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Year 2 Divs > Endocrine > Flashcards

Endocrine Flashcards

1
Q

The anterior pituitary gland releases(6):

A

Thyroid-stimulating hormone (TSH)

Adrenocorticotropic hormone (ACTH)

Follicle-stimulating hormone (FSH)

luteinising hormone (LH)

Growth hormone (GH)

Prolactin

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2
Q

The posterior pituitary releases (2):

A

Oxytocin

Antidiuretic hormone (ADH)

Both created in hypothalamus

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3
Q

When the hypothalamus detects low thyroid hormone levels- what is released?

A

Thyrotropin-Releasing Hormone (TRH)

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4
Q

Pituitary Gland: It responds to TRH to release what?

A

Thyroid-Stimulating Hormone (TSH)

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5
Q

Thyroid Gland: XXX signals the thyroid gland, which is located in your neck, to produce and release thyroid hormones - YY and ZZ

A

XXX = TSH

YY= T3 (triiodothyronine)

ZZ= T4 (thyroxine).

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6
Q

When the end hormone (e.g., T3 and T4) suppresses the release of the controlling hormones (e.g., TRH and TSH), this is called what?

A

negative feedback.

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7
Q

which part of the brain releases Growth Hormone-Releasing Hormone (GHRH) ?

A

Hypothalamus

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8
Q

GHRH signals the pituitary gland to release what?

A

Growth Hormone (GH)

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9
Q

What stimulates the production of Insulin-Like Growth Factor 1 (IGF-1)

A

GH

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10
Q

in response to low levels of calcium in the blood- what is released?

A

Parathyroid Hormone (PTH)

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11
Q

PrimaryHyperthyroidism:

Raised or lowered what?

A

Lowered TSH, Raised T3 and T4 levels.

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12
Q

Primary Hypothyroidism:

Raised or lowered what?

A

High TSH, Low T3 and T4 levels.

Hashimoto’s thyroiditis

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13
Q

Secondary Hyperthyroidism

A

Abnormal pituitary; high TSH, T3, and T4.

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14
Q

Secondary Hyporthyroidism TSH, T3 T4

A

Low TSH

Low T3

Low T4

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15
Q

Relevant antibody in autoimmune thyroid disease Hashimoto’s

A

Anti-TPO antibodies

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16
Q

Which antibodies raised in:

Graves’, Hashimoto’s, and thyroid cancer

A

Anti-Tg antibodies

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17
Q

Which antibodies Cause Graves’ disease;

A

TSH receptor antibodies

TRAb

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18
Q

Radioisotope scans are used to investigate what?

A

hyperthyroidism and thyroid cancers

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19
Q

Ultrasound of the thyroid gland helps diagnose what?

A

thyroid nodules and

distinguish between cystic (less bad) and solid nodules

anantomy

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20
Q

Radioisotope scans in Grave’s Disease show?

A

Diffuse high uptake is found in Grave’s

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21
Q

Radioisotope Toxic Multinodular Goitre and Adenomas show?

A

Focal High Uptake of Iodine

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22
Q

Thyroid Cancer on Radioisotope shows?

A

“Cold” Areas (Abnormally Low Uptake)

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23
Q

eyeballs sticking out (exophthalmos)- Woman 30 - 50 age

Which disease?

TSH- low or high?
T3+T4 low or high?

TSH recepter antibodies? +Ve or -Ve

A

Grave’s disease

TSH- low
T3+T4 high

TSH receptor antibodies +Ve (TRAb)

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24
Q

3 clinical features of Graves’

A

exophthalmos

Diffuse Goitre (no nodules)

Pretibial Myxedema

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25
Q

“What are three conditions, aside from Graves’ disease, (HYPER)

that can cause an elevation in both T3 and T4 thyroid hormone levels?”

