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Metabolic > Endocrine bits > Flashcards

Endocrine bits Flashcards

1
Q

What is Addison’s disease?

A

Autoimmune destruction of the adrenal glands

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2
Q

Features of Addison’s disease?

A 
Lethargy
Weakness
Anorexia
Nausea+vomiting
Weight loss
Salt-craving
Hyperpigmentation 
Vitiligo
Loss of pubic hair in women
Hypotension
Hypoglycemia
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3
Q

Causes of hypoadrenalism?

A 
TB
Metastases
Meningococcal Septicaemia
HIV
Antiphospholipid syndrome
Pituitary disorders
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4
Q

Investigations of Addison’s?

A

Short synacthen test - ACTH stimulation

<100 abnormal

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5
Q

Electrolyte disorders that can be seen in Addison’s?

A

Hyperkalemia
Hyponatremia
Hypoglycemia
Metabolic acidosis

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6
Q

Starting dose of levothyroxine in over 50?

A

25mcg and titre up

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7
Q

Starting dose of levothyroxine in under 50?

A

50-100 mcg

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8
Q

When to check blood after change in thyroxine dose?

A

8-12 weeks

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9
Q

Side effects of thyroxine therapy?

A

Hyperthyroidism
Reduced bone mineral density
Worsening angina
Atrial fibrillation

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10
Q

What drug to avoid on levothyroxine?

A

Iron - give 2 hours apart - reduces absorption

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11
Q

Causes of raised prolactin?

A 
Pregnancy
Prolactinoma
Physiological
Polycystic ovarian syndrome
Primary hypothyroidism
Phenothiazines
MetocloPramide
DomPeridone
ResPeridone
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12
Q

Drugs cause hyperthyroidism?

A

Iodine

Amiodarone

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13
Q

Drugs causing hypothyroidism?

A

Lithium

Amiodarone

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14
Q

Drugs causing galactorrhea?

A

Chlorpromazine
Metoclopramide
Oestrogens

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15
Q

Drug causing inappropriate ADH secretion?

A

Chlorpropamide

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16
Q

Drugs causing hypoaldrenalism?

A

Ketoconazole
Metyrapone
Aminoglutethimide

17
Q

Drugs that may mimic thyrotoxicosis or phaeocromocytoma?

A

Amfetmines

Sympathomimetics

18
Q

What may increase aldosterone activity?

A

Liquorice

Carbenoxolone

19
Q

What drugs case hypoaldosteronism?

A

ACE inhibitors

20
Q

What drugs may cause secondary aldosteronism?

A

Diuretics

21
Q

What drugs may affects TBG?

A

Anticonvulsants - bind to TBG - decrease T4

Oestrogen - raise TBG - increase T4

22
Q

What is Kallmann’s syndrome?

A

Isolated gonadotrophin deficiency

23
Q

What is septo-optic dysplasia?

A

Congenital
Midline forebrain abnormalities
Optic nerve hypoplasia
Hypopituitarism

24
Q

What is Sheehan’s syndrome?

A

Pulmonary infarction secondary to postpartum haemorrhage

25
Q

What is pendred’s syndrome?

A

Mutation in chromosome 7

Defects in synthesis of thyroid hormone and sensorineural deafness

26
Q

Causes of primary hypothyroidism?

A 
Atrophic thyroiditis
Hashimotos thyroiditis
Postpartum thyroiditis
Iatrogenic
Iodine deficiency
Amiodarone
Contrast media
Lithium
Congenital
27
Q

Causes of secondary hypothyroidism?

A

TSH deficiency
Hypopituitarism
Hypothalamic disorders

28
Q

Hashimoto’s thyroiditis?

A

TPO antibodies

29
Q

Symptoms of hypothyroidism?

A 
Bradycardia
Slow reflexes
Ataxia
Dry, thin hair
Fatigue, drowsiness
Cold intolerance
Ascites/oedema/effusion
Round puffy face
Immoblile
Neuropathy
Myopathy
Goitre
Myxoedema
30
Q

What is myxoedema coma?

A 
Severe form of hypothyroidism 
Confusion coma
Cardiac failure
Hypoventilation
Hypoglycemia
Hyponatremia
31
Q

Treatment of myxoedema coma?

A 
Oxygen
Monitoring cardiac output
Gradual rewarming
Hydrocortisone
Glucose infusion
32
Q

TFTs for thyrotoxicosis?

A

TSH low

T4 high

33
Q

TFTs in primary hypothyroidism?

A

TSH high

T4 low

34
Q

TFTs in secondary hypothyroidism?

A

TSH low

T4 low

35
Q

TFTs in sick euthyroid syndrome?

A

TSH low
T4 low
T3 low

36
Q

TFTs in subclinical hypothyroid?

A

TSH high

T4 normal

37
Q

TFTs in poor thyroxine compliance?

A

TSH high

T4 normal

38
Q

TFTs in steroid therapy?

A

TSH low

T4 normal

Metabolic (5 decks)

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