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Finals > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Anti-thyroid peroxidase antibodies raised in what? clinical presentation?

A

Hashimotos- often a goitre too

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2
Q

Very low tsh high T4?

A

Thyrotoxicosis (with symptoms)

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3
Q

High tsh normal T4

A

Poor compliance or sub clinical

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4
Q

Sick euthyroid results? And in who?

A

Low TSH low T4, Tsh May be normal however T3 particularly low often hospital inpatient

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5
Q

Secondary hypothyroidism?

A

Low tsh low t4

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6
Q

What can give falsely low hba1c?

A

Sickle cells

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7
Q

Thiazides can cause what electrolyte problem?

A

Hypercalcaemia, hypokalaemia and natraemia

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8
Q

Very low TSH, high T4 and painful goitre? Scan shows?

A

De quervains (subacute hyperthyroidism) Can follow viral illness often become hypo after a short while, globally reduced uptake on radioisotope scan

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9
Q

Very low TSH, high T4 painless goitre?

A

Graves’ disease

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10
Q

TSH, T3 and T4 low? Often following hospital

A

Sick euthyroid

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11
Q

Primary Hyperparathyroidism bloods?

A

PTH high normal or high, calcium high

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12
Q

Patient presents with high PTH and low Ca2+? Usual cause?

A

Secondary hyperparathyroidism usually CKD often low vit D also

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13
Q

Conn’s syndrome symptoms?

A

Hypokalaemia, Hypertension, polyuria, confusion/difficulty concentrating, lethargy

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14
Q

Symptoms of Addison’s disease?

A

Anorexia, weight loss, hyperpigmentation, fatigue, uncommonly salt craving, hypotension.

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15
Q

Bloods in Addison’s?

A

Hyperkalaemia, Hyponatraemia, can be elevated urea, sometimes anaemia.

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16
Q

Addisonian crisis and treatment?

A

Hyponatraemia, Hyperkalaemia, Hypoglycaemia, Hypotension, headache, fatigue, confusion vomiting. Hydrocortisone and saline with dextrose do not delay treatment for bloods (FBC, UE, LFT, glucose, cortisol ACTH) consider ECG for potassium

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17
Q

What differentiates graves from other hyperthyroid disease?

A

Eye signs, TSH antibodies and high uptake on radio scan

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18
Q

Bloods in Hypercalcaemia due to malignancy?

A

High calcium, Low phosphorous, appropriately low PTH

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19
Q

Hypercalcaemia symptoms?

A

Polydipsia, polyuria, nausea, confusion, constipation, bone pain.

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20
Q

Common hypoglycaemia symptoms?

A

Confused, sweating, hunger, tremor, drowsiness, hunger, anxiety

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21
Q

Type of addisons in people who were receiving steroids?

A

Secondary- and no pigmentation

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22
Q

TSH antibodies in what disease?

A

Graves’

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23
Q

Graves symptoms?

A

Tremor, palpitation, goitre, tachy, murmur, sweating, heat intolerance- eye signs

24
Q

Hypothryroid symptoms?

A

Weakness, weight gain, cold intolerance, constipation, menstrual irregularity, brady, coarse hair, delayed relaxing of tendon reflex.

25
Q

Most common cause of hypothyroidism western world?

A

Autoimmune, thyroid antiperoxidase antibodies

26
Q

Graves’ treatment?

A

Carbimazole, steroids, beta blockers

27
Q

Treatment of hypoglycaemia IV?

A

75ml or 20% glucose 150ml of 10% glucose

28
Q

When would glucagon be inappropriate to use?

A

Liver disease, alcohol, malnourished

29
Q

Symptoms of DKA?

A

Weight loss, confusion, dehydration, abdo pain, nausea, headache and vomiting, weakness, tachy, hypotension.

30
Q

Low Ca2+ High PO4- Low or normal PTH

A

Primary hypoparathyroidism

31
Q

Hypocalcaemia symptoms?

A

Diarrhoea, muscles twitches and cramps, numbness and tingling, poor memory or slowed thinking.

32
Q

Toxic multinodular goitre scan?

A

Patchy uptake

33
Q

Common infections and drugs that may cause DKA?

A

UTI and pneumonia thiazides, antipsychotics, steroids

34
Q

In DKa when to introduce gucose again?

A

Introduction of 10% glucose is recommended when the blood glucose falls below 14.0mmol/L. It is important to continue 0.9% sodium chloride solution to correct circulatory volume

35
Q

Rate of insulin in DKA?

A

Fixed 0.1 units/kg/hr

36
Q

What should you do with SC insulin in DKA?

A

Continue as normal

37
Q

When to replace potassium in DKA and how much?

A

After first litre of fluid providing the potassium is 3.5-5.5 not needed if >5.5 Give as 40mmol per additional litre of fluid

38
Q

Along with fluids, insulin and potassium what else is given in DKA as per NICE?

A

LMWH

39
Q

Aim for what HBa1c in type 1 diabetes?

A

48 or less

40
Q

How many times a day to test blood glucose in type 1?

A

at least 4 before meals and before bed too

41
Q

Diagnosis of type 1 diabetes random and fasting?

A

Random >11.1 or fasting >7 with symptoms

42
Q

Differentiate between type 1 and 2 diabetes blood test?

A

C-peptide or GAD (90%) not measured routinely

43
Q

Diagnose type 1 in who with hyperglycaemia?

A

ketosis rapid weight loss age of onset below 50 years BMI below 25 kg/m2 personal and/or family history of autoimmune disease

44
Q

Diagnosis of diabetes based upon :

A

Diabetes symptoms + a random venous plasma glucose concentration ≥ 11.1 mmol/l or a fasting plasma glucose concentration ≥ 7.0 mmol/l (whole blood ≥ 6.1 mmol/l) or

45
Q

If no symptoms what do you need to do to diagnose diabetes?

A

Have two elevated readings

46
Q

Type 2 diabetes educational program?

A

DESMOND

47
Q

Recommended target HbA1c for type 2 managed by lifestyle and or metformin?

A

48mmol

48
Q

If HbA1c not controlled below 48 on one drug and rises to 58 or more, new target?

A

53mmol and intensify antidiabetic treatment

49
Q

When to stop metformin egfr?

A

<30ml

50
Q

Course for type 1 diabetics?

A

DAFNE

51
Q

What is shown why has it happened? Treatment?

A

Diabetic neuropathy causes unstable gait and bone deformity, can be casted

52
Q

Statin therapy in type 1 diabetes?

A

All adults with type 1 diabetes who are aged over 40 years or have had diabetes for more than 10 years, or have established nephropathy or have other cardiovascular risk factors.

53
Q

Ck in statin therapy with muscle pains?

A

Normal continue if tolerated give at night

>x10 upper limit is rhabdomyolysis

54
Q

Target in cholesterol reduction?

A

Target should be a greater than 40% reduction in non-HDL cholesterol.

55
Q

What endocrine condition is this associated with? What is it?

A

Thyroid acropachy, Graves’ disease

Finals (16 decks)

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