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Racp > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Carb ratio (g/unit)

A

Grams of carbohydrate covered by 1 unit of insulin

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2
Q

Estimate Total daily Insulin requirement (unit/kg/day)

A

0.5 to 1

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3
Q

Insulin sensitivity factor

A

120/TDD

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4
Q

Teenagers more insulin resistant in the morning

A

Than night

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5
Q

Carb ratio

A

400/TDD

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6
Q

Slice of bread

A

15g

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7
Q

Glp agonists

A

Lower hba1c by 1.3%
Incretin mimicker
- increase insulin secretion
- suppress glucagon

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8
Q

Hba1c target

A

<7%

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9
Q

Target time in range

A

<70%

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10
Q

Target bgl

A

3.9-10

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11
Q

Metformin

A

Biguanide

Increase insulin sensitivity

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12
Q

Psychosocial issues (long case)

A

Sleep
Mood disorder
eating disorder
Diabetes burnout

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13
Q

Minimise cardiovascular risk factors (long case)

A

Dont smoke

Exercise

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14
Q

Sick day (except gastroenteritis)

A

Insulin resistance

Increase lantus dose by 10-15%
temporary basal on pump

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15
Q

Precocious puberty in girls

A

before 8 yo

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16
Q

Precocious puberty in boys

A

before 9yo

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17
Q

Delayed puberty in girls

A

after 15yo

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18
Q

Delayed puberty in boys

A

after 14yo

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19
Q

Investigation of central precocious pubery

A

MRI brain in all boys + girls <6yo

Bone age

20
Q

What does advance bone age suggest

A

central or peripheral precocity

rather than benign

21
Q

What does high LH suggest

A

Central precocious puberty

22
Q

What does high DHEAS suggest

A

Adrenal production of sex hormones

such as non-classical CAH and virilizing adrenal tumors

23
Q

Adrenarche

A

activation of adrenal androgen production causing pubarche, in conjunction with a mild elevation (DHEAS)

24
Q

Pubarche

A

Pubic/axillary hair

25
Q

Gonadarche

A

Activation of gonads by the pituitary hormones FSH and LH

26
Q

Menarche

A

Onset of menses

27
Q

Thelarche

A

Onset of breast development

28
Q

Normal progression of -arche’s

A

Girls : adrenarche → gonadarche → thelarche → (growth spurt → pubarche) → menarche

Boys: adrenarche → gonadarche→ (pubarche → growth spurt ) → androgenic hair growth

29
Q

Causes of central procicity

A

Idiopathic

CNS tumour e.g. hypothalamic hamartoma, pit adenoma

30
Q

Causes of peripheral precocity

A

Adrenal tumour secreting sex hormone
Ovarian/testicular tumour which may secrete hCG or sex hormone)
Autonomous gonadal activation (McCune Albright)
Familial male-limited PP (mutation of LH receptor gene)
CAH
Primary hypothyroidism
Exposure to exogenous sex steroids

31
Q

Treatment of central precocious puberty

A

GnRH agonist DEPOT

Target LH <2

32
Q

Treatment of peripheral precocity

A

Blocking production of / response to the excess sex steroids

33
Q

Hypogonadotrophic hypogonadism + anosmia

A

Kallman

34
Q

What causes low serum TOTAL T4 but normal free T4 and TSH

A

TBG deficiency

35
Q

Indication for GnRH stimulation test

A

Differentiate CPP from benign pubertal variant

36
Q

Is GH, IGF1 and insulin anabolic or catabolic

A

Anabolic (build up)
thus GH abused by body builders
and diabetes (insulin deficiency) causes breakdown

37
Q

Post resection of craniopharyngioma

A

Hypothalamic dysfunction including obesity

Panhypopit

38
Q

Sensorineural deafness + hypothyroidism

A

Pendred syndrome

39
Q

Prolactin indicative of

A

hypothalamic damage

40
Q

GH stimulation test

A

Use glucagon –> insulin –> GH

Positive if GH >7.5

41
Q

Endogenous hydrocort production

A

5-6mg/m2

42
Q

Dosage regimes of hydrocort for Hypopit vs CAH

A

Hypopit - use 6-8 mg/mg2

CAH - need to overcome a block and reduce production of sex steroids - higher dose

43
Q

Treatment of delayed puberty in boys

A

cyclical hCG (similar LH) and FSH

44
Q

Treatment of delayed puberty in girls

A

oestrogen

45
Q

When to treat precocious puberty

A

> 3 year bone age advancement

<6yo

46
Q

What does having serum thyroglobulin indicate, when no uptake seen on radionucleotide scan

A

Hypoplastic thyroid, as opposed to NO thyroid

Racp (21 decks)

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