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Endocrine Flashcards

1
Q

Process of T3/4 production

A

Hypothalamus makes TRH
Pituitary makes TSH
Thyroid makes T3/4

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2
Q

Difference between Grave’s and De Quervain’s

A

Graves is painless goitre, de Quervains is painful goitre

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3
Q

treatment graves

A

Propanolol and carbimazole

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4
Q

Treatment hashimoto

A

Levothyroxine

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5
Q

Treatment de Quervains

A

NSAIDs

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6
Q

Treatment iodine deficiency

A

Iodine replacement

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7
Q

Diabetes 2 treatment pathway

A

lifestyle changes
metformin
Gliclazide when no concern about weight, sitagliptin when there is

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8
Q

Cushings cause

A

high cortisol - steroids or pituitary tumour

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9
Q

Cushing’s symptoms

A

Moon face, buffalo hump, high BP, striae, loss of strength

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10
Q

Addison’s cause

A

Low cortisol and low aldosterone
destructions of adreansl

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11
Q

Bloods for Addisons

A

Low Na+, low glucose, high K+

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12
Q

Sx Addisons

A

Lethargy, hyperpigmentation, vitiligo, hyponatraemia and hyperkalaemia

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13
Q

Signs fibroidd

A

menorrhagia and dysmenorrhea
Suprapubic mass
Pelvic pressure and discomfort

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14
Q

Diagnosing fibroids

A

Transvaginal US

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15
Q

management fibroids

A

<3cm mirena coil + NSAID + tranexamic acid
>3cm surgery

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16
Q

Endometriosis sx

A

Abdominal pain, chocolate cysts on USS

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17
Q

Diagnosing endometriosis

A

Laparoscopy

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18
Q

Sx ectopic pregnancy

A

Shoulder tip pain, unilateral pelvic pain, chandelier’s sign

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19
Q

treatment ectopic pregnancy

A

methotrexate or surgery

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20
Q

Stress incontinence

A

Leaking of urine due to increases abdominal pressure

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21
Q

Urge incontinence

A

Involuntary loss of urine associated with urgency

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22
Q

Tx stress incontinence

A

Pelvic floor exercise, duloxetine

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23
Q

Tx urge incontinence

A

Bladder train and anticholinergic

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24
Q

Missing 1 COCP

A

Take missing pill, no extra protection needed

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25
Q

Missing >1 COCP

A

Take most recent missed pill ASAP
Abstain from sex until 7 days taking pill

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26
Q

Missing POP

A

Take pill ASAP, continue with next pill and extra contraception for 48 hours

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27
Q

When can you start COCP after pregnancy?

A

6 weeks

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28
Q

When can you start POP after pregnancy?

A

Anytime

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29
Q

bacterial vaginosis sx

A

Fishy smelling, watery discharge
pH >4.5

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30
Q

Tx bacterial vaginosis

A

Metronidazole 400mg

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31
Q

Candidiasis sx

A

pH <4.5
Cottage cheese discharge

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32
Q

candidiasis treatment

A

clotrimaxole

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33
Q

Chlamydia sx

A

Dysuria, abnormal bleeding

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34
Q

tx chlamydia

A

doxycycline 100mg

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35
Q

Gonorrhoea sx

A

dysuria, abnormal discharge - odourless but yellow/green
Abnormal bleeding

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36
Q

tx gonorrhoea

A

Ceftriaxone

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37
Q

PID sx

A

dysuria, abnormal discharge, cervical tenderness

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38
Q

Tx PID

A

doxycycline + ceftriaxone

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39
Q

Ovarian torsion sx

A

Worst pain
Palpable pelvic mass
Tenderness
Whirlpool sign on USS

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40
Q

Sheehan’s syndrome

A

Complication following PPH
PPH = low blood volume = low BP = low perfusion of pituitary = AVN

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41
Q

Sx Sheehan’s syndrome

A

lack of milk production + amenorrhea

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42
Q

Most common type of ovarian cancer

A

serous

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43
Q

Sx Grave’s disease

A

Weight loss
Heat intolerance
Anxiety and tremor
Smooth, painless goitre
Exophthalmos

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44
Q

ABs in Grave’s

A

Anti-TSH

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45
Q

Tx Hashimoto

A

Levothyroxine

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46
Q

What is De Quervain’s syndrome?

