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Endocrine Flashcards

1
Q

sweating, palpitations, tachycardia and acute confusion.
On examination she is warm to touch, has an irregular pulse, a heaving apex, evidence of pulmonary oedema and a smooth symmetrical swelling of the anterior neck.

A

thryoid storm

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2
Q

Mx of thyroid storm

A

IV propanolol (control symptoms)
propylthiouracil (control thyroid)
IV hydrocortisone (prevent thyroid inflammation)

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3
Q

DKA Mx

A

fluids
insulin infusion 0.1

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4
Q

hypotension, hyponatremia, hyperkalaemia, fatigue, nausea
hyperpigmentation

A

addisons disease

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5
Q

large hands, feet, macroglossia, sweating, fatigue

A

acromegaly

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6
Q

pathophis of acromegaly

A

increased growth hormone = increased insulin-like growth factor IGF1

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7
Q

Mx for acromegaly

A

trans sphenoidal surgery
follow up for cardiac (echo) and colon cancer issues

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8
Q

mx of diabetes insipidus

A

desmopressin

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9
Q

mx for cushings

A

surgically remove the tuour

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10
Q

hypertension resistant to treatment. metabolic alkalosis, hypokalaemia

A

conns syndrome (hyperaldosteronism)

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11
Q

primary and 2ndary hyperaldosteronism

A

1: adrenal hyperplasia producing excess aldosterone
2: renal artery stenosis

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12
Q

Mx of conns

A

spironolactone (aldosterone antagonist, potassium sparing diuretic)

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13
Q

hashimotos antibodies

A

anti-tpo, anti-thyroglobulin

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14
Q

mx of hypothyroidism

A

levothyroxine

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15
Q

mx of hyperthyroidism

A
  1. carbimazole
  2. propylthiouracil
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16
Q

Dx of acromegaly

A

insulin like growth factor
IGF1

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17
Q

diagnosis of type 2 diabetes (HbA1c and fasting glucose values)

