Endocrine Flashcards
What is MODY, what is its inheritance pattern, what gene mutations are associated with it, and what is the first line treatment?
Type 2 DM before 25
Autosomal dominant
HNF1 alpha gene and glucokinase gene (MODY2)
Gliclazide
Causes of cushings syndrome
Iatrogenic - steroid therapy
ACTH causes - cushings disease and ACTH producing tumours
Cortisol producing tumours such as adrenal adenomas
Which electrolyte is lowered in Cushings?
Potassium
Which two tests are done in Cushings
Overnight dexamethasone test - morning cortisol spike would not be suppressed if they have cushings
24hr urinary cortisol
What would a high dose dexamethasone test show in an adrenal adenoma
Cortisol unsuppressed and ACTH suppressed
High dose dexamethasone test on cushings disease
ACTH and cortisol suppressed
High dose dexamethasone test results in an ectopic ACTH producing tumour?
ACTH and cortisol not suppressed
What antibodies are seen in hashimotos thyroiditis?
Anti-TPO (goitre and hypothyroidism)
What are the GLP-1 drugs in type 2DM?
Liraglutide and exenatide - cause weight loss - increase insulin but decrease glucagon
What are the DPP-4 inhibitors in type 2DM?
Gliptins - decrease peripheral breakdown of incretins which increases their levels
What is seen in primary hyperparathyroidism and what is its main cause?
Elevated PTH, elevated calcium, low phosphate, and urine Ca:creatinine clearance >0.01
Can get recurrent abdominal pain and changes to cognition (bones, groans, and intestinal moans)
Caused by solitary adenoma in majority of cases
Secondary hyperparathyroidism
High PTH, low or normal calcium, high phosphate, and low vitamin D. Result of parathyroid hyperplasia in the setting of chronic renal failure
Tertiary hyperparathyroidism
Normal calcium, high PTH, normal phosphate, normal Vitamin D, high ALP
Usually see metastatic calcification, bone pain
Tertiary occurs due to ongoing hyperplasia of the parathyroid even after correction of the underlying renal problem
