Endo Flashcards
What happens to serum copper etc in Wilsons?
Free copper increased, but SERUM goes down. Ceruloplasmin goes down (95% of copper bound to this)
MEN1
MEN 1 gene § Pituitary adenomas § Parathyroid tumours § Pancreatic islet-cell tumours (and other endocrine tumours of the gastroenterohepatic tract e.g. gastrinomas) § Fascial angiofibromas and collagenomas
HYPERCALCEMIA most common presentation
MEN2a
RET Oncogene
Parathyroid tumours (60%)
Medullary thyroid cancer (70%)
Phaeochromocytomas
MEN2b
RET oncogene Medullary thyroid cancers Phaeochromocytomas Marfanoid appearance Neuromas of the GI tract
PTH effect on phosphate
High PTH =low phosphate normally
Ca, PO4 and PTH in; malignancy
High calcium
Normal phosphate
Low PTH
Ca, PO4 and PTH in; renal failure
Low calcium
HIGH phosphate (would be low because of PTH but it is not being filtered out due to failure)
High PTH
Ca, PO4 and PTH in; vitamin D deficiency
Low calcium
Low phosphate (as PTH is high)
High PTH
Outline T2DM medications, examples, MOA and side effects.
Write out as much as can then check notes.
Cushing’s diagnosis
9 AM ACTH; low in adrenal causes or exogenous glucocrticoids. High in ectopic or DISEASE.
High dose dexamethasone; suppression means DISEASE (do MRI), non-supressed means ectopic ACTH production
Causes of diabetes insipidus
Cranial; pituitary tumour, infection, sarcoidosis
Nephrogenic; high calcium, low potassium, lithium, AVPV2 gene, idiopathic
Treatment of diabetes insipidus
Treat cause
Cranial; intranasal desmopressin
Nephrogenic; thiazide diuretic or NSAIDs
Causes of SIADH
CNS pathology, lung pathology, drugs (SSRI, TCA, opiates, PPI, carbamazepine), tumours
Treatment of SIADH
cause. fluid restrict. if persists then demeclocycline or vasopressin receptor antagonist eg tolvaptan
Do you see anything else with hypothyroidism
Hyperprolactinemia
