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1MRCP Part 1 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Fall in which hormone precedes menstruation?

A

Progesterone
= corpus luteum degrades, reduced production of progesterone > shedding of endometrium

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2
Q

Panretinal photocoagulation
- Target
- Complication

A

= focuses on peripheral retina
- Decrease in night vision: rods found mainly in periphery and responsible for night vision
- Decrease in peripheral vision

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3
Q

Pseudohypoparathyroidism
- What is it?
- Inheritance
- Blood results profile

A

Type I and II
- Lack of response to PTH due to mutation in receptor
- Autosomal dominant
- Raised PTH but LOW calcium

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4
Q

What endocrine abnormality is associated with pulmonary TB?

A

Hyponatraemia due to SIADH

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5
Q

What kind of receptor does insulin act on?

A

Tyrosine kinase

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6
Q

Firm non tender goitre with nil thyroid symptoms
- diagnosis
- association

A

Riedel’s thyroiditis = fibrous invasion of thryoid
Associated with retroperitoneal fibrosis

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7
Q

How does vitamin D raise serum calcium

A

Via increased gut absorption of calcium

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8
Q

First line management of primary hyperparathyroidism

A

Surgery

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9
Q

Klinefelter’s Syndrome
- Hormone results

A

Testosterone LOW
LH and FSH LOW or inappropriately normal
- they should be raised to try and boost the testosterone levels

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10
Q

Treatment of phaeochromocytoma

A

Non-selective alpha blocker
e.g. phenoxybenzamine

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11
Q

Phaeochromocytoma + medullary thyroid cancer
- Syndrome
- Genetic fault

A

MEN II
A. parathyroid adenomas
B. marfanoid habitus
RET oncogene

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12
Q

Drug class sitagliptin
- Mechanism

A

DPP-4 inhibitor
= increases GLP-1 levels by decreasing their breakdown

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13
Q

Mechanism of action of bisphosphonates

A

Inhibition of osteoclasts

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14
Q

Glucocorticoid VS mineralocorticoid effects

A

Glucocorticoid = anti-inflammatory
Mineralocorticoid = fluid retention (via secretion of aldosterone)

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15
Q

Which steroid has the least mineralocorticoid effects?

A

Dexamethasone - why so useful in brain tumours and desired anti-swelling effect

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16
Q

What cancer is associated with hashimoto’s thyroiditis?

A

MALT lymphoma

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17
Q

What is octreotide?
Mechanism of action
Produced from where?

A

Somatostatin analogue
Inhibits serotonin
D cells

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18
Q

How does carbimazole work?

A

Blocks thyroid peroxidase from binding to residues on thyroglobulin

19
Q

Kallman Syndrome =

A

hypogonadotrophic hypogonandism

20
Q

11 beta hydroxylase deficiency =

A

Congenital adrenal hyperplasia

21
Q

Subacute thyroiditis =

A

De Quervain’s thyroiditis

22
Q

Results in high dose dexamethasone suppression test
- +VE
- -VE

A

+VE = supressed cortisol, likely pituitary cause
-VE = cortisol not supressed, likely adrenal/ectopic cause

23
Q

Causes of raised gastrin (4)

A

Gastrinoma
Zollinger-Ellison syndrome
Vagotomy
PPI

24
Q

TSH
- controlled by
- actions (2)

A

Under control of TRH
Actions
1. Growth of thyroid gland
2. Synthesis + release of T3/T4

25
Q

LH
- controlled by
- cell
- actions (2)

A

GnRH
Leydig cells
1. Male - increased testosterone production
2. Female - development of corpus luteum

26
Q

FSH
- controlled by
- cell
- action

A

GnRH
Sertoli cell
Action = increase in seminiferous tubules

27
Q

Prolactin
- controlled by
- increased (4)

A

Inhibited by dopamine
Increased = exercise, pregnancy, hypothyroidism, renal failure

28
Q

Growth Hormone
- controlled by

A

Inhibited by somatostatin

29
Q

What is the most common cause of Conn’s syndrome

A

Bilateral adrenal hyperplasia

30
Q

Effect of hypocalcaemia on NMJ

A

Increased neuronal excitability - can result in tetany

31
Q

What does axillary freckling feature in?

A

Neurofibromatosis
NOT a feature of tuberous sclerosis

32
Q

Types of amiodarone-induced thyrotoxicosis
- management of each type

A

Type 1 = excess hormone synthesis, see goitre
Give carbimazole

Type 2 = destructive thyroiditis
Give steroids

33
Q

Type 1 amiodarone thyrotoxicosis management

A

Give carbimazole

34
Q

Type 2 amiodarone thyrotoxicosis management

A

Give steroids

35
Q

Treatment of Paget’s Disease

A

Bisphosphonate

36
Q

Mechanism of action of Bisphosphonate

A

Inhibits bone resorption by INTERFERING with osteoclasts

37
Q

Gold standard diagnosis for insulinoma

A

Supervised prolonged fasting

38
Q

Malignancy associated with acromegaly
- why?

A

Colorectal cancer
Increased secretion of growth hormone

39
Q

Investigation of Zollinger Ellison Syndrome

A

Secretin stimulation test
= paradoxical rise in gastrin secretion

Gastrin is usually inhibited by secretin

40
Q

What can cause a worsening of thyroid eye disease?

A

Radioiodine

41
Q

Most common cause of congenital adrenal hyperplasia

A

21 hydroxylase deficiency

42
Q

Options for management of Grave’s Disease (2)

A

Down titration of carbimazole

Block and replace - carbimazole, start levothyroxine when euthyroid

Down titration has a better side effect profile

43
Q

Mechanism of metabolic alkalosis in cirrhosis

A

Reduced steroid hormone production
Depleted intravascular volume
= increased secretion of aldosterone
= metabolic alkalosis

44
Q

How do the metaglitinides work?

A

Same mechanism as sulphonylureas

1MRCP Part 1 (20 decks)

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