endo+gastro Flashcards
Nelsons syndrome
post B/L adrenalectomy,adenoma ACTH production, increased pigmentation
Nelsons syndrome prevention
Pituitary radiotherapy
octreotide key side effect
gallstones(30%)
Pioglitazone contraindications(2)
Heart failure, LFT derangement
Kallman syndrome(hypogonadotrophic hypogonadism)- 2 key features on top of no secondary sexual characteristics and short stature
Lack of smell, cleft palate
latent autoimmune diabetes of Adults(LADA)
Type 1 DM in older people
Type of autoimmunce cells seen in T1DM
Islet cells
Impaired glucose tolerance level
glucose reading after oral glucose tolerance(7.8-11.1)
Impaired fasting glucose level
Fasting glucose (6.1-7.0)+ normal oral glucose tolerance.(<7.8)
Specific features of graves disease
pretibial myxoedema, acropachy, ophthalmoplegia, exophthalmos
NOT a specific feature of graves disease
Lid lag(thyrotoxicosis)
suitability of islet cell transplant
2 or more severe hypos+ impaired hypoglycaemic awareness
Initial insulin regime for T1DM
Twice daily premixed insulin
Initial insulin regime for T2DM
once a day insulin
dizziness, blurred vision upon standing, profuse sweating when eating- diabetic
Autonomic neuropathy(affects blood pressure, digestion, respiratory function, urination, sexual response and vision)
diabetic- burning sensation at both feet which is worse at night
distal symmetric peripheral neuropathy(numbness, tingling, prickling sensations)
pseudohypoparathyroidism
short 4th and 5th fingers(genetic), low calcium, high phosphe, ELEVATED parathyroid levels
Pseudopseudohypoparathyroidism
same as pseudo +normal biochemistry results
Secondary hypoparathyroidism causes (2)
1) damage or removal of parathyroid glands
2) Hypomagnesiaemia
Addisons disease key investigation
Short synacthen
addisons serum changes
hyponatraemia, hyperkalaemia, hypoglycaemia
Insulinoma key features
1) low glucose, high insulin levels
2) associated with MEN
Dumping Syndrome key surgical proponent
Fundoplication to treat reflux(wrapping upper portion of stomach to give lower oesophagus some pressure)- can lead to unintended nerve damage
Dumping syndrome- what is it?
Ingested food bypasses stomach rapidly and enter small bowel- pancreas overproduces insulin- leads to hypo post food(flushing, shaking, dizzyness)
Klinefelter’s syndrome chromosome
XXY- tend to be diagnosed later as adults.- most common sex chromosome disorder
Klinefelters features
low testosterone- absent body hair, GYNAECOMASTIA
learning difficulties, tall.
Hyperthyroidism key male symptom
Decreased libido(decrease in testosterone levels)
Sheehans syndrome- key featurss
Panhypopituitarism post partum haemorrhage. Secondary amenorrhoea( hypogonadism), fatigue( hypocortisolaemia), failure of lactation( hypoprolactinaemia), feature of hypothyroidism.
Most common eosinophilic pituitary adenoma
Growth hormone tumour
Most common pituitary adenoma in children
Prolactinoma
Most common pituitary adenoma adults
Growth hormone adenoma
Brimocriptine and cabergoline. Key endocrine treatment
Dopamine agonists- key treatment for prolactinaemia
Domperidone, haloperidol, chlorpromazine, metoclopramide- class of drug and side effect
Dopamine antagonists- hyperprolactinaemia
Symptoms of hyperprolactinaemia
Hypogonadism, loss of libido, erectile dysfunction
Microprolactinoma- how common compared to macroprolactinoma
90% microprolactinoma-
10% macroprolactinoma >10mm diameter
Wolfram syndrome(triad)(DOD)
Diabetes mellitus ,optic atrophy, deafness
Optic atrophy symptoms
Colour vision and poor peripheral vision
Lithium - Kidney damage symptoms
Nephrogenic diabetes insipidis- polyuria, polydipsia and persistent thirst
Demeclocycline used in animal bites infections- key caution
Nephrogenic diabetes insipidus
Sore throat, cervical lymphadenopathy and palatal petechiae
Epstein Barr virus
most common organism SBP
E.coli
Antibiotic prophylaxis for SBP
Ciprofloxacin/norfloxacin
management of SBP
IV cefotaxime
triple therapy in htn
ACE+CCb+ Thiazide like diuretic
what to give when triple therapy HTN does not work
Doxazocin(if K+ >4.5)
Spiro(If K+ <4.5)
pernicious anaemia is a RF for what cancer
gastric
when to stop omeprazole for endoscopy
2 weeks before
