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AMK > Endocrine > Flashcards

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

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
Q

graves

A

autoimmune hyperthyroidism

26
Q

hashimotos

A

autoimmune hypothyroidism

27
Q

MEN 2a

A

medullary thyroid cancer
hyperparathyroidism
phaeochromocytoma

28
Q

MEN type 1

A

pancreas
pituitary
parathyroid

29
Q

how do the paratyroid glands work (3 effects)

A
  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
Q

primary hyperparathyroidism
Causes
blood results
Mx

A

parathyroid adenoma
raised Ca, low Phosphate, raised ALP, raised PTH
Mx: remove the tumour

31
Q

2ndary hyperparathyroidism
Causes
blood results
Mx

A

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
Q

tertiary hyperparathyroidism
Causes
blood results
Mx

A

prolonged secondary hyperparathyroidism

hyperplasia of the parathyroid glands

high Ca, normal PO4, high PTH, high ALP

Mx: surgical resection. cinaclet + alendronate

33
Q

how does CKD relate to parathyroid disease

mention all the compound

A

causes secondary hyperparathyroidism

reduced 25-hydroxycholecalciferol
reduced calcitriol
reduced Ca reabsorption
increased PTH

34
Q

Signs of hyperparathyroidism in the absence of high PTH?

A

malignancy induced release of PTHrP (parathyroid related protein, mimics the action of PTH)

35
Q

hypoparathyroidism
cause
px
blood results
Mx

A

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
Q

special sign in hypoparathyroidism

A

Chovstek sign (facial twitches when the cheek is tapped)

37
Q

cause of acromegaly

A

pituitary tumour secreting excess growth hormone
OR
ectopic secretion of GH from a carcinoid tumour

38
Q

psammoma bodies indicate

A

papillary thyroid cancer
they are the remnants of dead papillary cells

39
Q

SIADH should not be diagnosed in the presence of…

A

hypovolemia
hypotension
addisons
fluid overload
hypothyroidism

40
Q

de quervains thyroiditis diagnosis

A

low radio iodine uptake test

41
Q

difference between graves + de quervains on radio iodine uptake test

A

graves = high
de quervains = low

42
Q

what class of drug is metformin
MOA
Side effects

A

biguanides
reduces gluconeogenesis in the liver
increases insulin sensitivty
SE: diarrhoea, lactic acidosis

43
Q

what class of drug is gliclazide
MOA
Side effects

A

sulphonylurea
stimulated insulin secretion from the pancreas
SE: weight gain,

44
Q

what class of drug is dapagliflozin
MOA
Side effects

A

SGLT-2 inhibitor
increases renal excretion of glucose
SE: increased risk of UTI, polyuria

45
Q

what class of drug is sitagliptin
MOA
Side effects

A

DPP-4 inhibitor
increases insulin release from pancreas
SE: constipation

46
Q

what class of drug is sulaglutide
MOA
Side effects

A

Trulicity
GLP - analogue
increases insulin secretion
SE: nausea, weight loss

47
Q

what class of drug pioglitazone
MOA
Side effect

A

thiazolidinediones
reduced circulating free fatty acids = glucose uptake by muscle cells
SE: weight gain, peripheral oedema

48
Q

Conns syndrome renin and aldosterone results

A

Low renin
High aldosterone

49
Q

Secondary hyperaldosteronism renin and aldosterone

A

High and high

50
Q

Pseudohypoparathyroidism results

A

Low calcium
High phosphate
Low PTH

51
Q

Most important mechanism of immunosuppression in prolonged hypoglycemia

A

Impaired neutrophil and macrophage chemotaxis

52
Q

what is waterhouse-fridreichsen syndrome

A

bilateral adrenal haemorrhage
associated with severe bacterial infection e.g. neisseria meningitis

53
Q

SIADH vs primary polydipsia vs diabetes insipidus

A

euvolemia hyponatremia high urine osmolality

polydipsia: hypervolemia, low urine osmolality (very diluted)

diabetes insipidus: hypernatremia

54
Q

diabetic ketoacidosis vs diabetic hyperosmolar coma

A

DKA seen in Type 1 diabetics, poorly controlled

diabetic hyperosmolar coma seen in older patients with T2DM

55
Q

adrenal crisis px
result of ACTH test

A

caused by abrupt withdrawal of steroids
symptoms of adrenal hypo function (hyponatremia, hyperkalaemia, dizziness)
postural hypotension

no cortisol response to ACTH test

56
Q

urgent Mx of DKA

A

normal saline infusion

57
Q

what medication can cause nephrogenic diabetes insipidus

A

lithium

58
Q

what medications can cause SIADH

A

carbamazepine
chlorpromazine

59
Q

what medication could be used to treat SIADH and why

A

demclocycline
tetracycline-like antibiotic, promotes water diuresis

60
Q

link between cortisol and calcium

A

hypercortisolism leads to reduced serum calcium
leads to secondary hyperparathyroidism

61
Q

familial hypercholesterolaemia pathophysiology

A

deficiency of apo B 100

62
Q
A

AMK (29 decks)

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