A

Viral infection causes painful goitre

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47
Q

Function of adrenal medulla

A

Chromaffin cells to make catecholamines - adrenaline etc

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48
Q

Treatment pathway for t2 diabetes

A

first line: metformin
second line: metformin + gliclazide
third line: metformin + 2x gliptins/sulfonylureas/pioglitazone/gliflozins

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48
Q

Treatment pathway for t2 diabetes

A

first line: metformin
second line: metformin + gliclazide
third line: metformin + 2x gliptins/sulfonylureas/pioglitazone/gliflozins

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49
Q

treatment for t1 diabetes

A

Insulin

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50
Q

S/e insulin

A

Hypoglycaemia and weight gain

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51
Q

MOA metformin

A

Decreases hepatic gluconeogenesis

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52
Q

MOA sulfonylureas

A

Stimulate B cells to make insulin

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53
Q

S/e sulfonylureas

A

Weight gain and hyponatraemia

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54
Q

E.g. sulfonylureas

A

Gliclazide

55
Q

MOA thiazolidinediones

A

Activate PPAR = adipogenesis and fatty acid uptake

56
Q

S/e thiazolidinediones

A

Weight gain and fluid retention

57
Q

MOA DPP-4 inhibitors

A

Increases incretin levels = inhibited glucagon

58
Q

MOA SGLT-2 inhibitors

A

Inhibits glucose reabsorption in kidney

59
Q

Management Graves’s disease

A

Carbimazole

60
Q

Treatment for Hashimoto’s

A

Levothyroxine

61
Q

Sx primary hyperparathyroidism

A

Goitre, exophthalmos

62
Q

Tx primary hyperparathyroidism

A

Parathyroidectomy

63
Q

Sx secondary and tertiary hyperparathyroidism

A

Fractures, salt and pepper skull

64
Q

Sx primary hypoparathyroidism

A

Chvostek and Trousseau sign

65
Q

Investigations primary hypoparathyroidism

A

low PTH and calcium, high phosphate

66
Q

How to treat hypoparathyroidism

A

Calcium and vit D

67
Q

Sx acromegaly

A

Large hands and feet
Frontla bossing
ED
Galactorrhoea

68
Q

Management of acromegaly

A

Transsphenoidal surgery and ocreotide

69
Q

What is SIADH?

A

Too much ADH made - more water reabsorbed

70
Q

Sx SIADH

A

Headache, myalgia, N+V, coma

71
Q

Tx SIADH

A

Treat underlying condition
ADH antagonist

72
Q

What are the three parts of the fallopian tube?

A

Isthmus (closest to uterus), ampulla, infundibulum

73
Q

Where does fertilisation most commonly occur:

A

Ampulla (middle third of Fallopian tube)

74
Q

What is secondary amenorrhoea?

A

Periods have started but stop for 6+ months - due to stress etc

75
Q

What is primary amenorrhoea?

A

Periods haven’t started but breast development etc has - by age 15

76
Q

Absent vas deferens cause

A

Cystic fibrosus

77
Q

Sheehan syndrome

A

severe blood loss or extremely low blood pressure during or after childbirth. Lack of blood flow to the pituitary gland, can cause damage to the gland and lead the pituitary dysfunction

78
Q

receptor on theca cell

79
Q

Receptor on granulose cell

80
Q

Ulipristal acetate

A

EllaOne - used as emergency contraception
Take within 120 hours
Selective progesterone receptor modulator - inhibits ovulation

81
Q

How long before POP is effective?

82
Q

What are the two hormones involved in milk and their functions?

A

Oxytocin = milk ejection
Prolactin = milk production

83
Q

The testicular artery is a branch of the …

A

Abdominal aorta

84
Q

Treatment for hypermeesis gravidarum

A

Antihistamines (cyclising or promethazine)
Ondansetron and metoclopramide are second line

85
Q

Most common cause of PID

86
Q

Most common cause od neonatal sepsis

87
Q

most common type of ovarian cancer

A

Serous carcinoma

88
Q

Risk factors for ovarian cancer

A

BRCA1/2 mutation
Early menarche, late menopause, nulliparity (all increase ovulations)

89
Q

Sx ovarian cancer

A

Abdo distension/bloating
Abdo/pelvic pain
Urinary urgency
Early satiety
Diarrhoea

90
Q

Diagnosing ovarian cancer

A

CA125 screen and US if raised

91
Q

Into which layer of the uterus does an embryo implant?

A

Submucosal

92
Q

Major arterial supply to breast

A

Internal mammary

93
Q

How to treat hypertension in pregnancy

A

Aspirin 75mg from 12 weeks pregnant

94
Q

Describe the process of fertilisation

A

Sperm penetrates corona radiata
Sperm head binds to zone pellucid
This triggers acrosome reaction - hydrolytic enzymes digest zone pellucid and create pathway to ovum
Sperm enter ovum
Sperm and ovum fuse
Sperm releases calcium ions to prevent polyspermy

95
Q

Where is onuf’s nucleus found

A

Anterior horn of s2 nerve roots

96
Q

Which hormone reduced BP in pregnancy?

