Endocrine and Metabolic Medicine Flashcards
Which hypoglycaemic agents are indicated in patients at risk of/with established CVD or CCF?
SGT2 inhibitor (e.g. dapagliflozin)
Which hypoglycaemic agents are indicated in patients with low risk of CVD or CCF?
DPP-4 inhibitors (e.g. sitagliptin, saxagliptin, linagliptin, and alogliptin)
TZDs (Pioglitazone)
Sulphonylureas (e.g. Gliclazide, glipizide)
Which side effects are associated with sulfonylureas (e.g. gliclazide)?
Hypoglycaemia
Weight gain
GI upset
Hypersensitivity
Which side effects are associated with incretin analogues (e.g. exanatide)?
Weight loss
Reduced hepatic fat accumulation
Hypoglycaemia
Nausea
Which side effects are associated with pioglitazone?
Weight gain
Fluid retention
What are the contraindications of pioglitazone?
CCF
Bladder cancer
Liver impairmentW
Which hypoglycaemic drug should be given if Q Risk score > 10%?
SGLT2 inhibitors
Which disorder is phaeochromocytoma associated with?
MEN II
Which investigation is used to diagnose pheochromocytoma?
24 hour urinary metanephrines
Which metabolic abnormality is seen in Cushing’s syndrome?
Hypokalaemia metabolic alkalosis
Which TFT pattern is seen in thyrotoxicosis (e.g. Grave’s disease)?
Low TSH
High free T4
Which biochemical pattern is seen in primary hyperparathyroidism?
High calcium
Low phosphate
High/normal PTH
Which biochemical pattern is seen in secondary hyperparathyroidism?
Chronic disease (e.g. CKD)
Low calcium
High phosphate
Compensatory increased PTH
Which biochemical pattern is seen in tertiary hyperparathyroidism?
Parathyroid hyperplasia
High calcium
High PTH
How is primary hyperparathyroidism treated?
Total parathyroidectomy
Which investigations are diagnostic in T1DM?
Low C peptide
Anti - GAD (80%)
Islet cell antibodies (70-80%)
Insulin autoantibodies (IAA)
What are the caused of primary hyperaldosteronism?
Bilateral idiopathic hyperplasia (60-70% of cases)
Adrenal adenoma
Unilateral hyperplasia
Familial hyperaldosteronism
Adrenal carcinoma
How is bilateral adrenal hyperplasia treated?
Spironolactone
Which fasting glucose level is diagnostic of T2DM?
> = 7.0 mmol/l
Which random glucose level is diagnostic of T2DM?
> = 11.1 mmol/l
What is a normal fasting glucose?
<=6.0 mmol/l
Which HbA1c level is diagnostic of T2DM?
> = 48 mol/mol
Define impaired fasting glucose
> =6.1 mmol/l but < 7.0 mmol/l
Define impaired glucose tolerance
Plasma glucose <7.0 mmol/l
AND
OGTT at 2 hours >= 7.8 mmol/l but < 11.1 mmol/l
How is suspected Addison’s disease diagnosed?
Short Synacthen test
Which metabolic abnormalities are seen in Addison’s disease?
Raised K+
Low Na+
Low glucose
Metabolic acidosis
How is myxoedema coma managed?
IV thyroid replacement
IV fluids
IV steroids
Electrolyte imbalance correction
What can cause hypothyroidism?
Hashimoto’s thyroiditis
Riedels
Iodine deficiency
Lithium
Subacute thyroidits
How is thyroid replacement therapy monitored?
TSH - aim for 0.5 -2.5 mU/l
How is plasma osmolality calculated?
2Na+ + Urea + Glucose
Which is the commonest thyroid cancer?
Papillary carcinoma
How is acromegaly investigated?
IGF-1
What is the commonest cause of hypercalcaemia?
Primary hyperparathyroidism
Which drug is used to treat galactorrhea?
Bromocriptine (dopamine agonist)
Which conditions can cause lower-than-expected levels of HbA1c?
Sickle-cell anaemia
GP6D deficiency
Hereditary spherocytosis
Haemodialysis
(Due to reduced RBC lifespan)
