Endocrinology Flashcards
What do meglitinides (e repaglinide) do?
Increase pancreatic insulin secretion but binding to an ATP dependant potassium channel of the cell membranes of pancreatic beta cells
What is the treatment of severe hypocalcaemia?
10ml of 10% calcium gluconate over 10 minutes
Where is prolactin secreted from?
The anterior pituitary gland
What drugs cause a raised prolactin?
Metclopramide, domperidone
Phenothiazines (Chlorpromazine)
Haloperidol
How do sulfonylureas work?
Increase pancreatic insulin secretion by binding to an ATP dependant potassium channel
Why do patients with cushings syndrome get metalbolic alkalosis?
Excess aldosterone increased acid and pottasium secretion in the kidney
Why do patients with addisons get a hyperkalaemic metabolic acidosis?
Insufficiency of aldosterone which decreases acid secretion in the kidney and leads to the retention of potassium
What tests are used to confirm cushings syndrome?
Overnight dexamethasone suppression test
24 hr urinary cortisol
What are the main complications of acromegaly?
Hypertension
Diabetes
Cardiomyopathy
Colorectal cancer
What is the first line investigation for primary aldosteronism?
Renin/aldosterone ratio
What is the diagnostic criteria for type 2 diabetes?
If the patient is symptomatic:
- Fasting glucose greater than 7
- Random glucose greater than 11.1
(if asymptomatic then the same criteria but must be demonstrated on two occasions )
An HbA1c of 48 or above in diagnostic of diabetes
What is the criteria for impaired fasting glucose?
Glucose of greater than 6.1 but less than 7
What is the criteria for impaired glucose tolerence?
Fasting glucose less than 7 and oral glucose tolerence test equal or greater than 7.8 but less than 11.1
What thyroid cancerare you more at risk of if you have hashimotos thyroiditis?
Thyroid lymphoma - due to chronic infiltration of the thyroid gland with B lymphocytes which are prone to clonal proliferation
What is the most common type of thyroid cancer?
Papillary
What is the first hormone secreted in response to hypoglycaemia?
Glucagon
How do fibrate drugs work?
Acivation of PPAR alpha receptors which result in an increase in LPL activity reducing triglyceride levels.
What do you need to increase thyroxine too if a women falls pregnant?
Increase dose by 50% by 4 - 6 weeks of pregnancy
In what groups of patients is a QRISK2 score contraindicated?
Type 1 diabetics
eGFR less than 60ml/min
Patients with a history of familial hyperlipidaemia
What is liddle’s syndrome?
A rare autosomal dominant condition that causes hypertension and hypokalaemia acidosis. It is thought to be caused by disordered sodium channels in the distal tubules leading to an increased reapsoprtion of sodium
What is the first line drug treatment for painful diabetic neuropathy?
Amitriptyline, duoloxetine, gabapentin or pregabalin
What antibodies are seen in hashimotos thyroiditis?
Anti TPO antibodies
Anti thyroglobulin antibodies
What kind of drug is octreotide?
A somatostatin analogue - this directly inhibits the release of growth hormone
What is the usual first line treatment for acromegaly?
Trans-sphenoidal surgery
