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Y3 MedEd > Endo > Flashcards

Endo Flashcards

1
Q

Causes of cranial DI (3)

A

Cranial: pituitary tumour, infection (meningitis), sarcoidosis

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2
Q

Causes of nephrogenic DI (5)

A

↑ Ca, ↓ K, lithium, inherited (AVPV2 gene), idiopathic

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3
Q

Presentation of DI

A

Presentation:
Polyuria (including nocturia) – UO often >3L
Polydipsia
Symptoms of hypernatremia: lethargy, irritability, confusion

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4
Q

What are symptoms of hypernatraemia (3)

A

lethargy, irritability, confusion

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5
Q

Ix for DI

A

General: U&Es (Ca, Na, K), glucose (to exclude DM)

Water deprivation test

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6
Q

What is the water deprivation test

A

Water is restricted for 8 hours
Plasma and urine osmolality are measured every hour
After 8 hours, give desmopressin and measure urine osmolality

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7
Q

Mx of cranial DI

A

Cranial: intranasal desmopressin

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8
Q

Mx of nephrogenic DI

A

Nephrogenic: thiazide diuretic or NSAIDs

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9
Q

Signs of DKA (5)

A

N&V, abdo pain, Kussmaul breathing, sweet breath

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10
Q

Which genes involves in DM

A

HLA DR3/4

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11
Q

RF of DMT2 (5)

A

Obesity, FH, ethnicity, endocrine, drugs

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12
Q

Diagnosis criteria of DM

A

Blood glucose measurement
Fasting ≥7 mmol/L
Random >11.1 mmol/L

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13
Q

Mx of DKA

A

Fluids, correct Na K

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14
Q

1st line and 2nd line treatment of T2DM

A

1st line = diet and lifestyle
2nd line = metformin
+/- sulphonylurea +/- insulin

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15
Q

Main 3 causes of hypovolaemic hyponatraemia

A

Diarrhea
Vomiting
Diuretics

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16
Q

Main 3 causes of euvolaemic hyponatraemia

A

Hypothyroidism,
Hypoadrenalism,
SIADH (pneumonia/cancer)

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17
Q

Main 3 causes of hypervolaemic hyponatraemia

A

HF
Cirrhosis
Nephrotic syndrome

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18
Q

Ix for hypovolaemic hyponatraemia (1)

A
  • Clinically hypovolaemic
  • Low urine sodium  kidneys will detect  volume and hang on to salt
    (measure off diuretics)
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19
Q

Ix for euvolaemic hyponatraemia (6)

A

TFTs
Short synACTHen: ACTH injection (cortisol will not rise)
Drug review, breast examination, CXR, brain MRI

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20
Q

Ix for hypervolaemic hyponatraemia (2)

A

Fluid overloaded

Low urine sodium   aldosterone secretion –> retention of Na

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21
Q

Signs of severe hyponatraemia (2)

A

seizures/↓ consciousness

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22
Q

Causes of hypernatraemia (4)

A

vomiting, diarrhea, diabetes insipidus, primary aldosteronism

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23
Q

Presentation of hypernatraemia (7)

A

lethargy, irritability, thirst, signs of dehydration, confusion, coma, fits

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24
Q

Mx of hypernatraemia

A

Drink water/IV fluids

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25
Q

Mx of hypervolaemic hyponatraemia

A

fluid restrict and treat cause

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26
Q

Mx of euvolaemic hyponatraemia

A

fluid restrict and treat cause

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27
Q

Mx of hypovolaemic hyponatraemia

A

Saline

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28
Q

Why do you hyperprolactinaemia in hypothyroidism

A

TRH stimulates prolactin release

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29
Q

Causes of hyyperprolactinaemia (4)

A

Pituitary prolactinoma (commonest)
Hypothyroidism
Drugs e.g. metoclopramide, antipsychotics (DA antagonists)
Physiological! Pregnancy, breast feeding

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30
Q

Drug causes of hyperprolactinaemia (2)

A

Metoclopramide, antipsychotics

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31
Q

Presentation of hyperprolactinaemia in women (4)

A

galactorrhoea, amenorrhoea, infertility, loss of libido

32
Q

Presentation of hyperprolactinaemia in men (3)

A

loss of libido, infertility, galactorrhoea uncommon

33
Q

Mass effects of prolactinoma (2)

A

Mass effects of tumour: headache, loss of visual fields

34
Q

Ix of prolactinoma (2)

A

Prolactin
TFTs
Pituitary MRI

35
Q

Mx of hyperprolactinaemia (2)