A

1) Toxic Multinodular goitre

2) solitary toxic thyroid nodule

3) thyroiditis (de quervain’s)

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26
Q

Symptomatic treatment Graves 1st line

A

Propanolol

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27
Q

treatment for Graves(4)

A

Carbimazole (agranular cytosis)
Propylthiouracil (PTU preferred 1st trimester- then carbimazole)
Radioactive Iodine
Surgery

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28
Q

45 YO Woman. Tired, Fat, low mood, dry skin and constipation ,cold - diagnosis?

A

Hashimoto’s Thyroiditis (causes hypothyroidism)

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29
Q

Hashimoto’s Thyroiditis- antibodies (2)

A

Antithyroid peroxidase (Anti-TPO) antibodies

Antithyroglobulin antibodies (Anti-TG)

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30
Q

Hashimoto’s Thyroiditis- expected T3, T4 and TSH?

A

T3 and T4 low

TSH High

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31
Q

Other causes of Low T3/T4 & High TSH i.e. hypothryoidism (not Hashimoto’s Thyroiditis) (3)

A

TIM

  1. Treatmentfor Hyperthryoidism.
  2. Iron Deficiency
  3. Meds (Lithium)
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32
Q

Treatment for Hashimoto’s Thyroiditis?

A

Levothyroxine

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33
Q

What does disease Parathyroid Tumour cause?

A

Primary Hyperparathyroidism

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34
Q

how does PTH increase serum calcium (3)

A

Increase osteoclast activity in bones

Increase Calcium absorption in kidneys

Increase Vit D activity which Increases gut absorption.

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35
Q

how does hypercalcemia present (2)

A
  1. Renal Stones lead to abdo groans.
  2. Painful bones lead to psychiatric moans.
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36
Q

Cause of primary hyperparathyroidism? Calcium and Phospate up or down?

A

Tumour , Calcium Up, Phosphate Down

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37
Q

Cause of Secondary hyperparathyroidism(2)? and Calcium up or down?

A

decrease Vit D and CKD.

Calcium down or same.

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38
Q

Cause of tertiary hyperparathyroidism? and Calcium up or down?

A

prolonged secondary hyperparathyroidism -eg, renal failure causes tertiary, Hyperplasia, Calcium Up

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39
Q

Woman, Age 30-50, 2 months fatigue, cramps, abdo pain, vomiting, sleepy, hypotensive. Unusual Tan skin. TB/Autoimmunity / WFS issue DIAGNOSIS?

A

ADDISON’S

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40
Q

Acute diagnosis of Addison’s

A

Adrenal Crisis

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41
Q

bronzing of skin in Addison’s, why is this?

A

excessive ACTH stimulates melanocytes

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42
Q

Primary Addison’s Disease- damage to what?

What is decreased?

Which syndrome can it lead to?

A

damage to the adrenal glands.

Decrease Cortisol and Aldosterone

Waterhouse-Friderichsen syndrome

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43
Q

Secondary Addison’s Disease-how does it happen

A

Decrease ATCH from pituitary

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44
Q

Tertiary Addison’s Disease-how?

A

Decrease CRH from hypothalamus

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45
Q

Key biological findings in Addison’s(3)

A

Hyponatraemia, low cortisol, hyperkalemia

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46
Q

Diagnostic test Addison’s

A

Short Synacthen Test (ACTH)

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47
Q

Treatment for Addison’s

A

Hydrocortisone replace Cortisol

Fludrocortisone replace Aldosterone

Horny Cowboys Fuck Alot

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48
Q

Great Khali, what disease

A

Acromegaly

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49
Q

which hormone raised in Acromegaly

A

GH

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50
Q

Cause of Acromegaly

A

Pituitary Adenoma

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51
Q

Initial blood test for acromegaly

A

IGF-1

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52
Q

Definitive Treatment Acromegaly

A

transsphenoidal removal

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53
Q

Options for blocking the raised GH

A

Somatostatin (Ocreotide)1st line

GH Antagonist (Pegvisomant)

Dopamine Agonist (Bromocriptine)

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54
Q

Acromegaly = Increased risk of which cancer?

