Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GRACE Phase 2a Medicine > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What is phaeochromocytoma?

A

Rare tumour that secretes catecholamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Clinical presentation of phaeochromocytoma?

A

headache, profuse sweating, palpitations, tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Ix for phaeochromocytoma?

A

24hr urinary total catecholamines, CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Carcinoid tumours

A

slow growing type of neuroendocrine tumour (arising from the cells in the endocrine and NS), commonly occur in the intestines, but are also found in the pancreas and lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Carcinoid syndrome

A

Group of symptoms due to the release of serotonin and other vasoactive peptides into the systemic circulation due to a carcinoid tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Presentation of carcinoid syndrome

A

Diarrhoea, abdominal cramps, palpitations, signs of R heart failure, bronchospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ix for carcinoid syndrome?

A

high volume of 5-hydroxyindoleacetic acid (breakdown product of serotonin), LFTs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When does ketogenesis occur?

A

When the body is starved of glucose and glucagon stores are used, phenomenon also occurs in diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens in ketogenesis?

A

Liver takes fatty acids –> ketones (from acetyl CoA - ketones = water soluble fatty acids). Ketones can cross the BBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the problem with ketogenesis in diabetics?

A

Ketones = acidic, normally buffered, in T1DM –> metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cardinal symptoms of T1DM?

A

weight loss, polyuria, polydysia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why do you get polyuria in T1DM?

A

More glucose than normal in nephron - therefore less water reabsorbed –> more urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Normal glucose range /mmol/L?

A

4-6mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Fasting glucose levels for diabetics? Random?

A

Fasting - >7 mmol/L

Random - >11 mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

GS test for DM?

A

HbA1c - glycated Hb >48mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mx of T1DM

A

SC insulin, long acting once daily, short acting before meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Fasting glucose levels for pre-diabetics? Random?

A

Fasting - 6.1-6.9 mmol/L

Random - 7.8-11.0 mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Px of T2DM

A

asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mx of T2DM

A
  1. lifestyle advice

2. Metformin (+sulfonylurea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Signs of hypoglycaemia

A

Sweating, pallor, tachycardia, confusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Respiration typical of DKA?

A

Kussmauls - deep and rapid, reduce acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Complications of diabetes

A

hypoglycaemia, DKA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is hepatomegaly?

A

Excessive release of GH, most often due to pituitary adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Presentation of acromegaly?

A

Large extremities, coarsening of facial features, bitemporal hemianopia, large protruding jaw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Ix for acromegaly?

A
  1. IGF-1 blood test
  2. Oral glucose tolerance (high glucose –> suppresses GH normallu)
  3. MRI scan
  4. Visual field test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Mx for acromegaly?

A
  1. Trans-sphenoidal surgical removal of adenoma
  2. GH antagonist - pegvisomant
  3. Somatostatin analogue (inhibits GH release) - ocretide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Highest point of cortisol release?

A

Morning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Functions of cortisol

A

Stress hormone, increased energy source by carbohydrate breakdown and protein, diminished host response, vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Causes of Cushings

A

Iatrogenic - oral steroids
Cushings (too much ACTH)
Pituitary adenomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Px of Cushings?

A

Central obesity, moon face, stretch marks, poor healing, proximal muscle wasting, depression, HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Ix of Cushings?

A

Overnight dexamethasone suppression test, 24hr urinary cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Mx of Cushings?

A

Stop steroids

tumour removal

33
Q

Addisons/Primary adrenal insufficiency

A

Disorder causing reduced production of adrenocortical hormones, most commonly due to autoimmune destruction of the adrenal gland (Addisons)

34
Q

mnemonic for cardinal symptoms of Addisons?

A

Tanned, toned, tired, tearful

35
Q

Ix for Addisons?

A
  1. Short ACTH stimulation test (Synacthen) - doesn’t lead to cortisol production
  2. Urinary/serum electrolytes (hyponatraemia, hyperkalaemia)
36
Q

Mx of Addisons?

A

Oral hydrocortisone - cortisol

Fludrocortisone - aldosterone

37
Q

Common cause of secondary hyperaldosteronism?

A

Renal artery stenosis (increased production of renin due to decreased perfusion in the kidneys)

38
Q

Conn’s syndrome/ hyperaldosteronism?

A

Hypersecretion of aldosterone due a pituitary adenoma or bilateral adrenal hyperplasia most commonly

39
Q

Hallmarks of Conn’s syndrome

A
  1. HTN

2. Hypokalaemia (weakness, irritability, polyuria/nocturia)

40
Q

Ix for Conn’s?

A
  1. U+E’s - decreased renin and increased aldosterone

2. Hypokalaemic ECG

41
Q

Mx for Conns?

A
  1. Laparascopic adrenalectomy

2. Aldosterone anatagonist - spironolactone

42
Q

Which cells secrete calcitonin? When is this release?

