ENDOCRINE Flashcards
Which insulin do you give once a day
basal (long acting) e.g. Lantus
DIFFERENT names for insulins
rapid acting analogue (humalog, novorapid)
short-acting (humulin S, actrapid)
intermediate acting (insulatard, humulin I)
long acting (lantus, levemir)
rapid acting analogue-intermediate mix (humalog mix25, novomix30)
short acting-intermediate mix (humulin M3)
Glucocorticoid receptor
binds corticosteroids
Thyroxine biochemistry
T3 is more active than T4 and they work on nuclear receptor THR
Which diabetic drug is weight neutral
DPP4 Inhibitors e.g. sitagliptin
Weight loss diabetic drug
GLP1 agonist e.g. exenatide
Which causes glycosuria
– SGLT2 inhibitor e.g. dapagliflozin
Hyperparathyroidism causes what conditions?
– bone disease, renal stones, GI complications, depression, lethargy, seizures, weakness, fatigue, calcification of aortic and mitral valves
Hypoparathyroidism causes what
– rare, neuromuscular irritability, Chovstek’s sign, Trousseau’s sign, emotional lability, anxiety, confusion, psychosis, basal ganglia calcification, cataract formation, prolonged QT, dental abnormalities
Strawberry milkshake coloured blood ?
hyperlipidaemia
What hormone do you test for in pregnancy –
HCG
Which hormone peaks before ovulation
– LH ~ 12 hours before
What hormone do you test for fertility –
progesterone
Pagets what is it
(normal Ca and phosphate, high alk phos) increased osteoclastic reabsorption followed by increased osteoblastic activity
pagets aetiology
Old age, male, FH. Bone pain (pelvis, lumbar spine, femur).
pages treatment and complications
Tx: Bisphosphonate (risedronate). Complications - deafness, cardiac failure, fractures, skull thickening
Osteomalacia – (rickets in children) - what is it?
vit D deficiency. Low Ca & phosphate & high alk phos. abnormal softening of bone due to deficient mineralization of osteoid (immature) bone
causes/symptoms/treatment of osteomalacia
Causes are vit D def (malabsorption, poor diet or lack of sunlight).
Bone pain, tenderness, fractures - esp femoral neck, proximal myopathy - waddling gait.
Tx: Vit D therapy with Ca & phosphate supplements.
cause of bone mets
Bone mets – high Ca. Osteoclast proliferation. Bone pain
what is indicative of normal biochem and bone pain
osteoporosis
graves symptoms/signs
gradual onset mild/moderate thyroid enlargement diffuse enlargement on palpation hyperdynamic tachycardia heat intolerance thrill or bruit over thyroid tremor present dysthyroid eye disease restless anxious insomnia warm sweating pretibial myxoedema
increased BMR weight loss (or gain due to appetite), raised T4 and free T3, suppressed TSH
hashimotos
slow onset can be huge or impalpable enlargement firm and well-defined lymph nodes bradycardia cold intolerance tremor absent hoarseness dysphagia pressure effect sleep apnoea fatigue depression pseudo-dementia memory dysfunction decreased sweating hair loss neuropathies weight loss low T4 and free T3, raised TSH
de quervians
acute, painful, moderate swelling, smooth, diffuse and tender bilateral swelling, initially transiently hyperdynamic, tremor in early stages, painful dysphagia, initially warm with sweating, flu-like symptoms, raised T4 and free T3, supressed TSH
multi nodular goitre
slow onset (years), mild/moderate swelling with palpable nodules, normal CVS, no tremor, obstructive neck symptoms, normal mental health and skin, normal bloods Idiopathic thyroid swelling – gradual onset, moderate smooth swelling, no CVS symptoms, no tremor, mild pressure effects, normal mental health, no skin changes or other symptoms of note, increased BMR, weight loss (or gain due to increased appetite), normal bloods
