ENDOCRINE Flashcards
Diagnostic confirmation for Addison’s disease
Short synacthen test
(measure cortisol levels before and after a synthetic ACTH (synacthen) injection
- in a patient with Addison’s, there is an inadequate response).
What is synacthen?
Synthetic ACTH
First line diagnostic test for Cushing’s syndrome ?
Overnight dexamethasone suppression test
What is a dexamethasone suppression test ?
Single dose of dexamethasone at 11pm
At 8am, measure cortisol and dexamethasone levels to ensure appropriate levels are achieved.
Alternative first line test for Cushing’s syndrome
24hr urinary free cortisol
Conn’s syndrome (Primary hyperaldosteronism) - why does hypertension occur ?
High aldosterone leads to sodium reabsorption and potassium secretion (hypernatraemia and hypokalaemia).
This results in increased water retention therefore hypertension.
- It also causes urinary acidification, therefore metabolic alkalosis
Bilateral adrenal disease causing hyperaldosteronism - management ?
Potassium-sparing diuretic e.g. amiloride
Unilateral adrenal disease causing hyperaldosteronism - management ?
Surgical removal of affected adrenal gland
1-week history of palpitations
Feeling hot and sweating more than usual
Flu-like symptoms 2 weeks ago which self-resolved after 2 days.
On examination, she is tender on palpation of her anterior neck
De Quervain’s thyroiditis
Toxic thyroid adenoma - radioisotope test results ?
Increased uptake in one area of the thyroid
Severe bacterial infection which results in disseminated intravascular coagulation (DIC) and subsequent adrenal haemorrhage and failure.
Waterhouse-Friedrichsen syndrome
Pathogenesis of diabetic neuropathy
Chronic hyperglycaemia
high glucose damages peripheral nerves
MEN1 - inherited mutation in what gene ?
MEN 1 gene
MEN 2a + MEN 2b - mutation in what gene ?
RET gene on chromosome 10
Features of MEN 1
3 Ps:
Parathyroid - hyperplasia/adenomas
Pituitary - prolactinoma
Pancreas - gastrinoma/insulinoma
