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MRCP > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Acromegaly investigations

A

IGF-1 (initial)
confirmation (growth hormone and glucose tolerance test, glucose should inhibit growth hormone)

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2
Q

MOA alendronic acid

A

Inhibits osteoclasts

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3
Q

Non classical congenital adrenal hypoplasia

A

Presents similarly to PCOS but also will have raised 1-17 OH progesterone

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4
Q

Signs of Graves disease only

A

lid lag and lid retraction
periorbital oedema
exopthalmos
opthalmoplegia
optic nerve compression

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5
Q

Is carbimazole safe in pregnancy

A

yes

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6
Q

Addisons, hormone

A

Cortisol and aldosterone

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7
Q

Main cause of Addisons?

A

autoimmune destruction of adrenal glands

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8
Q

Cause of skin hyperpigmentation in Addisons

A

XS ACTH

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9
Q

Cause of amenorrhoea in Addisons

A

High levels of prolactin

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10
Q

Conns disease

A

XS aldosterone

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11
Q

Diabetes drug that doesn’t need to be adjusted in renal impairnment

A

Linagliptin

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12
Q

Diabetes meds that cause weight loss

A

GLP-1 analogue (-glutide)
SGLT-2i (-flozin)

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13
Q

Diabetes meds that cause weight gain

A

Insulin
Pioglitazone
Sulfonylurea

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14
Q

Diabetes med that is at risk of hypoglycaemia

A

Insulin

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15
Q

Diabetes meds that cause ketoacidosis

A

DPP-4i (-gliptin)
GLP-1 analogue (-glutide)
SGLT-2i (-flozin)

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16
Q

Diabetes medication to be avoided in HF

A

Pioglitazone

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17
Q

Diabetes medication to be avoided in bladder cancer

A

Pioglitazone

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18
Q

Diabetes medication to be avoided in gastro disease

A

GLP-1 (-glutide)

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19
Q

How does an insulinoma present

A

Hypoglycaemia
Rapid weight gain may be seen
high insulin, raised proinsulin:insulin ratio
high C-peptide

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20
Q

What is an insulinoma

A

Neuroendocrine tumour deriving mainly from pancreatic Islets of Langerhans cells

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21
Q

Management of insulinoma

A

Surgery (if not fit for somatostatin)

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22
Q

Where are insulinomas normally found

A

Pancreas - requires a CT pancrease

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23
Q

Familial hypocalciuric hypercalcaemia

A

moderately high calcium with low calcium excretion (autosomal dominant)

Mx:

24
Q

Management of acromegaly

A

Transphenoidal surgery (can use somatostatin analogue to reduce the size)

25
Q

Dopamine analogue example

A

Pramipexole
Ropinirole

26
Q

MODY 2

A

Fasting glucose is normal and increase when given glucose only increases very slightly

If patients relatives have remained well for a while MODY type 2 > type 3

27
Q

MODY 3

A

Present very similarly to type 1

28
Q

MODY 5

A

Renal cysts and diabetes

Treated with insulin

29
Q

Cushing’s investigation

A

24 hour urinary cortisol
Dexamethasone suppression test

30
Q

Tamoxifen MOA

A

Mixed oestrogen receptor antagonist and partial agonist

31
Q

Post menopausal breast cancer

A

Letrozole (aromatase inhibitor)

32
Q

Pre menopausal breast cancer

A

Tamoxifen

33
Q

Hormone that stops growth and fuses the epiphyseal plates

A

Oestrogen

34
Q

How to measure the volume of the thyroid gland

A

USS

35
Q

Hyperemesis and thyroid bloods

A

Appears to have hyperthyroidism but this is driven by BHCG, can observe and wait to normalise if no symptoms

36
Q

Thyroid lymphoma management

A

RCHOP + external beam radiotherapy

37
Q

Medullary carcinoma

A

Calcitonin

38
Q

Type of cancer causing stridor and regional lymphadenopathy

A

Anaplastic carcinoma

38
Q

Thyroid lymphoma

A

Seen in over 60s

39
Q

Acromegaly cancer link

A

Colorectal cancer

40
Q

How is denosumab given

A

SC 6 monthly

41
Q

How is teriparatide given

A

Daily injection

42
Q

When is metformin CI

A

eGFR <30

43
Q

Why does metaclopramide cause galactorrhoea

A

It is a dopamine antagonist that binds to the D2 receptors on pituitary lactotrophs stimulating prolactin. Prolactin causes galactorrhoea (also inhibits GnRH so can cause amenorrhoea)

44
Q

Diabetic amyotrophy presentation

A

Proximal muscle weakness

45
Q

Hashimotos antibodies

A

HYPOTHYROIDISM anti-TPO or anti-Tg

46
Q

Graves disease

A

HYPERTHYROIDIDM
anti TSH or anti-TPO

47
Q

What is prolactin controlled by

A

Under negative control of dopamine

48
Q

Nelsons syndrome

A

Cushings and development of an ACTH producing tumour –> causes skin pigmentation and bitemporal hemianopeia

49
Q

Acromegaly hormone and ix

A

XS GH, serum IGF-1/OGTT

50
Q

Cushings hormone and ix

A

XS cortisol, dexamethasone suppression test or 2x 24 hour urinary cortisol levels

51
Q

Addisons hormone and ix

A

Decrease in cortisol
SynACTHen test

52
Q

Conns hormone and ix

A

XS aldosterone
aldosterone:renin
MRI/renal vein sampling

53
Q

Early pregnancy hyperthyroid management

A

Propyluracil

54
Q

Late pregnancy hyperthyroid management

A

Carbamazapine as propyluracil has an increased risk of hepatic toxicity

55
Q

Insulinoma investigation

A

72 hour supervised fast

MRCP (28 decks)

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