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Icm > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What is cortisol

A

Glucocorticoid hormone
Increase blood sugars
Aiding in fat protein carb metabolism
Anti inflammatory

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2
Q

Where is cortisol produced

A

Adrenal cortex - zona fasciculata

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3
Q

What triggers cortisol release

A

hypothalamus reacts to low levels cortisol
Produces CRH
cHR stimulates ACTH production in pituitary
ACTH stimulates adrenal cortex to produce cortisol
Cortisol stimulates the medulla to secrete adrenaline and norad

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4
Q

Causes of primary adrenal failure

A

Autoimmune- addisons
Tumour
Sepsis
Ischaemia

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5
Q

What is a marker of Addison’s disease

A

21 hydroxylase autoantibodies

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6
Q

What causes secondary and tertiary adrenal failure

A

Secondary- absent acth production from pituitary problems (surgery or Tumour)

Tertiary failure of crh production from hypothalamus

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7
Q

What is sick euthyroid

A

Dyregulation of thyrotropic feedback when t3 or t4 are abnormal

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8
Q

Tell me about the Correction of sodium

A

Correct with hypertonic saline until over 120

Increase by no more than 8-10 over 24 hours

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9
Q

Tell me about siadh changes

A

Normovolaemic
High urinary sodium
Low osmolality state

Failure to suppress adh

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10
Q

Causes hyperosmolar hyponatraemia (>295)

A

Hyperglycaemia

Mannitol

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11
Q

Causes of normal osmolality hyponatraemia

A

Pseudohyponatraemia

  • hyperlipidaemia
  • hyperproteinaemia
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12
Q

Causes of hypo osmolar (<285)
Hyponatraemia with hypovolaemia
and low urinary sodium

A 
Vomiting 
Diarrhoea 
Sweating 
Burns
Pancreatitis
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13
Q

Causes of hypo osmolar (<285)
Hyponatraemia with hypovolaemia
and high urinary sodium

A

Diuretics

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14
Q

Causes of hypo osmolar (<285)
Hyponatraemia with normovolaemia
and high urinary sodium

A

Hypothyroidism
Adrenal insufficiency
Siadh

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15
Q

Causes of hypo osmolar (<285)
Hyponatraemia with normal volume
and low urinary sodium

A

Low solute intake

Polydipsia

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16
Q

Causes of hypo osmolar (<285)
Hyponatraemia with hypervolaemia
and low urinary sodium

A

CCF
Nephrotic syndrome
Cirrhosis

17
Q

Causes of hypo osmolar (<285)
Hyponatraemia with hypervolaemia
and high urinary sodium

A

Renal failure

18
Q

What is a high and low urinary sodium

A

Low < 20

High > 20

19
Q

What is a normal osmolality

A

285-295

20
Q

What is central pontine myelinosis

A

symmetrical midline demyelination of the central pons

Motor dysfunction, respiratory paralysis and change in mental state

21
Q

Causes of siadh

A

Drugs - antidepressants, antipsychotics, vincristine

Malignancy- sclc, brain, pancreas

Cns infection, trauma, ischaemia

Pulmonary- pneumonia, ards

22
Q

Define gpa

A

Small and medium vessel vascitilits involving the formation of granuloma

Commonly affect the lungs, upper respiratory tract and kidneys

23
Q

Diagnosis of GPA

A

Anna
Pr3
Less commonly mpo

24
Q

Diagnosis goodpastures

A

Anti gbm

Anca

25
Q

Diagnosis eosinophilic granulomatosis with polyangitis

A

P- Anca with mpo

Serum iGg

26
Q

Define eosinophilic granulomatosis with polyangitis

A

Inflammation of small and medium vessels affecting the skin heart kidneys and gut

Allergic stage, eosinophilia stage (weight loss, night sweats asthma abdo pain) vascularised stage

27
Q

Define sle

A

Auto immune multisystem disease with expression of B and T cells with deficiency in phagocytosis

Photosensitive Discoid or malar rash with pleurisy, pericarditis, arthritis, aki

28
Q

Diagnosis SLE

A

Ana

Anti ena

29
Q

Define sjogrens

A

Autoimmune disease characterised by lymphocytic infiltration of exocrine glands causing dry eyes dry mouth and joint pain

30
Q

Diagnosis sjogrens

A

Ana
Anti ro
Anti la
RF

31
Q

Define phaochromocytoma

A

Adrenal medullary tumour that secrets catecholamines leading to HTN , sweating and anxiety

32
Q

Treatment of phaeochromocytoma

A

Alpha blocker
+- beta blocker

Give mgso4 intra op and vasopressin and fluid for low BP

33
Q

Define tumour lysis syndrome

A

Breakdown of malignant cells releases K phosphate and decreases calcium

Phosphate binds and crystallises in renal tubules and release of Uric acid deposits in kidneys

34
Q

Prevention and treatment of Tumour lysis

A

Prevent
- allopurinol
Rasburicase
3l in 24hrs

Treat
Rasburicase (uric acid to soluble form) 
Phosphate binder 
Hydrate 
rRT

Icm (16 decks)

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