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Tomakesense 2 > Endo > Flashcards

Endo Flashcards

1
Q

What are the low and high dose Dex suppression test findings for Cushing’s disease

A

Does not suppress with low dose

Suppresses with high dose

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2
Q

Patient with Zollinger-Ellinson syndrome and Whipple’s presents with polyuria and constipation?

A

Parathyroid adenoma causing hyperPTH and hypercalcaemia

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3
Q

Acarbose MoA and common side effect

A

inhibits alpha glucosidases in SI, delaying digestion of starch
SEs: diarrhoea/flatulence, (hepatoxicity)

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4
Q

Antihypertensive that can increase insulin requirement

A

Bendroflumethiazide

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5
Q

Grave’s ophthalmopathy treatment

A

High dose steroids

Surgical orbital decompression if refractory or vision threatened

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6
Q

SEs/important contraindication of sulphonylureas

Give examples

A

Hypo
Weight gain ie. not recommended in obese
Glibenclamide, Glimepiride

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7
Q

Prolactin level 9000, macro or micro adenoma?

A

If Prolactin >2000, likely macroadenoma

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8
Q

Nelson’s syndrome

A

hormone secreting pituitary macroadenoma following adrenalectomy for Cushing disease

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9
Q

Most commonly occurring thyroid cancer

A

Papillary thyroid cancer (70%)

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10
Q

Octreotide indications and important SE

A 
Indications:
VIPomes
Carcinoid tumours
Acromegaly
Glucagonomas

SE: gallstones (in long term use)

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11
Q

Karyotype of Turners

A

45 X0

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12
Q

Kallman’s syndrome

A

hypothalamic gonadotrophin deficiency and hypo/anosmia

Other features: craniofacial feature eg. cleft palate, nerve deafness, colourblindness

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13
Q

If fasting glucose shows IFG
AND
OGTT shows IGT
what is the diagnosis?

A

Impaired glucose tolerance

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14
Q

Which features are more specific for Grave’s disease than other causes of hyperthyroidism?

A

Exopthalmos
Ophthalmoplegia
Thyroid acropachy
Pretibial myxoedema

NB. NOT lid lag

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15
Q

Indications for islet translplant

A

T1DM + >2 severe hypos in last 2 years + impaired awareness/warning of hypo

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16
Q

Precocious puberty causes and treatment (early onset puberty)

A

Idiopathic
Harmartomas of posterior hypothalamus

Treat idiopathic with long term GnRH analogues

17
Q

Troisier’s sign

A

Palpable left supraclavicular node
~GI malignancy

Not to be confused with Trousseau’s sign (hypocalcaemia): carpopedal spasm if brachial artery occluded with BP cuff

18
Q

Pseudohypoparathyroidism presentation

A

Same blood panel as secondary hyperparathyroidism (low Ca, high PTH) but with high PO4

BUT also round face and short 4th and 5th fingers

ie. PTH Resistance

19
Q

Dumping syndrome

A

Nerve supply to stomach damage ie. fast transit into SI -> pancreas over produces insulin = hypo symptoms post-meals

Usually a complication to GI surgery. eg. fundoplication

20
Q

Karyotype and features of Klinefelters

A

47 XXY

Hypogonadism ie. little body hair, slight, gynaecomastia

21
Q

Most common hormonally active pituitary tumours

A

Eosinophilic GH secreting adenoma
Basophilic ACTH secreting adenoma
Prolactin secreting adenoma

22
Q

Persistent hyperprolactinaemia despite no symptoms, dx?

A

Macroprolactinaemia

Macroprolactin = auto-antibody complex with no biological activity

23
Q

Endo cause of hyperglycaemia + hepatosplenomegaly

A

Acromegaly (not hypoglycaemia!)

24
Q

Wolfram syndrome triad

A

T1DM (Dx <16yo) + optic atrophy + deafness

25
Q

Most likely diabetes meds to cause hypoglycaemia

A

Gliclazide

26
Q

CAH pathology and Rx

A

Excess production of androgens - little cortisol
Increased ACTH causes hyperplasia
Rx: Hydrocortisone

27
Q

Most common cause of secondary hypertension

A

Conns

Suspect if <40yo hypertensive

28
Q

Probable second most common cause of secondary hypertension

A

Renal disease

eg. GN, RAS (asymmetrical kidneys on scan), PKD

29
Q

Chronic fatigue syndrome definition, features, Rx

A

at least 4mo disabling fatigue affecting mental and physical functionmore than 50% of the time

Female>male
Exertion (physical or mental) makes symptoms WORSE
Palpitations
PAINFUL LNs, no enlargement
Muscle/joint pain
Sore throat
Sleep disturbance
Nausea
Dizziness
Rx:
CBT
Graded exercise therapy
"pacing"
Pain team referral if dominant
Low dose amitryptilline for sleep
30
Q

DM Dx

A

Random glucose or 2h OGTT >11.1
Fasting glucose >7
HbA1c >48 (but does not exclude if less)

Asymptomatic: need above criteria twice
Symptomatic: once

(IFG: 6.1-7
IGT: 7.8-11.1)

31
Q

How does treatment differ for osteoporosis if on long term steroids

A

Treat if t-score <1.5 as opposed to <2.5

32
Q

Example of GLP-1 mimetic

Indication

A

Exenatide

Latter Rx for T2DM

33
Q

Skin manifestation of DM

A

Necrobiosis lipoidica
Shiny painless yellow/red/brown skin on shins
~telangiectasia (unlike EN)

34
Q

Which DM med should you monitor LFT

A

Pioglitazone

35
Q

When to start primary prevention statin in T1DM

A

Nephropathy
had T1DM for 10 years
>40yo
Other CVD RFs

36
Q

When to start primary prevention statin in T2DM

A

As per QRISK

37
Q

Commonest cause of male hypogonadism

Rx

A

Klinefelter’s 47XXY
(Low testosterone + gynaecomastiae)

Rx: testosterone

38
Q

Pituitary tumour causing thyrotoxicosis, TFTs?

A 
NORMAL TSH (inappropriately)
High fT4

Tomakesense 2 (18 decks)

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