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Medicine > Endocrine/ clinical chemistry > Flashcards

Endocrine/ clinical chemistry Flashcards

1
Q

Suggest which tests should be done to investigate the cause of hyponatraemia.

A

Bloods- FBC, UEs, LFTs, TFTs, Protein, lipids, glucose

Serum osmolality

Urine sodium and osmolality

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2
Q

Which of these tests is used to determine whether the cause of Diabetes Insipidus is cranial or nephrigenic?

  1. Serum osmolality
  2. 8 hour water deprivation test
  3. CT pituitary
A

8 hour water deprivation test

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3
Q

Which of these drugs is used to manage cranial diabetes insipidus?

  1. Desmopressin
  2. Demecleocyclin
  3. Tolvaptan
A

Desmopressin

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4
Q

Which of these drugs is used to manage nephrogenic diabetes insipidus?

  1. Desmopressin
  2. Thiazide diuretics eg. Bendroflumethiazide
  3. Tolvaptan
A

Thiazide diuretics eg. Bendroflumethiazide

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5
Q

A patient who recently underwent an adrenalectomy to treat Cushing’s syndrome presents to GP with skin hyperpigmentation. Investigations reveal raised serum ACTH and an enlarging pituitary tumour. What condition are they most likely to have?

  1. Nelson’s syndrome
  2. Alport syndrome
  3. Haemolytic uraemia syndrome
A

Nelson’s syndrome

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6
Q

What triad of features is typical of Phaeochromocytoma?

A
  1. Sweating
  2. Episodic headaches
  3. Tachycardia
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7
Q

Which of these drugs should be given BEFORE adrenalectomy to remove a phaeochromocytoma?

  1. Alpha blockers and Beta blockers
  2. Beta blockers and Diuretics
  3. Alpha blockers and Diuretics
A
  1. Alpha blockers and Beta blockers

To prevent intraoperative morbidity and mortality from large alterations in blood pressure.

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8
Q

Which condition is diagnosed using the 9am serum cortisol and short synacthen tests?

  1. Cushing’s syndrome
  2. Phaeochromocytoma
  3. Diabetes insipidus
  4. Addison’s disease
A

Addison’s disease

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9
Q

Which condition is diagnosed by initially measuring serum aldosterone and renin measurements?

  1. Cushing’s syndrome
  2. Phaeochromocytoma
  3. Primary aldosteronism (Conn’s)
  4. Addison’s disease
A

Primary aldosteronism (Conn’s)

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10
Q

Which condition is most likely to present with hypokalaemic hypertension?

  1. Cushing’s syndrome
  2. Phaeochromocytoma
  3. Primary aldosteronism (Conn’s)
  4. Addison’s disease
A

Primary aldosteronism (Conn’s)

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11
Q

What is the most common endocrine condition in women of reproductive age?

A

Polycystic ovarian syndrome

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12
Q

2/3 of the following criteria should be present to diagnose PCOS…

A
  1. Clinical and/or biochemical features of hyperandrogenism
  2. Oligo/anovulation
  3. Polycystic ovaries on USS
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13
Q

Name 3 or more features of PCOS.

A
  1. Polycystic ovaries
  2. Hyperandrogenism
  3. Oligo or amenorrhoea
  4. Obesity
  5. Hirtuism
  6. Subfertility
  7. Acne
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14
Q

Name 2 or more options for managing PCOS.

A
  1. Weight loss
  2. Metformin
  3. Combined oral contraceptive pill- with withdrawal bleed at least every 3 months. Manages amenorrhoea
  4. IVF
  5. Clomifene citrate for stimulation of ovulation
  6. Anti-androgen creams or systemic therapy (Spironalactone, Finasteride) for hirtuism
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15
Q

Why is a withdrawal bleed recommended at least every 3 months in patients with PCOS?

