Endocrine Flashcards
What condition/s does this represent and what symptoms are being referred to:
‘Bones, stones, abdominal groans, psychiatric overtones’
Hypercalcaemia
This is often a presentation of primary hyperparathyroidism
Bones- osteolysis and fractures
Stones- kidney stones
Abdominal groans- constipation, nausea and vomiting
Psychiatric overtones- depression, hallucinations, confusion and coma
What type of hypothyroidism is caused by lithium and amiodarone?
Primary hypothyroidism- it affects the thyroid gland, not pituitary gland (responsible secondary hypothyroidism) or hypothalamus (responsible tertiary hypothyroidism)
What is the sign of hertoghe?
Hair on the lateral third of the eyebrow is significantly thinned
A 21-year-old woman presents to the Emergency Department with a 2-day history of confusion. She also has diffuse abdominal pain, nausea and vomiting, polyuria and polydipsia. She has a history of bulimia nervosa and type 1 diabetes mellitus.
Her observations are as follows:
Temperature 36.8 °C
Heart rate 106 bpm
Respiratory rate 22 breaths/min
Blood pressure 102/70 mmHg
SpO2 97%
Physical examination reveals a capillary refill time of <2 seconds, dry mucous membranes and reduced skin turgor. She has laboured breathing. The abdomen is soft with generalised tenderness but without rigidity.
Which is the most likely investigation finding in this presentation?
-metabolic acidosis
-raised creatinine
-metabolic alkalosis
-hypoglycaemia
-hyponatraemia
A 4 year old girl is brought in to see her GP due to persistent ear pain for the past 2 days which has disrupted her sleep and normal routine. She is very tearful. Her mother reports that she is otherwise doing well at home and in nursery. On examination the GP is able to visualise her tympanic membrane well and notes that it appears very red and inflamed. Her mother reports that this is the 6th or 7th time this has happened in the past year. The girl is of notable short stature yet her mother appears of normal height. On further review of the red book the GP can see that at birth she was a normal weight and height but her height has now fallen down to the 3rd centile. On further examination the GP notes she has spoon shaped nails. Given her presentation what is the most probable diagnosis?
A 60-year-old man presents with recurrent kidney stones and depression. Laboratory investigations reveal elevated serum calcium levels and normal serum phosphate levels. What other laboratory investigation may be abnormal given the likely diagnosis?
elevated serum calcium levels and normal serum phosphate levels. What other laboratory investigation may be abnormal given the likely diagnosis?
In primary hyperparathyroidism, serum 25-hydroxyvitamin D levels are often decreased as its conversion is downregulated to raised serum calcium levels
A 27 year old man is admitted for an left nephrectomy. His past medical history includes a kidney lesion of unknown etiology and type 1 diabetes. He is on a basal-bolus regimen with a morning long acting insulin dose followed by short acting insulin doses after meals. He is on the morning list and the operation may last several hours. What is the most appropriate pre-operative management of this patient’s diabetes?
A 42-year-old woman has finally decided to undergo thyroidectomy for her Graves’ disease. This procedure will involve the ligation of vasculature supplying blood to the thyroid gland, one of which is the superior thyroid artery.
Which one of the following correctly describes the superior thyroid artery?
-A branch of the external carotid artery that supplies the superior portion of the thyroid gland
-A branch of the internal carotid artery that supplies the superior portion of the thyroid gland
- branch of the external carotid artery that supplies the superior and inferior poles of the thyroid gland
-A branch of the subclavian artery that supplies the superior portion of the thyroid gland
-A branch of the thyrocervical trunk that supplies the anterior portions of the thyroid gland
A 28-year-old female is brought in by her parents following a mixed overdose. They report the patient had locked herself in her room following an argument. As the patient has a history of depression and previous suicide attempts, after a short period of time they forced open her door and found her drowsy on the floor. They also found her grandmother’s medical box, containing paracetamol, gliclazide, bisoprolol and atorvastatin empty but they do not know how much of each she has ingested.
On examination, the patient is sweaty with a global tremor and is confused. She is tachycardic and seems globally weak.
Which of the following molecules is likely to be first produced by the patient in response to their overdose?
-Glycogen synthase
-Cortisol
-Glucagon
-Glutathione
-Glycogen phosphorylase
