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Phase 2a Basic Knowledge > Endocine Missed Points > Flashcards

Endocine Missed Points Flashcards

1
Q

What drug may cause hypokalaemia

A

Salbutamol is associated with hypokalaemia

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2
Q

What drug is associated with Hyperkalaemia

A

ACEi - ramapril

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3
Q

What can inhibit GH in normal physiology

A

Dopamine

Hyperglycaemia

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4
Q

Cause of primary hyperaldosteronism

A

(Unilateral) Adrenal adenoma - 1/3 = conns syndrome

Bilateral adrenal hyperplasia - 2/3

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5
Q

Main cause of secondary hypertension

A

Conns syndrome

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6
Q

1st line investigation for conns syndrome

A

Aldosterone: renin ratio

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7
Q

Investigations for conns syndrome / hyperaldosteronism

A

Aldosterone : renin ratio

AVS (adrenal venous sampling)

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8
Q

What does AVS show

A

AVS = adrenal venous sampling

Shows if excessive hormones are being secreted from the adrenal glands

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9
Q

How do you differentiate from conns syndrome & bilateral adrenal hyperplasia

A

HRCT (high-resolution CT) abdomen + AVS

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10
Q

Primary hyperparathyroidism results..?

A

Calcium = high —> should trigger -ve feedback so PTH should be low, if Normal/high = primary hyperparathyroidism

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11
Q

Secondary hyperparathyroidism results..?

A

Ca2+ low (Vit d deficiency / renal impairment)
High PTH

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12
Q

In pheochromocytoma surgical treatment what else is done

A

Give alpha blocker prior surgery - phenylbenzamine

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13
Q

1st line treatment for T2DM

A

LIFESTYLE ADVICE

Then meds: 1st line medication = metformin

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14
Q

Gold standard investigation / Dx for pheochromocytoma

A

Elevated plasma free metanephrine

Then…

After G.S. Do MRI of adrenal

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15
Q

If Px previously Dx with autoimmune condition remember….

A

If Px has Sx of another autoimmune condition then its probably the new Dx

E.g. Px previous Dx with T1DM and presents with new symptoms like… hypotensive, salt craving, tanned, weight loss/anorexia = Addisons

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16
Q

Signs / symptoms for Addisons

A

Hyperpigmentation

Salt craving (decrease aldosterone —> increased Na+ excretion // increased K+ absorption)

Anorexia / weight loss

Hypoglycaemic

Vitiligo + change in body hair

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17
Q

Which thyroid cancer is most abundant

A

Papillary

Follicular

Medullary + anaplastic

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18
Q

Give a corticotropin independant cause of Cushing’s

A

Iatrogenic (steroid use) - most common overall cause

Adrenal adenoma

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19
Q

Give corticotopin dependant causes of Cushing’s

A

Cushings disease - most common ACTH dependant cause

Ectopic ACTH (SCLC)

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20
Q

What causes pseudo Cushing’s

A

Alcohol use

Resolves in 1-3 weeks

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21
Q

When is IgE seen

A

In allergic diseases

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22
Q

When is IgG seen

A

IgG is most common immunoglobulin

Seen in graves

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23
Q

Which immunoglobulin is seen in graves

A

IgG

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24
Q

Signs / symptoms for Hypercalcaemia

A

Stones - renal / biliary
Bones - bone pain / fractures
Psychiatric moans - depression
Abdominal groans - abdominal pain, constipation, pancreatitis

Polyuria + polydipsia

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25
Q

Hyperkalaemia ecg changes

A

GO ; absent p waves
GO LONG ; pronged PR interval
GO TALL ; tall tented T waves
GO UNDER ; wide QRS

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26
Q

Type of oedema seen in Graves and in Low serum albumin

A

Graves - NON-PITTING oedema

Low serum albumin - PITTING oedema
(Leakage of water in tissue)

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27
Q

Results of primary hypothyroidism..?

A

Low T3/4
High TSH

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28
Q

Results of secondary hypothyroidism?

A

Low T3/4
Low TSH (pituitary adenoma compresses TSH secreting cells

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29
Q

Common Sx of PCOS

A

Hirsutism
Acne
Oligoamenorrhoea

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30
Q

ADH synthesis..?