A

Progesterone

97
Q

Advantages of breast feeding

A

Involution of uterus, protecting against breast and ovarian cancer
IgA and lactoferrin (ensures iron absorption) to baby, reduced incidence of ear infections and eczema, reduced T1DM

98
Q

Disadvantages of breast feeding

A

Jaundice
Vit d/k deficiency
Transmission of disease

99
Q

How do you differentiate between primary and primordial follicles?

A

Primordial contain oocyte and granulose cells
Primary marked by development of zone pellucida

100
Q

Up to what stage of oogenesis do cells develop in utero

A

Prophase I

101
Q

U; until what stage are oocytes held before fertilisation

A

Metaphase ii

102
Q

Skin layers of scrotum

A

skin
dartos muscle
external spermatic fascia
cremasteruc muscle
internal spermatic fascia
parietal layer of tunica vaginalis

103
Q

How do you extract fluid from pouch of Douglas?

A

Needle through posterior vaginal fornix

104
Q

What causes asymmetrical intrauterine growth reduction

A

Placental insufficiency

105
Q

Hormonal changes menopause

A

Cessation of estradiol and progesterone production

106
Q

What is an amniotic fluid embolism

A

Foetal cells enter mother’s bloodstream

107
Q

Sx amniotic fluid embolism

A

Chills, shivering, sweating, coughing, cyanosis, hypotension, tachycardia, MI

108
Q

What is acromegaly ?

A

Excess growth hormone due to pituitary adenoma

109
Q

Sx acromegaly

A
  • Spade-like hands
  • Coarse facial appeartance
  • Large tongue
  • Excessive sweating
  • Pituitary tumour sx - headaches, hypopituitarism, bi-temporal hemianopia
    ED
    galactorrhea
110
Q

Tx acromegaly

A

trans-sphenoidal surgery and somatostatin analogue - ocreotide

111
Q

Diagnosing acromegaly

A

OGTT
Glucose normally suppresses growth hormone. In normal OGTT, GH levels will be undetectable but in acromegaly they remain elevated

112
Q

Treatment for acute and chronic Addison’s

A

acute = hydrocortisone
Chronic = glucocorticoids and mineralocorticoid

113
Q

What is Bartter’s syndrome

A

Autosomal recessive cause of hypokalaemia following defective NaKCC transporters in aLOH
Like taking lots of furosemide

114
Q

Sx Bartter’s

A

Weakness
Polyuria/polydipsia
Hypokalaemia
Normotension

115
Q

most common cause of congenital adrenal hyperplasia

A

21-hydroxylase

116
Q

What is DKA

A

Complication of T1DM, uncontrolled lipolysis makes FFA that are converted to ketones
Caused by infection, missed insulin dose and MI

117
Q

Sx DKA

A

Abdo pain
Polyuria, polydipsia and dehydration
Kussmaul breathing
Acetone smelling breath

118
Q

Tx DKA

A

fluid bolus and insulin infusion

119
Q

Blood results for DKA

A

Glucose >11 or known diabetes
PH<7.3
bicarb <15
Ketones >3

120
Q

What is Klinefelter’s

A

An example of primary hypogonadism with high LH and low testosterone

Karyotype 47 XXY

121
Q

Sx Klinefelter’s

A
  • Very tall
  • Lack of secondary sexual characteristics
  • Small, firm testes
  • Infertility
  • Gynaecomastia
122
Q

What is Kallman’s syndrome

A

Delayed puberty due to hypogonadotrophic hypogonadism - failure of GnRH neurons in hypothalamus

A type of secondary hypogonadism

X-linked recessive

123
Q

Sx Kallman’s syndrome

A
  • Delayed puberty
  • Anosmia
  • LH and FSH levels are low
  • Cleft lip/palate
  • Normal/above average height
124
Q

drug causes of gynaecomastia

A

SPIRONOLACTONE, digoxin

125
Q

most common type of thyroid cancer

126
Q

treatment thyroid cancer

A

thyroidectomy and iodine

127
Q

which compound indicates thyroid cancer recurrence

A

thyroglobulin

128
Q

causes of primary hyperaldosteronism

A

unilateral can be by adrenal adenoma - Conn’s syndrome

129
Q

Sx primary hyperaldosteronism

A

hypertension and hypokalaemia

130
Q

Ix hyperaldosteronism

A

aldosterone:renin
CT
AVS

131
Q

Mx hyperaldosteronism

A

unilateral: surgeru
bilateral: aldosterone antagonist - spironolactone

132
Q

Water deprivation results for cranial DI

A

Low after deprivation, high after ADH

133
Q

Water deprivation tests for nephrogenic DI

A

Low after deprivation, high after ADH

134
Q

Which drug causes both hypo and hyper thyroidism

A

Amiodarone

AMK (33 decks)

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