  1. Reduces hyperandrogenism
  2. Reduces endometrial hyperplasia
  3. Reduces prolactin levels
A
  1. Reduces endometrial hyperplasia
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16
Q

Diabetic retinopathy is most common in which type of diabetes?

A

Type 1 diabetes

17
Q

What is the target clinic BP in diabetics aged 80 or under?

  1. 150/90
  2. 140/90
  3. 135/85
A

140/90

Same as non diabetics

18
Q

Which of these retinal features usually occurs first in non-proliferative diabetic retinopathy?

  1. Neovascularisation
  2. Micro aneurysms
  3. Cotton wool spots
  4. Macula oedema
A

Microaneurysms

19
Q

Name 1 or more non-retinal feature of diabetic eye disease.

A
  1. Cataracts
  2. Cranial nerve palsies (CN 3 and 6)
  3. Neovascular glaucoma
  4. Frequent lens changes
  5. Argyll Robertson pupils
20
Q

Which drug used for managing diabetes has side effects including weight gain, hypoglycaemia and hyponatreamia?

  1. Metformin
  2. Sulfonylureas (Glicazide)
  3. DPP4 inhibitors (Gliptins)
  4. GLP1 mimetics
A
  1. Sulfonylureas (Glicazide)
21
Q

Which drug used for managing diabetes has side effects including rashes and hypersensitivity, headaches and pancreatitis?

  1. Metformin
  2. Sulfonylureas (Glicazide)
  3. DPP4 inhibitors (Gliptins)
  4. GLP1 mimetics
A
  1. DPP4 inhibitors (Gliptins)
22
Q

Which drug used for managing diabetes has side effects including weight gain, deranged lipids and LFTS, increased fracture risk and fluid retention?

  1. Pioglitazone
  2. Sulfonylureas (Glicazide)
  3. DPP4 inhibitors (Gliptins)
  4. GLP1 mimetics
A
  1. Pioglitazone
23
Q

Which of these drugs used for managing diabetes is contraindicated in patients with high fracture risk, bladder cancer, haematuria or heart failure?

  1. Pioglitazone
  2. Sulfonylureas (Glicazide)
  3. DPP4 inhibitors (Gliptins)
  4. GLP1 mimetics
A
  1. Pioglitazone
24
Q

Which of these drugs is used to manage treatment refractory diabetes in patients with a high BMI, who have already tried 3 other diabetic drugs?

  1. Pioglitazone
  2. Sulfonylureas (Glicazide)
  3. DPP4 inhibitors (Gliptins)
  4. GLP1 mimetics
A
  1. GLP1 mimetics
25
Q

Which treatment should be given first in patients with acute severe hyponatraemia?

  1. Tolvaptan
  2. IV Dextrose 10%
  3. Hypertonic saline (1.8%) bolus
A
  1. Hypertonic saline (1.8%) bolus
26
Q

Central pontine myelinolysis can occur due to over-correction of severe ……

  1. Hypocalcaemia
  2. Hyponatraemia
  3. Hypernatramia
  4. Hypokalaemia
A
  1. Hyponatraemia
27
Q

Name 2 or more causes of hyponatramia where patients are dehydrated and have high urine sodium levels?

A
  1. Addison’s
  2. Diuretics- loop and thiazide
  3. Renal failure
28
Q

Name 2 or more causes of hyponatramia where patients are NOT dehydrated and appear oedematous?

A
  1. Heart failure
  2. Liver failure
  3. Renal failure
  4. Nephrotic syndrome
29
Q

Gestational diabetes is diagnosed if fasting blood glucose levels are:

  1. > 5.6
  2. > 7
  3. > 11
A
  1. > 5.6
30
Q

What are the 2 most common causes of hypercalcaemia?

  1. Primary hyperparathyroidism & malignancy
  2. Primary hyperparathyroidism & sarcoidosis
  3. Primary hyperparathyroidism & thyrotoxicosis
A
  1. Primary hyperparathyroidism & malignancy

Medicine (11 decks)

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