A

Supraoptic nuclei of hypothalamus

Stored in posterior pituitary

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31
Q

Where is glucagon secreted from

A

Alpha pancreatic cells

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32
Q

When is glucagon secreted

A

In response to hypoglycaemia

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33
Q

Role of glucagon

A

Acts on liver to convert glycogen —> glucose

Increases lipolysis + proteolysis

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34
Q

Difference in insulin and glucagon structure

A

Glucagon —> single polypeptide (29 amino-acids)
Insulin —> 2 polypeptides (51 amino acids)

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35
Q

How’s Vit D activated…

A

PTH increases activity of 1alpha-hydroxylase enzyme

Increased conversion of 25-hydroxycholecaleciferol —> 1, 25-dihydroxycholecaliciferol (active form of Vit D)

Helps Ca2+ absorption in small intestine

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36
Q

The role of PTH in osteoclast activity

A

Indirect stimulation of osteoclasts to increase bone resorption

OPG (secreted by osteoblasts) binds to block RANK-L : RANK complexes which are used to help mature osteoclasts for reduced bone resorption
so… PTH inhibits OPG… theres more complexes formed so more osteoclasts activity

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37
Q

Role of PTH…

A

Vit D activation….
Increases Ca2+ absorption in kidneys
Increased Ca2+ gut reabsorption
Increased osteoclast activity for bone resorption

Decreased phosphate reabsorption

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38
Q

Role of round ligament

A

Maintains anteverted position of uterus

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39
Q

Role of ovarian ligament

A

Connects ovaries to uterus

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40
Q

Role of cardinal ligament

A

Connects cervix —> later pelvic wall (supports vagina + cervix)

Contains uterine artery + vein

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41
Q

Role of broad ligament

A

Connect uterus —> pelvic wall

Splits pelvic cavity into uteri rectal pouch & uterovesicle pouch

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42
Q

Where does uterine arteries + vaginal arteries branch from

A

Internal pudendal arteries

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43
Q

What branch is the ovarian arteries come from

A

Abdominal aorta

44
Q

Function of laydig cells

A

Produce testosterone

45
Q

What stimulates wolffian duct to differentiate and into what

A

Testosterone

Into… epididymis, ejaculatory ducts, vas deferens, seminal vesicles

46
Q

More potent version of testosterone and what does that form

A

Dihydrotestosterone

Later leads to penis, scrotum, prostate formation

47
Q

Type of epithelium of vas deferens

A

Pseudostratified squamous with stereocilia lined by smooth muscle

48
Q

Time frame of fertilisation after ovulation

A

Within 24-48 hrs

49
Q

Where does fertilisation of egg take place

A

Ampulla of the fallopian tube

50
Q

Stages of zygote development

A

Day What happens..?
1. Fertilisation
2-3. Cleavage (increasing cell no. For cell differentiation )
4. Compaction (flattening of cells)
5. Cavitation and differentiation
21. Implantation

51
Q

Contents of spermatic duct..?

A

Remember rule of 3…
3 arteries
3 nerves
3 fascia’s
3 others….

Inguinal nerve runs outside spermatic duct outside inguinal canal

52
Q

If Px is being treated with long-term steroids + they stop…. Think of what…

A

Suppression of adrenal glands
Secondary’s adrenal insufficiency

53
Q

What cancers can cause SIADH

A

Think ectopic ADH…
SCLC
Pancreatic
Prostate
Lymphomas

54
Q

Most commonly caused by renal impairment

A

Hyperkalaemia

55
Q

Causes of renal impairment….

A

Hyperkalaemia
Trauma
Addisons
DKA

56
Q

Sx for Hyperkalaemia

A

Palpitations
Dyspnoea
Hyperreflexia
Paraesthesia
Abdominal pain + diarrhoea

57
Q

Complications of acromegaly

A

T2DM
Sleep apnoea
Cardiomyopathy
Colorectal cancers

58
Q

1st line investigation for acromegaly and why

A

GH is pulsatile so IGF-1 is 1st line investigation

59
Q

1st line treatment for acromegaly

A

Trans-sphenoidal resection … or …

Medication:
Dopamine agonists (Cabergoline / Bromocriptine)
SST analogue (octreotide)
GH antagonist (pegvisomant)

60
Q

Differential; diagnosis for polyuria and polydipsia

A

DM
DI
Primary polydipsia
Hypercalcaemia
Hyperparathyroidism

61
Q

Most likely cause of primary hyperparathyroidism

A

Solitary adenoma (80%)

