Endocrine Flashcards
Drug causes of SIADH?
Carbamazepine, SSRI, SUs, TCAs
Hashimotos thyroid cancer association?
MALT
MEN 1?
PTH
Pituitary
Pancreas
MEN IIa?
Phaeo
Medullary Thyroid Ca
PTH
MEN IIb?
Phaeo
Medullary Thyroid Ca
Marfanoid
Fibromas
Hypokalaemia but normotensive, often presenting in childhood with failure to thrive?
Bartters
Bartters defect?
Sodium potassium chloride pump in ascending limb of LoH
Hypercalcaemia with (inappropriately) high PTH?
Primary HPTH
SU mechanism?
Potassium ATP channel
Increase stimulation of insulin secretion by pancreatic B-cells and decrease hepatic clearance of insulin
Mainstay of treatment for MODY?
Gliclazide
Most common thyroid tumour, esp in young females?
Papillary
Thyroid malignancy in elderly females causing pressure symptoms?
Anplastic
Solitary nodule thyroid cancer?
Follicular
Gestational diabetes thresholds?
fasting glucose is >= 5.6 mmol/L
2-hour glucose is >= 7.8 mmol/L
First line for suspected acromegaly
IGF-1 measurement
DPP4s, examples and mechanism?
Gliptins
Think incretins
Hypothyroid
TPO
Goitre
Hashimoto’s
Congenital adrenal hyperplasia cause? What specific blood marker will be elevated?
21-hydroxylase deficiency
17-hydroxyprogesterone
Grave’s disease management?
Initially propranolol for symptoms
Then carbimazole
If euthyroid add thyroxine
RET oncogene?
Men IIa and IIb
First line hormonal treatment for prolactinoma?
Cabergoline
Glitazones mechanism and SEs
agonists of PPAR-gamma receptors, reducing peripheral insulin resistance
Weight gain
Fluid retention - not used in CCF
Liver injury
Hashimoto’s antibiody?
Anti TPO
Drug therapy in stress incontinence?
Duloxetine
Gynaecomastia drug causes?
Spiro
Digoxin
Finasteride
Gosrelin
Most common cause of Conn’s?
Bilateral adrenal hyperplasia
PCOS management:
1. Infertility
2. Acne and hirsutism
- Weight loss
Metformin if obese, clomifene - COCP, if fails then topical eflornithene
Statins safe in pregnancy?
No
Antibodies in Grave’s?
TSH receptor-stimulating
Extrathyroid features unique to Grave’s?
Pretibial myxoedema
Thyroid acropachy
Gitelmans features?
Normotension
Hypokalaemia
Hypocalciuria
Hypomagnasaemia
Metabolic alkalosis
History that sounds like a brief period of hyperthyroidism followed by hypothyroidism?
Subacute (de Quervein’s) thyroiditis
Presentation of insulinoma?
Hypoglycaemia: typically early in morning or just before meal, e.g. diplopia, weakness etc
Rapid weight gain may be seen!!
Hypocalaemia ECG finding?
Long QT
Most common non-iatrogenic cause of Cushing’s?
Pituitary tumour
Very high cholesterol and slight hyponatraemia?
Pseudohyponatraemia
Criteria for parathyroidectomy?
Age under 50 years.
Adjusted serum calcium concentration that is 0.25 mmol/L or more above the upper end of the reference range.
Estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2 although this threshold depends on other factors, such as age.
Renal stones or presence of nephrocalcinosis on ultrasound or CT.
Presence of osteoporosis or osteoporotic fracture.
Symptomatic disease
PTU or carbimazole in pregnancy?
PTU first trimester
Carbimazole after that
General HbA1c target in T1DM?
48
Target after commencing statin use in primary CVD prevention?
A greater than 40% reduction in non-HDL cholesterol
Familial hypercholesterolaemia inheritance and management?
AD
High dose statins
Tall, infertile, small firm testicles?
Karyotype?
Kleinfelter’s
47XXY
Mention of some secondary sexual characteristics in a largely female phenotype with “hernia”?
Androgen insensitivity syndrome - those herniae are undescended testicles
Most common MODY gene?
HNF-1 alpha
Mechanism responsible for hypercalcaemia in malignancy?
Parathyroid-hormone-related peptide
Increased cancer risk in acromegaly?
Colorectal
Phaeo and large port wine naevus on one side of the face?
Sturge-Weber syndrome
Amenorrhoea and clitoromegaly?
CAH
Drug therapy you can use in lithium induced diabetes insipidus to help with polyuria?
A thiazide
When is classical congenital adrenal hyperplasia diagnosed? (and can be helpful therefore in questions)
At birth (therefore presentation in an older girl likely to be non-classical
First line antiemetic in gastroparesis?
Domperidone
Amenorrhoea and high FSH, low oestrogen?
Primary ovarian failure
What complication will the vast majority of diabetic patients have?
Retinopathy
Cushings-sounding history but mildly raised cortisol and loads of alcohol?
Pseudocushings
Number one cause of dialysis dependant ESRF in UK/US?
Diabetic nephropathy
High alk phos, bone lesions in otherwise well man?
Paget’s
Most frequently reported SE of HRT
Breast tenderness
Preferred alpha blocker in phaeo?
Phenoxybenzamine
(preferred over doxasocin)
What hormone suppresses LH and FSH?
Prolactin
Prolactinoma - micro or macro more common?
Micro
Retinal haemangioblastomas?
VHL
Parathyroid sounding question with short neck, short 4th and 5th metacarpals?
Pseudohypoparathyroidism
Chromaffin cells produce what?
Dopamine
Delayed puberty and anosmia?
Kallmans