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MRCP Revision > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Does Eplerenone or Spironolactone have less chance of causing gynaecomastia?

A

Eplerenone

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2
Q

What is the most important modifiable risk factor for the development of thyroid eye disease?

A

Smoking

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3
Q

T/F Hashimoto thyroiditis is associated with he development of MALT?

A

True

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4
Q

Water deprivation test - Nephrogenic DI.
Urine osmolality after water deprivation?
Urine osmolality after desmopressin?

A

Low + Low

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5
Q

Water Deprivation test - Cranial DI.
Urine Osmolality after water deprivation?
Urine osmolality after desmopressin?

A

Low + High

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6
Q

16M reviewed in clinic due to concerns around development. Short stature, no facial hair, sparse pubic hair, testicular volume 3mls. Cleft palate. Anosmia. LH, FSH, Testosterone all low.

A

Kallman Syndrome

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7
Q

16M presents with delayed puberty. TSH and FSH high. Testosterone low.

A

Klinefelter Syndrome

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8
Q

Mechanism of Carbimazole?

A

Blocks thyroid peroxidase from coupling and iodinating the tyrosine residues on thyroglobulin

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9
Q

What gene is Medullary Thyroid Cancer associated with?

A

RET Oncogene

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10
Q

Karyotype of Klinefelters?

A

47, XXY

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11
Q

defective NKCC2 channel in the ascending loop of Henle

A

Bartters sybdrome

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12
Q

Mutated NCL sympoter in the distal convoluted tubule

A

Gitelman syndrome

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13
Q

How do solfonylureas exert there effect?

A

Inhibiting ATP-sensitive potassium channels on the membrane of pancreatic beta cells. This causes depolarisation of the beta cells, resulting in the opening of voltage-gated calcium channels. The subsequent calcium influx leads to exocytosis of vesicles containing insulin.

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14
Q

Why do Iron tablets need to be taken at least four hours after regular medication?

A

Iron/calcium carbonate can reduce the absorption of levothyroxine

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15
Q

How does octeritide work as a treatment for Acromegally?

A

Somatostatin directly inhibits the release of growth hormone

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16
Q

Autosomal dominant condition where there is continuous activation of epithelial sodium channels (ENaC) in the collecting duct. Leads to hypokalaemia and metabolic alkalosis but in the setting of hypertension and low renin + aldosterone. Tx involves medication which blocks ENaC (e.g. amiloride)

A

Liddle Syndrome

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17
Q

What are the muscarinic antagonists which are used in urge incontinence?

A

Tolterodine, Oxybutynin, Solifenacin

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18
Q

Triad of recurrent renal stones, Hypokalaemia, nephrocalcinosis. Presents with hyperchloremic metabolic acidosis with a normal anion gas.

A

RTA 1

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18
Q

Fanconi syndrome and Wilsons disease is associated with what type of RTA?

A

2

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19
Q

What medications can cause false renin:aldosterone ratio results?

A

ACEi + ARB + Direct renin inhibitors + Aldosterone antagonists

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20
Q

works by inhibiting the PCSK9 protein, which normally binds to LDL receptors on the liver. By blocking PCSK9, evolocumab allows more LDL receptors to remain available on liver cells, where they can remove LDL-C from the blood more effectively, leading to lower blood LDL-C levels. Primarily used in heterozygous familial hypercholesterolemia, homozygous familial hypercholesterolemia, and atherosclerotic cardiovascular disease (ASCVD)

A

Evolocumab

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21
Q

What antibodies are found in Graves Disease (Hyperthyroidism)?

A

Anti-TSH Receptor Antibodies

22
Q

What antibodies are associated with generalised Myasthenia Gravis?

A

Anti-MUSK antibodies

23
Q

What antibodies are associated with Myasthenia Gravis?

A

Anti-acetylcholine receptor antibodies

24
Q

What antibodies is associated with 75% of Grave disease patients?

A

Anti-thyroid peroxidase (TPO) antibodies

25
Q

Typical VBG abnormality pattern in Cushing syndrome?