A

Colorectal

55
Q

Old, fat man- sedentary lifestyle- polyuria- numbness in fingers and toes - what does he have?

A

T2D

56
Q

Diagnostic test for T2D

A

HbA1c

57
Q

Criteria for:

Prediabetes HBA1C
Diabetes

A
58
Q

HbA1c treatment target for T2D for new diagnosis?

A

48 mmol/mol

59
Q

HbA1c treatment target for T2D for moving beyond metformin?

A

53 mmol/mol

60
Q

1st line medication T2D

A

Metformin

61
Q

drug options T2D (6)

A

Sulfonylurea (Gliclazide)
Pioglitazone (TDZ)
DPP-4 Inhibitor (Sitagliptin)
SGL-2 inhibitor (Empagliflozin)
GLP-1 Mimetics (Extenatide)
Insulin

62
Q

Too much aldosterone - which disease?

A

Conn’s Syndrome (Primary Hyperaldosteronism)

63
Q

2 Primary causes of Conn’s

A

Adrenal Adenoma
Bilateral Adrenal Hyperplasia

64
Q

2 Secondary causes of Conn’s

A

Renal issues
Heart Failure

65
Q

How can renin levels be used to differentiate between primary and secondary forms of Conn’s syndrome?

A

Primary= Decrease Renin( adrenal gland issue)

Secondary = Increase Renin ( kidney issue)

66
Q

Conn’s BP exam findings

A

Hypertension

67
Q

Conn’s electrolyte findings (3)

A

Hypokalaemia

Hypernatremia

High bicarbonate

68
Q

Conn’s BG finding

A

Alkalosis

69
Q

Aldosterone antagonists for Conn’s

A

Eplerenone and spironolactone

70
Q

man ages 30-55 ,

anxiety, headaches, palpitations, and diaphoresis

What does he have

A

Pheochromocytoma

71
Q

Pheochromocytoma affects which part of adrenal glands

A

chromaffin cells in the adrenal medulla

72
Q

Associated genetic condition for Pheochromocytoma?

A

Multiple endocrine neoplasia type 2 (MEN2)

73
Q

“10% rule” in the context of pheochromocytoma

A

10% Rule:

10% of pheochromocytomas are extra-adrenal

10% Bilateral

10% Cancerous

74
Q

Initial test options for pheochromocytoma (2)

A

24-Hour Urine Catecholamines

Plasma Free Metanephrines

75
Q

Management of pheochromocytoma(3)

A

Alpha Blockers (Phenoxybenzamine)
Beta Blockers (After Alpha blockers)
Adrenalectomy

76
Q

Where is ADH normally secreted FROM?

A

Posterior pituitary

PP

77
Q

Eptopic ADH from SCLC leads to what disease?

A

SIADH

78
Q

Treatment SIADH

A

Fluid restriction

ADH receptor blockers (Tolvaptan)

79
Q

Concern with rapid changes in blood Na (SAIDH)

A

Central Pontine Myelinolysis

80
Q

Other endocrine causes of Hyponatraemia?

A

Adrenal insufficiency

81
Q

Common meds that cause Hyponatraemia (2)

A

Diurectics

SSRIS

82
Q

4 causes of a low blood and urinary sodium? I.e fluid loss

A

Sweating
Diarrhoea
Vomitting
Burns

83
Q

young person, weight loss, polyuria, polydipsia vomitting and drowsiness- diagnosis?

A

Diabetic Ketoacidosis

84
Q

Underlying diagnosis for DKA?