A

HbA1c > 48 mmol
fasting glucose >7.1

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18
Q

most common thyroid cancer

A

papillary

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19
Q

what thyroid cancer is associated with MEN

A

medullary thyroid cancer

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20
Q

4 types of thyroid cancer

A

medullary
anaplastic
follicular
papillary

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21
Q

primary hypothyroidism results

A

high tsh
low t4

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22
Q

secondary hypothyroidism results

A

low tsh
low t4

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23
Q

if they only take their hypothyroid medication a day before their appt? results

A

high TSH
normal t4

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24
Q

what is sick euthyroid syndrpme

A

happens when pt is ill
TSH, T4 and t3 are all low

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25
graves
autoimmune hyperthyroidism
26
hashimotos
autoimmune hypothyroidism
27
MEN 2a
medullary thyroid cancer hyperparathyroidism phaeochromocytoma
28
MEN type 1
pancreas pituitary parathyroid
29
how do the paratyroid glands work (3 effects)
1. low serum calcium 2. PTH is released from the chief cells of the parathyroid gland 3. This causes 1. increased osteoclast activity → break down of bone to release calcium into blood 2. causes kidneys to reabsorb waste calcium from the urine back into the blood 3. causes kidneys to release calcitriol 1. causes gut to reabsorb calcium from digesting food 4. Increased calcium!!
30
primary hyperparathyroidism Causes blood results Mx
parathyroid adenoma raised Ca, low Phosphate, raised ALP, raised PTH Mx: remove the tumour
31
2ndary hyperparathyroidism Causes blood results Mx
any condition that causes hypocalcemia, and therefore stimulates release of PTH (CKD, vit deficiency) low Ca, low PO4, high PTH, high ALP Mx: calcium and vit d supplementation
32
tertiary hyperparathyroidism Causes blood results Mx
prolonged secondary hyperparathyroidism hyperplasia of the parathyroid glands high Ca, normal PO4, high PTH, high ALP Mx: surgical resection. cinaclet + alendronate
33
how does CKD relate to parathyroid disease mention all the compound
causes secondary hyperparathyroidism reduced 25-hydroxycholecalciferol reduced calcitriol reduced Ca reabsorption increased PTH
34
Signs of hyperparathyroidism in the absence of high PTH?
malignancy induced release of PTHrP (parathyroid related protein, mimics the action of PTH)
35
hypoparathyroidism cause px blood results Mx
Causes: iatrogenic, Digeorge syndrome Px: hypocalcemia, muscle twitching, low Ca, high PO4, low ALP, low PTH Mx: iv calcium gluconate if severe hypocalcemia. Ca and vit d supplementation
36
special sign in hypoparathyroidism
Chovstek sign (facial twitches when the cheek is tapped)
37
cause of acromegaly
pituitary tumour secreting excess growth hormone OR ectopic secretion of GH from a carcinoid tumour
38
psammoma bodies indicate
papillary thyroid cancer they are the remnants of dead papillary cells
39
SIADH should not be diagnosed in the presence of...
hypovolemia hypotension addisons fluid overload hypothyroidism
40
de quervains thyroiditis diagnosis
low radio iodine uptake test
41
difference between graves + de quervains on radio iodine uptake test
graves = high de quervains = low
42
what class of drug is metformin MOA Side effects
biguanides reduces gluconeogenesis in the liver increases insulin sensitivty SE: diarrhoea, lactic acidosis
43
what class of drug is gliclazide MOA Side effects
sulphonylurea stimulated insulin secretion from the pancreas SE: weight gain,
44
what class of drug is dapagliflozin MOA Side effects
SGLT-2 inhibitor increases renal excretion of glucose SE: increased risk of UTI, polyuria
45
what class of drug is sitagliptin MOA Side effects
DPP-4 inhibitor increases insulin release from pancreas SE: constipation
46
what class of drug is sulaglutide MOA Side effects
Trulicity GLP - analogue increases insulin secretion SE: nausea, weight loss
47
what class of drug pioglitazone MOA Side effect
thiazolidinediones reduced circulating free fatty acids = glucose uptake by muscle cells SE: weight gain, peripheral oedema
48
Conns syndrome renin and aldosterone results
Low renin High aldosterone
49
Secondary hyperaldosteronism renin and aldosterone
High and high
50
Pseudohypoparathyroidism results
Low calcium High phosphate Low PTH
51
Most important mechanism of immunosuppression in prolonged hypoglycemia
Impaired neutrophil and macrophage chemotaxis
52
what is waterhouse-fridreichsen syndrome
bilateral adrenal haemorrhage associated with severe bacterial infection e.g. neisseria meningitis
53
SIADH vs primary polydipsia vs diabetes insipidus
euvolemia hyponatremia high urine osmolality polydipsia: hypervolemia, low urine osmolality (very diluted) diabetes insipidus: hypernatremia
54
diabetic ketoacidosis vs diabetic hyperosmolar coma
DKA seen in Type 1 diabetics, poorly controlled diabetic hyperosmolar coma seen in older patients with T2DM
55
adrenal crisis px result of ACTH test
caused by abrupt withdrawal of steroids symptoms of adrenal hypo function (hyponatremia, hyperkalaemia, dizziness) postural hypotension no cortisol response to ACTH test
56
urgent Mx of DKA
normal saline infusion
57
what medication can cause nephrogenic diabetes insipidus
lithium
58
what medications can cause SIADH
carbamazepine chlorpromazine
59
what medication could be used to treat SIADH and why
demclocycline tetracycline-like antibiotic, promotes water diuresis
60
link between cortisol and calcium
hypercortisolism leads to reduced serum calcium leads to secondary hyperparathyroidism
61
familial hypercholesterolaemia pathophysiology
deficiency of apo B 100
62
what is the inheritance pattern of MEN
autosomal dominant
63
Mx of HHS
iv fluids and thromboprophylaxis
64
klinefelters karyotype + symptoms
hypogonadism 47XXY high FSH low testosterone
65
2 drugs that cause gynacomastia
digoxin spironolacton
66
what drug causes galactorrhea
chlorpromazine
67
standard HbA1c target in T2DM
48 mmol/mol
68
baseline monitoring before starting amiodarone
TFT, U&E LFT Chest x ray
69
regular monitoring for amiodarone what tests and when
TFT + LFT 6 monthly

AMK (30 decks)

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