A

Hypokalaemia metabolic alkalosis

26
Q

Thyroid cancer types:
(1) 70%, often young females, excellent prognosis
(2) 20%
(3) 5%, cancer of parafollicular (c) cells, secrete calcitonin, Part of MEN-2
(4) 1%, not responsive to treatment, cause premature symptoms
(5) Rare, associated with Hashimotos thyroiditis

A

(1) Papillary
(2) Follicular
(3) Medullary
(4) Anaplastic
(5) Lymphoma

27
Q

Medication for stress incontinence?

A

Duloxetine

27
Q

Medication for urge incontinence (when anti-muscarinic are CI e.g. Alzheimer’s or closed angle glaucoma

A

Mirabegron (Beta-3 agonist)

28
Q

MEN 1. 3 Ps?

A

HyperParathyroidism + Pituitary Tumours + Pancreatic Tumours

29
Q

MEN 2A - 1 ‘M’ + 2 ‘Ps’

A

Medullary Thyroid Cancer + Hyperparathyroidism + Phaeochromocytoma

30
Q

MEN 2B - 2 ‘M’s + 1 ‘P’

A

Medullary Thyroid Cancer, Marfans + Phaeochromocytoma

31
Q

Four conditions which cause Hypokalaemia and Hypertension?

A

Cushing Syndrome / Conns Syndrome / Liddles Syndrome / 11 beta hydroxylase deficiency

32
Q

Five conditions with cause hypokalaemia without hypertension?

A

Diuretics / GI loses / Renal tubular acidosis / Bartters syndrome / Gitelman syndrome

33
Q

What will nuclear scintigraphy reveal in toxic multinodular goitre?

A

Patchy Uptake

34
Q

What cancer do patients with Acromegally have an increased risk of?

A

Colorectal

35
Q

What hormone triggers Ovulation?

A

LH

36
Q

At what point in the menstrual cycle do Progesterone levels peak?

A

Luteal Phase (Progesterone is produced by the corpus Luteum)

37
Q

A diagnosis of Impaired Fasting Glycaemia has a blood glucose level between?

A

6.1mmol/L to 6.9mmol/L

38
Q

Diagnosis of diabetes requires a fasting plasma glucose level above?

A

7 mmol/L

39
Q

What blood sugar level do you need for diagnosis of impaired glucose tolerance after oral glucose test?

A

7.8-11.1 mmol/L

40
Q

What type of renal tubular acidosis is linked with Sjogrens syndrome?

A

Type 1

41
Q

Peptic Ulceration, galactorrhoea, hypercalcaemia? Triad for..

A

Multiple Endocrine Neoplasia Type 1

42
Q

What pattern of uptake would you expect in subacute thyroiditis on the technetium scan?

A

Globally reduced

43
Q

In pregnancy Raised total T3 and T4 but normal fT3 and fT4 can be seen. Why?

A

high concentrations of thyroid binding globulin, which can be seen during pregnancy

44
Q

Women with hypothyroidism taking levothyroixne need to increase there thyroxine by upto how much during pregnancy?

A

50%

45
Q

Which hormone is under continuous inhibitory control?

A

Prolactin

46
Q

What regime is preferred in pregnancy for management of hyperthyroidism?

A

Titration regime with low dose of anti-thyroid medication

47
Q

What part of the renal syndrome is compromised in Barters Syndrome?

A

Sodium, potassium and Chloride pumps

48
Q

22F presents with secondary amenorrhoea, pregnancy test negative. FSH, TSH, Prolactin normal. Oestrogen and free androgen index low. Diagnosis?

A

Hypothalamic Hypogonadism

49
Q

Alcoholic excess patient presents with hypoglycaemia. 1st line management.Glucagon or IV 20% Dextrose 100mls (+Thaimine replacement)

A

IV Dextrose + Thaimine replacement

50
Q

How do you calculate serum osmolality?

A

2(Na+) + Glucose + Urea

51
Q

Diagnostic criteria for HHS? (Hyperosmolar Hyperglycaemic state)

A

1) Hypovolaemic (2) Hyperglycaemic (Glu > 30) (3) Raised serum osmolality (>320) (4)Ketones < 3 (5)No Acidosis

52
Q
A

MRCP Revision (14 decks)

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