Endo Flashcards
What is management of Phaeochromocytoma when a patient presents unstable?
- alpha-blocker (e.g. phenoxybenzamine), given before a
- beta-blocker (e.g. propranolol)
- Surgery
What are the signs of primary hyperaldosteronism?
- Hypertension
- Hypokalaemia
On a high-dose dexamethasone suppression test, what would be suppressed in Cushing’s syndrome + give example of disease?
- ACTH
- NOT cortisol
- Adrenal adenoma
On a high-dose dexamethasone suppression test, what would be suppressed in Cushing’s disease + give example of disease?
- Cortisol + ACTH
- pituitary adenoma → ACTH secretion)
On a high-dose dexamethasone suppression test, what would be suppressed in ectopic ACTH syndrome?
Nothing
Give an example of an SGLT-2
Empagliflozin
Give an example of a sulfonylurea
Gliclazide
Give an example of a GLP-1
Liraglutide
What are signs of Cushing’s disease?
Increased glucocorticoid production:
- weight gain
- thinning skin
- abdominal striae
Lab signs
- hypokalaemic
- metabolic alkalosis.
How is hydrocortisone given in Addison’d?
The hydrocortisone dose is split with the majority given in the first half of the day
What is Exophthalmos?
Bugging of the eyes. Seein hyperthyroidism
What are complications of Subclinical hyperthyroidism?
atrial fibrillation, osteoporosis and possibly dementia
What is Goserelin + a side effect?
GnRH agonists (e.g. goserelin) used in the management of prostate cancer may result in gynaecomastia
What indicates Impaired glucose tolerance?
Impaired glucose tolerance (IGT) is defined as fasting plasma glucose less than 7.0 mmol/l and OGTT 2-hour value greater than or equal to 7.8 mmol/l but less than 11.1 mmol/l
What indicates an impaired fasting glucose?
fasting glucose greater than or equal to 6.1 but less than 7.0 mmol/l
When do you add more medications in T2DM?
HBA1C> 58
What antibodies are seen in Graves?
- majority Anti-TSH receptor antibodies
- Anti-thyroid peroxidase TPO antibodies
When you give insulin in DKA what happens to the potassium?
It goes into the cells causing HYPOkalaemia
What is a side effect of metoclopramide?
Galactorrhoea
What should be done when taking levothyroxine and calcium supplements?
Iron/ calcium carbonate tablets should be taken 4 hours after levothyroxine as they reduce its absorption
When can prediabetics be prescribed liraglutide?
When they also have a BMI> 35 kg/m2
What thyroid cancer has good prognosis?
Papillary thyroid cancer
What is a complication of thyroid surgery?
damage to parathyroid glands can result in hypocalcaemia
What are signs of horners syndrome?
ptosis + constricted pupil
What are signs of 3rd nerve palsy?
Ptosis + dilated pupil
What can cause hypogonadotrophic hypogonadism
Haemochormatosis
What condition is pyridostigmine given?
Myasthenia gravis
Give an example of a DPP4?
Sitagliptin
What are signs of DKA resolution?
pH >7.3 and
blood ketones < 0.6 mmol/L and
bicarbonate > 15.0mmol/L
What are treatment options for acromegaly?
- trans-sphenoidal surgey
- Octreotide
What is metformin additional to their insulin given to T1DM?
BMI > 25
What is a VBG is Cushing syndrome?
Hypokalaemia metabolic alkalosis
What are features of renal artery stenosis?
-Secondary hyperaldosteronism (both plasma renin and aldosterone are raised)
- Severe headache
- refractory hypertension.
- ACE inhibitors can worsen the stenosis, resulting in a drop in eGFR
