Endocrine Investigations Flashcards

1
Q

First line investigation for thyroid cancer
And other investigations

A

1st) Ultra sound
Thyroid function
TSH receptor antibodies (TRAP)

No role for isotope scan/CT/MRI

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2
Q

screening test for excess cortisol (cushings)

A

best:
-overnight dexamtheasone suppression test
- 24 hr urinary free cortisol

Other:
-late night salivary cortisol

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3
Q

diagnostic test for cushings

A

low dexamethasone suppression test
(measure cortisol and aCTH at baseline and 48 hrs, normal response to supress. failure to supress diagnosis cushings syndrome. diagnoses cushings but not the cause)

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4
Q

diagnosis of primary aldosteronism

A

-confirm aldosterone excess
check aldosterone: renin ratio via saline supression test

  • confirm subtype by doing abdo CT and AVS (adrenal venous sampling) to find out if its unilateral or bilateral
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5
Q

diagnostic test for Addisons

A

short synACTHen test

inject ACTH, in Addisons cortisol won’t increase as adrenal glands don’t work

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6
Q

conns syndrome Ix

A

blood biochem, urinary potassium loss >30mmol/day, adrenal CT scan (for adenoma)

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7
Q

diagnostic criteria for diabetes

A

fasting>7.0, random >11.1- if asymptomatic need 2 readings

hba1c> 48mmol diagnostic in symptomatic patient

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8
Q

test for acromegaly

A

1st line: Serum IGF-1 levels

confirm diagnosis: oral glucose tolerance test (OGTT) with serial GH measurement

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9
Q

phaecromocytoma IXs

A

do 24 hr urinary metanephrines, not catecholamines

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10
Q

What does simmonds test, test

A

Achilles tendon rupture

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11
Q

How to work out hyperosomlality

A

(2xNa) + glucose + urea

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12
Q

What is classed as hyperosomolality and what is hyperosmolality seen in

A

> 320mmol/L

Seen in HHS

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13
Q

initial investigation for someone with a fever who is taking carbimazole

A

blood test
this is to check for neutropenia (low platelets) which can be caused by carbimazole

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14
Q

high dose dexamethasone results for
pituitary adenoma
adrenal adenoma
ecoptic ACTH eg small cell lung cancer

A

PA: low acth, low cortisol (as acth dependant)
adrenal adenoma: low ACT, high cortisol (as ACTH independant)
ectopic ACTH: high ACTH, high cortisol (as ACTH isnt being produced from pituitary so does not respond to test)

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15
Q

clinical examinations for hypoparathyroidism

A

chvosteks sign: tapping parotid= facial twitching
trousseaus sign: carpal spasm (fingers adduct, wrist flexes) when bp cuff on

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16
Q

scintigraphy: faint diffuse uptake/ no uptake

A

subacute thyroiditis

17
Q

scintigraphy: increased homogenous uptake

A

graves

18
Q

suspected diabetes inspidus testing

A

1st investigate PTH levels and serum calcium as hypercalcaemia due to hyperparathyroidism needs to be excluded

2nd- diagnostic: water deprivation test

19
Q

what is diagnostic of osteomalacia

A

low vit D, hypocalcaemia, low serum phosphate, raised ALP

20
Q

Ix for non functional thyroid nodule

A

ultrasonography of neck

Fine needla aspiration (FNA) may be inidicated