiditis

A

anti-thyroid peroxidase (TPO)
anti-thyroglobulin (Tg) antibodies

29
Q

When do you add glucose in treatment of DKA?

A

once blood glucose is < 14 mmol/l an infusion of 10% dextrose should be started at 125 mls/hr in addition to the saline regime

30
Q

What blood abnormality can prednisolone cause

A

neutrophilia

31
Q

Subclinical hypothyroidism treatment

A

Treat subclinical hypothyroidism if the TSH level is > 10 mU/L on 2 separate occasions 3 months apart
levothyroxine for 6mths

32
Q

subclinical hypothyroidism

A

TSH raised but T3,T4 normal

33
Q

Types of thyroid cancer from most common to least

A

Papillary
Follicular
Medullary
Anaplastic
Lymphoma

34
Q

Which thyroid cancer can be associated with hashimotos thyroiditis

A

lymphoma

35
Q

Medullary thyroid cancer
what cells
what secrete
what disease

A

Cancer of parafollicular (C) cells,
secrete calcitonin,
part of MEN-2

36
Q

Management of papillary and follicular cancer

A

total thyroidectomy
followed by radioiodine (I-131) to kill residual cells

37
Q

Follow up for papillary and follicular cancer

A

yearly thyroglobulin levels to detect early recurrent disease

38
Q

Papillary thyroid cancer invasion

A

lymphatic

39
Q

Follicular thyroid cancer invasion

A

Vascular invasion predominates

40
Q

Medullary thyroid cancer invasion

A

Both lymphatic and haematogenous metastasis are recognised,
nodal disease is associated with a very poor prognosis.

41
Q

WHich thyroid cancer young females which old

A

young: papillary
old: anaplastic

42
Q

Anaplastic thyroid cancer invasion

A

Local invasion is a common feature

43
Q

May appear macroscopically encapsulated, microscopically capsular invasion is seen. Without this finding the lesion is an adenoma.

A

follicular thyroid cancer

44
Q

Histologically tumour has papillary projections and pale empty nuclei

A

Papillary thyroid cancer

45
Q

pseudo-cushings

A

mimics Cushing’s
often due to alcohol excess or severe depression
causes false positive dexamethasone suppression test or 24 hr urinary free cortisol
insulin stress test may be used to differentiate

46
Q

low T4 low TSH

A

secondary hypothyroidism
get a pituitary MRI

47
Q

Tests and antibodies used to distinguish between T1 and T2 DM

A

c-peptides
anti-GAD
ICA
IAA
IA-2A

48
Q

DKA management insulin therapy

A

In the acute management of DKA, insulin should be fixed rate whilst continuing regular injected long-acting insulin but stopping short actin injected insulin

49
Q

Subacute thyroiditis management

A

usually self-limiting - most patients do not require treatment
thyroid pain may respond to aspirin or other NSAIDs
in more severe cases steroids are used, particularly if hypothyroidism develops

50
Q

Gynaecomastia

A

spironolactone (most common drug cause)
cimetidine
digoxin
cannabis
finasteride
GnRH agonists e.g. goserelin, buserelin
oestrogens, anabolic steroids

51
Q

Worst prognosis thyroid cancer

A

anaplastic

52
Q

Falsely low HbA1c causes

A

Sickle-cell anaemia
GP6D deficiency
Hereditary spherocytosis
Haemodialysis

53
Q

Falsely high HbA1c causes

A

Vitamin B12/folic acid deficiency
Iron-deficiency anaemia
Splenectomy

54
Q

Signs specific to Grave’s disease

A

exophthalmos
ophthalmoplegia
pretibial myxoedema
thyroid acropachy

55
Q

thyroid acropachy

A

digital clubbing
soft tissue swelling of the hands and feet
periosteal new bone formation

Year 4 Mine (14 decks)

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