A

Parafollicular C cells, low serum calcium

43
Q

TRH

A

thyrotropin releasing hormone is secreted from the paraventricular nucleus fo the hypothalamus, causing the release of TSH from the anterior pituitary

44
Q

Building blocks of thyroid hormone

A

Tyrosine (amino acid) and iodine are assembled onto the glycoprotein thyroglobulin, synthesis occurs in the colloid of the follicle

45
Q

Thyroid autoantibodies

A

Antithyroid peroxidase antibodies, anti-thyroglobulin antibodies

46
Q

2 types of autoimmune thyroid disease

A
  1. Graves - hyper

2. Hashimotos - hypo

47
Q

Thyroid function test

A
  1. Levels of TSH, levels of free T3 and T4
  2. Thyroid autoantibodies
  3. TSH receptor antibody (Graves)
  4. US
  5. Radioactive iodine isotope scan
48
Q

Causes of hyperthyroidism?

A
  1. Graves disease (60-80%)
  2. Toxic multinodular goitre
  3. Thyroid adenoma
  4. Pituitary adenoma (secondary)
49
Q

Clinical px of hyperthyroidism

A

Goitre, weight loss and increased appetite, heat intolerance and sweating, tremor, palpitations, anxiety/irritability

50
Q

Clinical px specific to Graves (IgG TSH antibodies)

A

Buldging eyes (exopthalmos), pretibial myoxedema

51
Q

Graves disease

A

Autoimmune cause of hyperthyroidism due to production of excessive IgG antibodies stimulation TSH receptors

52
Q

Thyrotoxicosis

A

excessive amounts of TH, hospital admission - beta-blockers, anti-arrhythmatic medication

53
Q

Mx for hyperthyroidism

A
  1. Anti-thyroid drugs - carbimazole
  2. Radioactive iodine
  3. Surgery
54
Q

Types of thyroid autoantibodies

A

Antithyroglobulin, antithyroid peroxidase, TSH receptor antibody (Graves)

55
Q

Commonest cause of hypothyroidism - developing and then Western world?

A

Iodine deficiency, autoimmune disease

56
Q

Hashimotos thyroiditis

A

Form of autoimmune hypothyroidism - anti-thyroid peroxidase, anti-thyroglobulin antibodies –> goitre

57
Q

Px of hypothyroidism?

A 
Weight gain, moon face
Cold intolerance, dry skin
Depressed, irritable, fatigue
Constipated
Goitre
Fluid retention - oedema
58
Q

Drug that interferes with TH synthesis, can cause both hypo- and hyperthyroidism (mainly hypo)?

A

Amiodarone (anti-arrhythmic), iodine rich, structurally like T4, 2% of px will get thyroid issues from it

59
Q

Tx for hypothyroidism?

A

Replace thyroid hormone - levothyroxine (CI in px with IHD)

60
Q

Myxoedema coma?

A

Complication of hypothyroidism - hypothermic, hypotensive, bradycardic - IV levothyroxine

61
Q

Levothyroxine

A

Synthetic T4

62
Q

4 cardinal symptoms of thyroid cancer?

A
  1. Hard, irregular thyroid nodules
  2. Hoarseness of voice
  3. Dysphagia (difficulty swallowing)
  4. Enlarged lymph nodes
63
Q

Dx of thyroid cancer

A
  1. US

2. Fine needle aspiration and biopsy

64
Q

Tx for thyroid cancer

A

Radioactive iodine

65
Q

Px of hyperparathyroidism/ hypercalcaemia?

A

Stones, bones, groans and psychiatric moans

66
Q

PTH acts to ?

A

Raise serum calcium by:

  1. Increasing bone resorption
  2. Increasing Ca2+ renal reabsorption
  3. Forming active vit D –> intestinal uptake of Ca2+ increased
67
Q

Causes of primary hyperparathyroidism?

A

Parathyroid adenoma

68
Q

Tx for primary hyperparathyroidism?

A

Increased Ca2+ and PTH

69
Q

Hypoparathyroidism causes

A

Autoimmune, Vit D deficiency

70
Q

SIADH

A

syndrome of inappropriate ADH secretion, excessive ADH –> increased water retention –> hyponatraemia

71
Q

Causes of SIADH

A

Infection, problem with posterior pituitary, SCLC

72
Q

px of SIADH

A

Headache, fatigue, muscle aches and cramps, confusion

73
Q

Mx of SIADH

A

Treat underlying cause, restrict fluid intake,

74
Q

Hypercalcaemia sx

A

Bones, stones, groans, psychiatric moans

75
Q

hypocalcaemia sx (SPAS)

A

spasms
paraesthesia
anxiety
seizures

76
Q

Causes of hypercalcaemia?

A

Primary hyperparathyroidism, malignancy

77
Q

Causes of hypocalcaemia?

A

Vit D deficiency, hypoparathyroidism, CKD

78
Q

ECG presentation of hypercalcaemia/hypo?

A

Short QT interval - hyper

Long Qt interval - hypo

79
Q

1st line mx for px with DKA?

A

IV fluids (not insulin)

GRACE Phase 2a Medicine (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions