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1. Jim > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Causes of hyperandrogenism
1+2+3+3

A

Ovarian
- benign or malignant ovarian tumours
Adrenal disease
- CAH
- Benign or malignant adreanl tumourse
Pituitary disease
- Cushings Syndrome
- Acromegaly
- prolactinoma
Other
- Obesity
- Metabolic syndrome
- Medications

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2
Q

Skin flushing + diarrhoea + valvular heart disease

A

Carcinoid syndrome
- hormone secretion from carcinoid cells/tumour
- other features: wheezing, hypotension, telengectasia
- Dx 24hr urine 5-hydroxyindoleacetic acid

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3
Q

Individual goals for T2DM (6)

A

Essentially SNAWAP (but BSL at end)
1. Diet - as per Australian dietary guidelines
2. BMI - 5-10% weight loss for overweight/obese
3. Physical activity - 150mins/wk
4. Smoking - CEASE
5. Alcohol - <2 STD per day
6. BSL - for insulin, pregnancy, or anyone who is at risk

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4
Q

DDx for primary amenorrhoea (no menses by 16) (6)

A
  1. Constitutional delay (FHx of delayed puberty)
  2. Hypothalamic dysfunction (excessive exercise, caloric restriction)
  3. PCOS (S+Sx hyperandrogenism: hirsutism, acne, abnormal hair growth)
  4. Prolactinoma (Galactorrhoea, headaches, visual changes)
  5. Hypothyroid (cold intolerance, weight gain)
  6. Imperforate Hymen (cyclical abdo or pelvic pain)
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5
Q

Contra-indication for DPP4 inhibitors (gliptins)

A

Pancreatitis, or PMHx of pancreatitis

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6
Q

Non-modifiable (2) + Lifestyle (7) risk factors for OP

A

Non Modifiable
- Age >70
- Parent with hip fracture
Lifestyle
- Falls/poor balance
- Low physical activity/immobility
- Low body weight
- Low muscle mass
- Protein/calcium malnutrition
- Vit D insufficiency
- Smoking/Alcohol >2STD/day

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7
Q

Non pharma management of OP (3+3)

A
  1. Calcium >1300mg/day
  2. Vit D - correcct <50 if treating OP
  3. Adequate protein in diet
  4. Mod-vig strengthening exercise 2+ days/week
  5. Weight bearing exercise most days
  6. Balance training, should be challenging
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8
Q

KFP: Screening Ix for pt with T1DM (7)

A
  1. HbA1c
  2. UEC
  3. UrACR
  4. TSH (screen for autoimmune)
  5. Coeliac serology (autoimmune)
  6. Fasting lipids (every yrs at min)
  7. LFT (MAFLD increased in T1DM)
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9
Q

KFP: Advice for diabetic with non commercial license re driving (other than needing annual review)? (3)

A
  1. Advise not to drive if BSL <5
  2. Advise check BSL for every 2hours during a journey
  3. Advise if any symptoms occur, safely pull over, turn the car off and remove the keys from ignition
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10
Q

Complication to be aware of with SGLT2-i (gliflozins)

A

DKA (often normoglycaemic)
- consider in acute illness, dehydration, lo carb diet or fastin

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11
Q

Pt with tiredness, high sodium, low potassium, HTN

A

Hyperaldosteronism / Conn Syndrome

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12
Q

Features of Addisons Disease
- 3 symptoms, 3 exam findings, 3 investigationss

A

Sx: Fatigue, weight loss, abdo pain
Ex: Hypotension, skin hyperpigmentation, Loss of axillary/pubic hair
Ix: HypoNa+, HyperK+, hypoglycaemia

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13
Q

Test for suspected Cushings

A

Overnight 1mg Dexamethasone supression test

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14
Q

Criteria for GDM diagnosis? (3)

A
  1. Fasting BSL >5.5
  2. 2hr BSL >8.0
  3. If meets DM diagnostic criteria = DMiP rather than GDM
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15
Q

Excluding insulin - 5 classes of diabetic drugs + eg

A
  1. Biguanide (Metformin)
  2. Sulfonylurea (Glicazide, glimepreride)
  3. DPPT-inhibitors = Gliptins
  4. SGLT2-inhibitors = Flozins
  5. GLP1 RA - semagluide, dulaglutide, liraglutide
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16
Q

Metformin dosing in CKD (3)

A

Max 2g if eGFR >60
Max 1g if eGFR 30-60
Dont use if eGFR <30

17
Q

DDx for short stature in children (5)

A
  1. Constitutional Delay
  2. Familial Short stature
  3. Hypothyroidism
  4. GH deficiency
  5. Malabsorptive if relevant (Coeliac)
18
Q

DDx for androgen deficiency in male (3+3)

A

Primary - Kleinfelters, testicular torsion, previous chemo
Secondary - Pituitary tumour, haemachromatosis, exogenous test

19
Q

Feet exam for peripheral neuropathy (4: 1/3 + 3)

A
  1. Sensation
    Small fibre - pinprick sensation
    Large fibre
    - vibration using 128Hz fork
    - 10g monofilament pressure sensation at distal plantar great toe + MT joints
    - ankle reflexes
  2. Pulses
  3. Foot deformity
  4. Active lesion/ulcer
20
Q

Pt with OP risk factors but no fracture. Has a DEXA scan. What are your cut-offs for treatment? (1,2)

A
  1. T <-2.5
  2. T score -1.5 to -2.5
    -> Check FRAX result
    If risk of MOF# >20% or Hip# >3%
21
Q

DDx for precocious puberty (3)

A
  1. Idiopathic central precocious puberty
  2. Adrenal tumour OR CAH
  3. Ovarian tumour OR functional ovarian cyst

1. Jim (20 decks)

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