Endocrine Flashcards
What is the pattern of bone in Paget’s disease?
Lamellar bone
What is the commonest cause of primary hyperparathyroidism?
Adenoma
What are the cause of secondary hyperparathyroidism?
Renal insufficiency
What are the laboratory results of hyperparathyroidism?
Hypercalcemia
Hypophosphatemia
What is Cushing’s Syndrome?
Elevated serum cortisol
What is the commonest cause of Cushing’s Syndrome?
Hypersecretion of ACTH from pituitary adenoma
= CUshing’s Disease
How to investigate for CUshing’s Syndrome?
Overnight suppression dexamethasone test
What is acromegaly
Elevated growth hormone
What are the symptoms of acromegaly
Bitemporal hemianopia Enlargement of the skull Hands and feet Large tongue Skin tag
Which diagnostic test is done for acromegaly?
IGF-1
What is the treatment of prolactinoma
Dopamine agonist: cabergoline
What is Diabetes insipidous?
dysfunction in ADH causing dilute urine
What are the 2 types of diabetes insipidus?
Central DI
Nephrogenic DI
What is central diabetes insipidus?
pituitary can’t make ADH because of past surgery, idiopathic, autoimmune, drugs…
What is nephrogenic diabetes insipidus?
Collecting tubules dont respond to ADH
How is diabetes insidious diagnosed?
Water deprivation test = don’t let them drink water –> still get dilute urine
What is SIADH?
Too much ADH = too much water being reabsorbed into the body
How is SIADH diagnosed?
Serum hyponatremia (<135)
Osmolality of blood low (<280)
High urine osmolality: urine more concentrated (>100)
High urine sodium (> 40)
What are the causes of SIADH?
Stress
Malignancy (lung, pancreas, lymphoma)
CNS disease (inflammation, hemorrhage, tumour)
Respiratory (TB, abscess, pneumonia, empyema)
Drugs SE
Chemotherapy agents (vincristine, cyclophosphamide, vinblastine)
What is the treatment of SIADH?
Fluid restrict
Hypertonic solution if hyponatremia severe
What is important to monitor when giving Hypertonic solution in the context of low hyponatremia
Central pontine demyelination
What is Addison’s Disease?
Low cortisol production
Benefit of fish oil?
Lower triglycerides
Problem of fish oils?
Disrupt glucose control in diabetic patient
Pro-Arhythmic effect in CAD patient
What are the criteria of metabolic syndrome?
Waist Expansion Impaired Glucose Hypertension HDL low Trig High
Hypoglycaemia treatment
D50W 50 mL (1 ampule) IV or 1 mg glucagon SC (if no IV available)
- may need ongoing glucose infusion once BG > 90 mg/dL (5 mmol/L)
In a patient with elevated LDL or any form hyperlipidemia what is important to rule out?
DM
Hypothyroid
Obstructive liver disease
Chronic renal failure
What is the optimal blood glucose range in a patient who is critically ill?
7.7-10
How to calculate anion gap?
Na - (Cl + HCO3-)
What is the key word in the symptoms of pheochromocytoma?
Paroxysmal
How do you investigate for pheochromocytoma?
VMA and HVA in the urine collection test
What is the treatment pheochromocytoma?
- Stabalise with alpha-blocker (phenoxybenzamine)
- Canse use beta blocker after
- Surgery
How to investigate for hyperaldosteronism?
K+: Hypokalemia
Aldosterone-to-plasma renin activity ratio: high
Which organs are involved in MEN 1?
3 P’s
Pancreas
Pituitary
Parathyroid
What organs are involved in MEN 2A?
2P’s
Parathyroid
Pheochromocytoma
Medullary thyroid cancer
What organs are involved in MEN 2B?
1 P
Pheochromocytoma
Neuroma
Medullary thyroid cancer
Which gene is involved in MEN 2 cancers?
RET proto-oncogene
What is the treatment of hyperkalaemia
- Calcium glutinate
2. Insulin / albuterol