62
Q

Definitive treatment hyperparathyroidism

A

Total parathyroidectomy

63
Q

Differential Dx for T2DM

A

Acromegaly
Cushing
Hypothyroidism

64
Q

1st line investigation for Cushing’s

A

Overnight dexamethasone

65
Q

Most common cause Cushing’s syndrome

A

Exogenous steroids

66
Q

Differential Dx for conns

A

Primary hyperparathyroidism
DM
Renal artery stenosis
SIADH

67
Q

Hypercalcaemia ECG changes

A

Short QT interval

68
Q

Sx / sign of hypocalcaemia

A

CATs go numb

Convulsion
Arrythmias
Tetany

Numbness

Chvostek
Troussoea

69
Q

When do you see…
Chvostek
Troussoea

A

Hypocalcaemia

70
Q

Where does superior thyroid artery branch off from

A

External carotid artery

71
Q

Where does inferior thyroid artery branch off from

A

3rd branch of subclavian
(Thyrocervical branch)

72
Q

Define Hypercalcaemia of malignancy

A

Caused by excessive secretion of PTHrP (parathyroid hormone peptide)

73
Q

Generalised Sx of pituitary adenoma

A

Headaches
Visual disturbance
N&V
Fatigue
Unexplained weight loss/gain

74
Q

Signs / symptoms of carcinoid tumour /// syndrome

A

Flushing
Diarrhoea
Asthma-like wheeze // SoB
Tricuspid incompetence (murmur)

75
Q

Define carcinoid syndrome

A

Poorly malignant tumour of enterochromaffin cells that secrete serotonin

76
Q

What drug decreases thyroid hormone production

A

Carbimazole

77
Q

Mechanism of action of carbimazole for decreased thyroid hormone production

A

Blocks thyroid peroxidase from coupling & iodinating the tyrosine residues on thyroglobulin

Decreasing thyroid hormone production

78
Q

Signs / Sx of DKA

A

Reduced consciousness
Fruity breath
Kausmauls breathing
Tachycardia + hypotensive

79
Q

Tx of Hyperkalaemia

A

Calcium gluconate (if showing ecg changes / Arrythmias)

Insulin + dextrose

80
Q

First line treatment type 2

A

ALWAYS CONSERVATIVE ;
Dietary and lifestyle changes

Then if asks about medication; metformin

81
Q

ECG changes seen in hypokalaemia

A

U waves
Prolonged QT
Inverted t waves

82
Q

What Sx does carcinoid syndrome come with

A

Diarrhoea
Itching
SOB
Facial flushing

83
Q

Complications of hyperthyroidism

A

Hyperthyroid crisis

Atrial fibrillation

84
Q

Side effect of carbimazole

A

Used for hyperthyroidism Tx

Agranulocytosis
Pancytopenia; bone marrow suppression

85
Q

Most common cause of hypothyroidism

A

Autoimmune condition; Hashimoto’s

86
Q

Complication of Addison’s

A

Addisonian crisis

+

Osteoporosis

87
Q

Tx for Addisonian crisis

A

Aggressive IV fluids and iv steroids

+

Glucose if hypoglycaemic

88
Q

Side effect of Amiodarone

A

Hypothyroidism

Can also cause hyperthyroidism

89
Q

What’s a byproduct of insulin

A

Serum-C peptide protein is a product of insulin PRODUCTION

90
Q

How do you tell the difference between exogenous and endogenous insulin effects

A

If serum-C peptide is raised it means the insulin is excessive endogenous production

91
Q

Most common cause of Addison’s

A

Autoimmune adrenalitis

92
Q

Give a severe complication of DKA

A

Cerebral oedema

93
Q

Which DI does lithium toxicity cause

A

Nephrogenic diabetes insipidus

94
Q

Which condition is linked to meningitis that decreases glucose

A

Waterhouse - friderichson syndrome

95
Q

What is the Tx of diabetic neuropathy

A

Pregabalin

96
Q

Target blood pressure for under 80s

A

<140/90

97
Q

Target blood pressure for over 80s

A

<150/90

98
Q

Which diabetes medication can give weight gain as a side effect

A

Sulfonylurea

99
Q

Symptomatic relief for hyperthyroidism

A

Propranolol

100
Q

Commonest cause of hypopituitarism

A

Pituitary adenoma

101
Q

A non-GI side effects of metformin

A

B12 deficiency
Lactic acidosis

102
Q

3 complications of HHS

A

MI
Stroke
Cerebral oedema

103
Q

What Sx is described as darkening of the skin folds and which disease can it be seen in

A

Acyanthosis nigracans

Sx of T2DM; seen under armpits, back of neck and groin

104
Q

Which diabetic medication can cause pulmonary oedema

A

Pioglitazone

105
Q

Which diabetic medication is related to UTIs

A

Dopagliflozin

Phase 2a Basic Knowledge (13 decks)

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