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*** Exam Medicine > Endocrine Summary Q's > Flashcards

Endocrine Summary Q's Flashcards

1
Q

Micro and Macrovasc cimplications of diabetes

A

Micro - Retinop/nephrop/ neurop

Macro - PVD, Stroke, MI

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2
Q

treating charcots foot

A

Offload weight, total contact cast, Bisphosphonates

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3
Q

what is most important aspect of management/ risk factor control in diabetics?

A

BP, Chol, Coagulation, BM control

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4
Q

why is UTI and other infections more common in DM?

A

decreased function of neutrophils, basophils and eosinophils

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5
Q

absolute indications for amputation of diabetic foot

A

deep abscess, gangrene/severe ischaemia, spreading infection, septic arthritis

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6
Q

DM retinopathy stages

A

Background - Dots, Blots and Hard exudates
Pre Pro - waxy exudates and cotton wool spots
Pro - new vessel growth
Advanced - new vessel leaking and haemorrhages/micro aneurysms

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7
Q

treatment of proliferative stage of DM retinopathy?

A

stop smoking, glyc control, lower BP and LASER PHOTO COAG

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8
Q

what might predispose a DKA episode?

A

viral infection, MI, poor insulin compliance, surgery

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9
Q

what is significance of raised lactate?

A

hypoxia? acidosis?

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10
Q

what can cause hypogly in Non-DM?

A

insulinoma, iatrogenic insulin use, alcohol excess, fasting, addisons?

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11
Q

graves pathophys

A

graves IgG autoABs bind to thyroid stimulating hormone receptors and stimulate release of T3/T4.

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12
Q

graves specific CF, and treatment of Graves Thyrotox

A

goitre WITH BRUIT, opthalmoplega, exopthalmus, thyroid acropachy, pre-tib myxoedema

T / Propanolol + Carbimazole or polythiouracil
definitive = radionuclear Iodine, or subtotal thyroidectomy

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13
Q

risk with polythiouracil

A

massive risk of neutropenia

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14
Q

myxoedema coma - cause and CF // basic T

A

HYPOthyroid issue. Any definitive treatment involving thyroid (radioactive iodine)

Cold, low HR, Hypoglyc, coma, low resp rate

T/ as seen basically. Give T3 is only pre-requisite

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15
Q

thyrotoxic storm - cause and CF

A

c - MI, surgery, radioiodine, infection

seems like opposite to myxoed coma
HR up, temp up, agitated, deleirium

T / same as for hyperthyroid + hydrocort

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16
Q

what drugs can cause HYPOthyroid

A

amiodarone, iodine, lithium, any hyperthy drug - polythiour/carbimazole)

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17
Q

thyroid eye disease CF

A

Hyperthyroid condition.

Lid Lag, Exopthalmus, Opthalmoplegia, lid retraction (white of sclera visible above iris)
can result in diplopia, RAPD, pain and decreased vision.

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18
Q

what is malignant hyperparathyroidism?

A

HyperPTH caused by squamous cell CA of lung

19
Q

what are the actions of PTHormone?

A
  1. Increase osteoclast action = resorption of bone causing increased CA
  2. decreases reabsorption of Phosphate in kidney
  3. increase conversion of vit D3 to calcitriol in kidney
  4. incresed absorption of Ca in intestine/kidney
20
Q

how does dexamethasone suppression test work? Short and Long

A

give dexamethasone at 2300 and measure serum cortisol at 0900. if not suppressed then excess ACTH condition.

distinguish ACTH dependant by Long Dexameth test. if some suppression, then ACTH dependant (cushings) if NO suppression at all then extopic ACTH tumor.

21
Q

synACTHen test details

A

measure serum cortisol, give synACTH then remeasure. If cortisol levels increased then NOT addisons

22
Q

what treatment is given to addisons sufferers?

A

Hydrocortisone And fludrocortisone + medic alert bracelet

23
Q

what are CF of acromegaly?

A

Split into Pit Tumor symp and excess GH cf’s.

Tumor: homonomous hemi, prom supra-orb ridge, hypo-pituatary

excess GH - large jaw, hands, feet, carpal tunnel, DM, pain, deep voice, SOB, large tongue

24
Q

details of water deprivation test

A

give desmopressin, if no suppression then problem is nephrogenic

25
Q

diff diag for diabetes insip

A

SiADH, ADH resistance in kidney (CKD)

26
Q

secondary causes of DM2?

A

cushings, preg, chronic panc, CF

27
Q

name the 3 oral hypoglycaemics

A

metformin, gliclazide, glitazones

28
Q

what increased risk is there for MI and Stroke in diabetics?

A

x4 and x2

29
Q

process of DM nephropathy

A

thickened Glom BM, (microalbuminuria) glom sclerosis, fibrosis (proteinuria)

30
Q

what eye changes apaprt from retinopathy can DM cause?

A

cataracts, 3rd and 6th nerve palsys

31
Q

management of DKA complications/side effects?

A

hypoglyc, hypokalaemia, pul oed/ARDS, cerebral oedema

32
Q

main concerns / CF for patient with HONK?

A

dehydration, hyperglyc, thrombosis risk (give LMWH), AKI

33
Q

how is hypo/hyper thyroid classed?

A

HYPO - 1,2,3

Hyper - none, either graves or tumor

34
Q

treatment of Thyroid CA? (3)

A

Surgical removal of entire gland, radioactive I, neck lymph node dissection

35
Q

CF of HYPO calc

A

SPASMODIC + trosseau’s + chvtoseks

36
Q

how are the causes of cushings split?

A

ACTH dependant and independant

37
Q

addisonian crisis treatment

A

saline and IV hydrocortsione

38
Q

CONNS treatment?

A

SPIRO and Surg Excision

39
Q

what might somatostatin be used for and why?

A

treatment of acromegaly as it suppresses effect of GrH meaning inhibitied release of GH

40
Q

what nerves might be affected by a pituatary tumor?

A

2 + 3/4/6

41
Q

diagnostic test for acromegaly?

A

OGTT and GH measurements

42
Q

treatment or hyperprolactinoma?

A

dopamine agonist

43
Q

PCOS diagnostic criteria?

A

US of ovaries, clinical features, menstral abnorm

44
Q

causes of a metabolic acidosis?

A 
DKA
diarrhoea
lactic acidosis (metformin)
rhabdo
toxin ingestion

*** Exam Medicine (20 decks)

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