A

T1D

85
Q

Criteria for Acute Diag for DKA in bloods? (3)

A

Acidosis
Hyperglycaemia
Ketosis

86
Q

Initial Mgt DKA

A

FIG PICK

F- Fluids
I- Insulin
G- Glucose

P- Potassium
I- Infection
C- Chart fluid balance
K- Ketone Monitoring

87
Q

Long term treatment DKA

A

Subcutaneous Insulin Regiment

88
Q

Methods for monitoring DKA(3)

A

HbA1c (3-6 months)
Capillary blood glucose
Flash glucose monitoring

89
Q

Woman 20-50 , central obesity (truncal adiposity), moon facies, buffalo hump (dorsocervical fat pad), purple striae (due to skin atrophy and easy bruising), and proximal muscle weakness.

Dx?

A

Cushing’s Syndrome

90
Q

Pathology of Cushing’s Syndrome

A

Excessive Cortisol

91
Q

Causes of Cushing’s syndrome (4)

A

Exogenous Steroids
Pituitary Adenoma (increased ACTH)
Adrenal Adenoma
Paraneoplastic (Eg SCLC)

92
Q

Resulting conditions of Cushing’s Syndrome (4)

A

Hypertension
T2D
Depression
Osteoporosis

93
Q

Diagnostic test for Cushing’s Syndrome

A

Dexamethasone Suppression test

94
Q

Tx for Cushing’s Sydnrome

A

Treat the cause (tumour removal)

95
Q

Polydipsia and Polyuria- Dx?

A

Diabetes Insipidus

96
Q

Two Types of DI?

A

Cranial (lack of ADH)

Nephrogenic (Lack of response to ADH)

97
Q

How do serum and urine osmolality values differ in the diagnosis of Diabetes Insipidus (DI)?

A

Serum Osmolality: High, because the body loses water through excessive urination, increasing the concentration of solutes in the blood.

Urine Osmolality: Low, indicating the urine is very diluted due to the kidneys’ failure to reabsorb water, resulting in a low concentration of solutes in the urine.

98
Q

Test of choice for DI?

A

Water Deprivation Test

99
Q

DI-

Interp of results from Water Depr. Test

A

Cranial DI: The brain doesn’t make enough ADH, but if we give a synthetic version, the kidneys start working better.

Nephrogenic DI: The kidneys don’t respond well to ADH, so even with the synthetic version, they don’t do much to concentrate the urine.

100
Q

Medical treatment for DI

A

Desmopressin

101
Q

Fasting Blood Glucose:

Normal:

Pre-Diabetets
**
Diabetes:

A

Normal: Less than 100 mg/dL (5.6 mmol/L)

Pre-diabetes (impaired fasting glucose): 100 to 125 mg/dL (5.6 to 6.9 mmol/L)

Diabetes: 126 mg/dL (7.0 mmol/L) or higher

102
Q

Oral Glucose Tolerance Test (2-hour plasma glucose):

Normal:

**Impaired Glucose Tolerance (IGT):
**

Diabetes:

A

Normal: Less than 140 mg/dL (7.8 mmol/L)

Impaired Glucose Tolerance (IGT): 140 to 199 mg/dL (7.8 to 11.0 mmol/L)

Diabetes: 200 mg/dL (11.1 mmol/L) or higher

103
Q

Hemoglobin A1c (HbA1c):

Normal:

**Pre-diabetes (increased risk):
**
Diabetes:

A

Hemoglobin A1c (HbA1c):

Normal: Less than 5.7%// less than 41 mmol/mol.

Pre-diabetes (increased risk): 5.7% to 6.4% // 42 to 47 mmol/mol.

Diabetes: 6.5% or higher// 48 mmol/mol or higher.

