Endo Flashcards
What can carpal tunnel syndrome be associated with and what to investigate?
Can be associated with hypothyroidism
-Thyroid function test
What can untreated hypothyroidism lead to and what do we use to treat it?
Can lead to myxedema and treated with hydrocortisone and levothyroxine
What happens to eyebrow in hypothyroidism?
Lose lateral third of eyebrow(queen anne sign)
What is de quervain’s thyroiditis?
-Post viral thyroiditis
-Hypothyroiditis
What is sick euthyroid syndrome?
Sick euthyroid syndrome is an abnormality of the thyroid function tests that can occur in any systemic illness. The most common abnormality is that the free T3 is low with a normal to low free T4 and TSH. These patients tend to have no symptoms of thyroid disease and it is usually seen in critical illness or in starvation states. Repeat thyroid function tests should be performed in 6 weeks after the patient has recovered.
Most common → Least common Thyroid Cancers
Papillary, Follicular, Medullary, Anaplastic, Lymphoma(non-hodgkins)
Please feel my awkward lump
What is a side effect of carbimazole and proplthiouracil?
Agranulocytosis which can lead to neutropenia and severe sepsis
-Must stop if pt comes in with sign of infection or neutropenia
How does anaplastic carcinoma present?
Presents with airway compromise(stridor), dysphagia and in older women
What would you screen for in a patient after a thyroidectomy due to medullary carcinoma?
Calcitonin as medullary carcinoma is a cancer of the parafollicular cells that secretes it
What is the Ix if pt comes in with mass on thyroid which is fast growing?
-Concern of malignancy
-Fine needle aspiration
What is carbimazole mechanism of action?
Inhibits thyroid peroxidase
Post pregnancy and showing symptoms of hyperthyroidism
Most likely transient hyperthyroidism and therefore symptomatic relief like propanolol
What diabetic drug is contraindicated in pregnancy?
Perindopril(ACE inhibitor)
What to give patient with hypoglycemia with no symptoms?
Glucogel
What to give patients with hypoglycemia with syncope?
Glucagon
Mx for steroid induced hyperglycemia?
Gliclazide
What does DKA present with?
Metabolic acidosis and raised anion gap >16
What would subclinical hyperthyroidism look like?
-Low TSH
-Normal T4
What would subclinical hypothyroidism look like?
-High/Normal TSH
-Normal T4
Target BP for diabetics <80
<140/90
What is recommended in patients who have diabetes as well as CKD if they are already on metoformin?
SGLT2 inhibitor
If goitre is tender what is that most likely?
De quervain’s which comes post viral illness
What drug in diabetes mx has a side effect of hypoglycemia?
Glimepiride is a sulfonylurea, these medications work by stimulating the pancreatic beta cells to promote insulin secretion. Hypoglycaemia is a well recognised and serious side effect of sulfonylureas and the likely cause of this gentleman’s hypoglycaemic episode.
How would you diagnose acromegaly
Insulin like growth factor → acromegaly → colorectal cancer
What is used to routinely check for excessive GH?
IGF 1alpha
What drug causes excessive thirst and nocturia and why?
Lithium
-can cause pts to get nephrogenic diabetes insipidus(AVP resistance)
What is the most common cause of primary hyperparathyroidism?
parathyroid adenoma
What is the most common cause of cushing’s syndrome?
oral corticosteroids
What glucose levels can you diagnose gestational diabetes? what is first line treatment
> =5.6
-First line if between 5.6-7 is diet and exercise
–if no improvement then metformin
What causes addissons?
Destruction of the adrenal glands (i.e. primary adrenal insufficiency) can be caused by:
Autoimmune process - around 90% of people in the UK
Infections, such as tuberculosis, especially in areas where TB is endemic. Other (less common) infections include fungal infections and opportunistic infections secondary to HIV
Infiltrating diseases, such as amyloidosis, sarcoidosis
Tumours, including both primary and metastatic cancers
