Endocrine Flashcards
Process of T3/4 production
Hypothalamus makes TRH
Pituitary makes TSH
Thyroid makes T3/4
Difference between Grave’s and De Quervain’s
Graves is painless goitre, de Quervains is painful goitre
treatment graves
Propanolol and carbimazole
Treatment hashimoto
Levothyroxine
Treatment de Quervains
NSAIDs
Treatment iodine deficiency
Iodine replacement
Diabetes 2 treatment pathway
lifestyle changes
metformin
Gliclazide when no concern about weight, sitagliptin when there is
Cushings cause
high cortisol - steroids or pituitary tumour
Cushing’s symptoms
Moon face, buffalo hump, high BP, striae, loss of strength
Addison’s cause
Low cortisol and low aldosterone
destructions of adreansl
Bloods for Addisons
Low Na+, low glucose, high K+
Sx Addisons
Lethargy, hyperpigmentation, vitiligo, hyponatraemia and hyperkalaemia
Signs fibroidd
menorrhagia and dysmenorrhea
Suprapubic mass
Pelvic pressure and discomfort
Diagnosing fibroids
Transvaginal US
management fibroids
<3cm mirena coil + NSAID + tranexamic acid
>3cm surgery
Endometriosis sx
Abdominal pain, chocolate cysts on USS
Diagnosing endometriosis
Laparoscopy
Sx ectopic pregnancy
Shoulder tip pain, unilateral pelvic pain, chandelier’s sign
treatment ectopic pregnancy
methotrexate or surgery
Stress incontinence
Leaking of urine due to increases abdominal pressure
Urge incontinence
Involuntary loss of urine associated with urgency
Tx stress incontinence
Pelvic floor exercise, duloxetine
Tx urge incontinence
Bladder train and anticholinergic
Missing 1 COCP
Take missing pill, no extra protection needed
Missing >1 COCP
Take most recent missed pill ASAP
Abstain from sex until 7 days taking pill
Missing POP
Take pill ASAP, continue with next pill and extra contraception for 48 hours
When can you start COCP after pregnancy?
6 weeks
When can you start POP after pregnancy?
Anytime
bacterial vaginosis sx
Fishy smelling, watery discharge
pH >4.5
Tx bacterial vaginosis
Metronidazole 400mg
Candidiasis sx
pH <4.5
Cottage cheese discharge
candidiasis treatment
clotrimaxole
Chlamydia sx
Dysuria, abnormal bleeding
tx chlamydia
doxycycline 100mg
Gonorrhoea sx
dysuria, abnormal discharge - odourless but yellow/green
Abnormal bleeding
tx gonorrhoea
Ceftriaxone
PID sx
dysuria, abnormal discharge, cervical tenderness
Tx PID
doxycycline + ceftriaxone
Ovarian torsion sx
Worst pain
Palpable pelvic mass
Tenderness
Whirlpool sign on USS
Sheehan’s syndrome
Complication following PPH
PPH = low blood volume = low BP = low perfusion of pituitary = AVN
Sx Sheehan’s syndrome
lack of milk production + amenorrhea
Most common type of ovarian cancer
serous
Sx Grave’s disease
Weight loss
Heat intolerance
Anxiety and tremor
Smooth, painless goitre
Exophthalmos
ABs in Grave’s
Anti-TSH
Tx Hashimoto
Levothyroxine
What is De Quervain’s syndrome?
Viral infection causes painful goitre
Function of adrenal medulla
Chromaffin cells to make catecholamines - adrenaline etc
Treatment pathway for t2 diabetes
first line: metformin
second line: metformin + gliclazide
third line: metformin + 2x gliptins/sulfonylureas/pioglitazone/gliflozins
Treatment pathway for t2 diabetes
first line: metformin
second line: metformin + gliclazide
third line: metformin + 2x gliptins/sulfonylureas/pioglitazone/gliflozins
treatment for t1 diabetes
Insulin
S/e insulin
Hypoglycaemia and weight gain
MOA metformin
Decreases hepatic gluconeogenesis
MOA sulfonylureas
Stimulate B cells to make insulin
S/e sulfonylureas
Weight gain and hyponatraemia