104
Q

Thiazolidinediones (TZDs) - Example: Pioglitazone
Contraindications (1)

A

Heart failure

105
Q

Thiazolidinediones (TZDs) - Example: Pioglitazone

Side Effects (1)

A

Fluid retention leading to edema

106
Q

Sulfonylureas - Example: Gliclazide
Contraindications:

A

Severe kidney or liver disease

107
Q

Sulfonylureas - Example: Gliclazide

Side Effect:

A

Weight gain

108
Q

SGLT2 Inhibitors - Example: Empagliflozin
Contraindications(2)

A

Type 1 diabetes
Diabetic ketoacidosis

109
Q

SGLT2 Inhibitors - Example: Empagliflozin
Side Effects:

A

Side Effects:

Genital yeast infections
Urinary tract infections
Increased urination
Dehydration

110
Q

Metformin
Contraindications:

A

Severe kidney disease

111
Q

Metformin:

Side Effects:

A

Metformin

Gastrointestinal upset (diarrhea, nausea)

112
Q

Hypothyroidism is typically treated with thyroid hormone replacement therapy, name?

A

Levothyroxine (T4).

113
Q

Exenatide mechanism

A

Mimic GLP-1, boost insulin, control sugar.

114
Q

Sitagliptin mechanism

A

Inhibit DPP-4, boost GLP-1.

115
Q

Cushings (too much cortisol) is what ref. Salt and Potassium.

A

Cushings = fat = weight gain from the sodium which brings in water

Hypernatremia and Hypokalaemia

116
Q

What is Addisons (too little cortisol) ref Salt and Potassium

A

Hyponatremia + Hyperkalaemia

Addisons = thin = weight loss from all the sodium lost so water lost too

117
Q

Go -
find -
rex -
make -
good -
sex -

A

Go - glomerulosa
find - fasciculata
rex - reticularis
make - mineralocorticoid (Aldosterone)
good - glucocorticoid (Cortisol)
sex - sex hormones

118
Q

Diabetes Melitus-

if fasting glucose is greater than or equal to x mmol/l

what is x?

A

7.0 mmol/l

119
Q

Diabetes Melitus-

random glucose is greater than or equal to Y mmol/l

What is Y?

A

11.1 mmol/l

120
Q

Nephrogenic DI, after Water Deprivation test and ADH

A

Low and Low

121
Q

pituitary adenoma in the context of Cushing’s 1 buzzword// vision

A

Bitemporal Hemianopsia

122
Q

Hyperosmolar Hyperglycemic State (HHS) 3 buzzwords

A

Extreme Hyperglycemia (> 33 mmol/L)

Increased Serum Osmolality

Minimal or No Ketosis

123
Q

Addison’s

Conn’s

Cushings

Excess/Too little WHAT?

A

Addisons= Too little cortisol

Conn’s= Excess Aldosterone

Cushings= Excess Cortisol

124
Q

Test for

Addison’s
Conn’s
Cushings

A

Addison’s= Short Synthaen test

Conn’s= Aldosterone:Renin

Cushings test= Dexamethasone suppression test

125
Q

MEN 1 (two buzzwords)

A

Primary Hyperparathyroidism

Adenoma

126
Q

MEN 2a (3 buzzwords)

A

Medullary Thyroid Carcinoma (MTC)

Pheochromocytoma

RET Gene

127
Q

Myxoedema Coma (1 buzzwords)

A

severe hypothyroidism

128
Q

PIGs

Thyroid Storm/Thyrotoxic crisis

A

Propranolol

Iodine

Glucorticoids

Prophylthiouracil

129
Q

Men2b (3 buzzwords)

A

Marfanoid hands

Mucosal Neuroma

RET

130
Q

Cushing Syndrome (2)

A

excess cortisol in the body regardless of cause

High levels of urinary free cortisol can Cushing’s syndrome

131
Q

Cushing Disease

A

where the excess cortisol is due to an ACTH-producing pituitary adenoma

132
Q

Low dose dexamethasone test

A

decrease cortisol, and acth

cushing SYNDROME

133
Q

high dose dexamethasone test

A

cushing DISEASE

Significant suppression of cortisol

If cortisol levels do not suppress with the high dose= ectopic ACTH source / adrenal tumour

134
Q

KEEP GOING DIVZ

A

YOU GOT THIS BRO

Year 2 Divs (12 decks)

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