A

1st line = DA agonist e.g. bromocriptine and carbergoline

2nd line = surgery

36
Q

Features of de Quervains thyroiditis (4)

A

Post-viral, fever, high ESR. Causes painful goitre

37
Q

Mx of de Quervains thyroiditis (4)

A

Self-limiting (treat with NSAIDs)

38
Q

Grave’s triad

A

Grave’s triad = exophthalmos, pretibial myxedema and thyroid acropachy

39
Q

Toxic multinodular goitre common population

A

In elderly and iodine deficient areas

40
Q

Describe a thyroid adenoma

A

Solitary nodule producing T3/T4

41
Q

Radioisotope scan findings of Grave’s disease

A

Diffuse increased uptake (smooth diffuse goitre)

42
Q

Radioisotope scan findings of de Quervain’s thyroiditis

43
Q

Radioisotope scan findings of toxic multi nodular goitre

A

Multiple areas of increased uptake

44
Q

Radioisotope scan findings of thyroid adenoma

A

Single area of increased uptake

45
Q

Commonest cause of hypothyroidism in the West

A

Autoimmune Hashimoto’s thyroiditis (commonest cause in the West)

46
Q

Commonest cause of hypothyroidism worldwide

A

Iodine deficiency (commonest cause worldwide)

47
Q

What are the three iatrogenic causes of hypothyroidism

A

Iatrogenic: post-surgery, radioiodine, amiodarone

48
Q

What happens in de Quervain’s thyroiditis briefly

A

hyperthyroidism then hypothyroidism.

49
Q

Mx of hypothyroidism

A

levothyroxine 25-200 micrograms/day (monitor TFTs at 6 weeks and adjust dose accordingly)

50
Q

5 types of thyroid cancer

A 
Papillary
Follicular
Medullary
Lymphoma
Anaplastic
51
Q

Which is the most common type of thyroid cancer

52
Q

Buzzwords for papillary thyroid cancer (2)

A

Psammoma bodies, Orphan Anne nuclei

53
Q

What do Orphan Anne nuclei suggest

A

Papillary thyroid cancer

54
Q

What do Psammoma bodies suggest

A

Papillary thyroid cancer

55
Q

RF for papillary thyroid cancer

A

Radiation exposure

56
Q

Which age group does papillary thyroid cancer affect

A

Younger patients

57
Q

Buzzword for follicular thyroid cancer

A

Hurthle cells

58
Q

What do Hurthle cells suggest

A

Follicular thyroid cancer

59
Q

Which thyroid cancer is associated with MEN2

60
Q

What is medullary thyroid cancer associated with

61
Q

Which gender is lymphoma more common in

62
Q

When does lymphoma thyroid cancer generally occur

A

After pre-existing Hashimoto’s thyroiditis

63
Q

What is the usual population of anapaestic thyroid cancer

A

Elderly females

64
Q

What are the buzzwords for anapaestic thyroid cancer (2)

A

giant cells, pleomorphic hyperchromatic nuclei

65
Q

What do giant cells suggest in thyroid cancer

A

Anaplastic thyroid cancer

66
Q

What do pleomorphic hyperchromatic nuclei suggest in thyroid cancer

A

Anaplastic thyroid cancer

67
Q

S/s of acromegaly (9)

A

rings and shoes become right, ↑ sweating, coarse facial features, sleep apnoea, weight gain, headaches/visual disturbance, carpal tunnel syndrome, hypertension, insulin resistance

68
Q

Diagnostic test of acromegaly

A

Diagnostic: OGTT  acromegalics fail to suppress GH after 75g glucose load

69
Q

Mx of acromegaly (20

A

1st line = transphenoidal hypophysectomy

2nd line = somatostatin analogue e.g. ocreotide

70
Q

MEN1 glands

A

Parathyroid adenoma/hyperplasia
Pancreas
Pituitary

71
Q

MEN2 glands

A

Thyroid
Adrenal
Parathyroid hyperplasia

72
Q

MEN3 features

A

MEN2 thyroid carcinoma + phaeo
+ Mucosal neuromas: bumps on lips/cheeks/tongue/eyelids
+ Marfanoid appearance
NO hyperparathyroidism

73
Q

Presentation of carcinoid syndrome (6)

A

paroxysmal flushing, diarrhea, crampy abdominal pain, wheeze, sweating, palpitations

74
Q

Ix for carcinoid syndrome (2)

A

urine collection: ↑ 5-HIAA levels (serotonin metabolite)

CT/MRI to localize tumour. Also consider looking for underlying MEN 1

75
Q

Common sites of carcinoid tumours (2)

A

Appendix and rectum

Y3 MedEd (34 decks)

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