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BNF crash course > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

What are examples of mineralcorticoids?

A

Fludrocortisone and hydrocortisone

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2
Q

What are examples of glucocorticoids?

A

Dexamethasone, betamethasone, prednisolone

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3
Q

What are the side effects of mineralocorticoids?

A

hypertension due to retention of sodium and water

Loss of potassium and calcium ions

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4
Q

What are the side effects of glucocorticoids?

A 
ACHINGBOSOM
Adrenal suppression 
Cushing syndrome 
Hyperglycaemia/ Hyperlipidaemia 
Insomnia / Infections 
Nervous system/ Psychiatric reactions 
Gastrointestinal / Glaucoma 
Blood pressure increase
Osteoporosis
Skin thinking 
Obesity 
Muscle wasting
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5
Q

When should abrupt withdrawal be avoided when taking steroids?

A
  • Long term use >3 weeks
  • > 40mg daily for one week
  • Repeated doses taken in the evening
  • Recent repeated courses
  • Short course within 1 year of stopping long term steroids
  • Have other causes of adrenal suppression
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6
Q

What are the symptoms of Cushing syndrome?

A
  • Skin thinning
  • Easy bruising
  • Reddish- purple stretch marks
  • Striae “stretch marks”
  • Fat deposits in the face
  • Moon face
  • Acne
  • Hirsutism “dark facial hair on woman”
  • Amenorrhoea “ the absence of menstruation”
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7
Q

When taking risedronate what should be avoided?

A

Leave 2 hr gap between risedronate and food, drink, antacids, calcium-containing products such as milk, iron or mineral supplements

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8
Q

What are the common side effects of Bisphosphonates?

A
  • Oesophageal reactions
  • Atypical femoral fractures
  • Osteonecrosis of the jaw - Report any oral symptoms: dental mobility, pain, swelling, non-healing sores or discharge– > this is most common with zolendronic acid
  • Osteonecrosis of external auditory canal: Report ear pain, ear discharge or ear infection during treatment.
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9
Q

What is tibolone?

A

Its a combined HRT of oestrogenic, progestogenic and weak androgenic

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10
Q

What cancers are caused by HRT as a SE?

A
  • Ovarian cancer
  • Breast cancer
  • Cervical Cancer
  • Endometrial cancer- adding progesterone reduces this additional risk
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11
Q

What are the reasons to stop HRT?

A

VTE
Stoke
Liver dysfunction caused by oestrogen
Blood pressure about 160/95

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12
Q

What is used to stimulate ovulation in infertile women?

A

Clomiphene

“max use is 6 cycles”

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13
Q

What’s first line treatment of hypothyroidism?

A

Levothyroxine; max dose usually 200mcg

Take in the morning at least 30 minutes before breakfast, caffeine-containing liquids or other medication

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14
Q

What’s second line treatment of hypothyroidism?

A

Liothyronine 25mcg = 100mcg of levothyroxine

ideal in severe hypothyroid emergencies as it has a rapid effect and more potent
Switching brands without a UK licence may not be bioequivalent

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15
Q

What course of action is taken if hyperthyroidism occurs with levothyroxine or liothyronine?

A

Reduce dose or withhold 1-2 doses and start again at a lower dose

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16
Q

What are the symptoms of hypothyroidism?

A 
Cold intolerances
Weight gain 
Constipation
Bradycardia 
Lethargy 
Muscle cramps 
Slow movements 
Slow thoughts 
Depression
Hair thinning
17
Q

What are the symptoms of hyperthyroidism?

A 
Heat intolerance 
Weight loss 
Diarrhoea 
Tachycardia 
Excitability 
Tremors 
Angina pain
Sweating 
Arrhythmias
18
Q

What is first line treatment of hyperthyroidism and what reason would cause it to be changed to second line?

A

1st line is carbimazole

if a rash is developed give antihistamine or switch to propylthiouracil

19
Q

What is second line treatment for hyperthyrodism?

A

Propylthiouracil

20
Q

What is used in first trimester and second trimester of pregnancy with hyperthyrodism?

A

1st trimester use Propylthiouracil

2nd trimester use Carbimazole

21
Q

What is the fasting blood-glucose concentration target on waking?

A

5-7 mmol/L

22
Q

What is the fasting blood-glucose concentration target on before meals?

A

4-7mmol/L

23
Q

What is the fasting blood-glucose concentration target 90 minutes after eating?

A

5-9 mmol/L

24
Q

What is the fasting blood-glucose concentration target when driving?

A

5mmol/L

25
Q

What is the HbA1C blood test recommended to be for initial diagnosis for T2D?

A

6.55 or 48 mmol/L

26
Q

What is the target hypertension for a diabetic without complication and with complications?

A

Without complications= 140/80

With complications= 130/80

27
Q

What drink/food can help in a hypoglycaemic event?

A 
10-20g of glucose/ sucrose 
Coca-Cola 100-200ml 
Lucozade original 55-100ml 
sugar lumps 3-6
Sugar 2-4 tsp
28
Q

What is diabetic ketoacidosis?

A

Occurs when blood glucose levels are extremely high which results in ketone build up

29
Q

What are the symptoms of diabetic ketoacidosis?

A

Symptoms:

  • Severe hyperglycaemia
  • High blood Ketones
  • Ketonuria
  • Pear drop breath
  • Dehydration or excessive thirst
  • Polyuria
  • Nausea and vomiting
  • Anorexia
  • Abdominal pain
  • Difficulty breathing
  • Electrolyte imbalance
  • Mental confusion
  • Drowsiness
  • Diabetic coma
  • Convulsion
30
Q

How is diabetic ketoacidosis treated?

A

soluble insulin- as its fast acting
fluid to hydrate
potassium to correct hypo

31
Q

What are the symptoms of hypoglycaemia ?

A

Symptoms:

  • hunger
  • pale skin
  • tingling lips
  • sweating, chills, clammy
  • Dizziness
  • Shakness
  • Palpitations
  • Blurred vision
  • Confusion
  • Irritability
  • Irrational behaviour
  • Slurred speech
  • Difficulty concentrating
  • Drowsiness and coma
32
Q

What actions are required if hypoglycaemia occur during driving i.e. below 5mmol/L?

A
  1. Stop vehicle in safe place and switch engine off
  2. Eat or drink a fast-acting sugar and then long-acting carbohydrate e.g. sandwich to maintain levels
  3. Wait 45 minutes after blood glucose levels return to normal, before continuing journey
33
Q

What antagonises the hypoglycaemic effect of insulin?

A

Corticosteroids
Oral contraceptives
Loop/Thiazide diuretics

34
Q

What masks the symptoms of a hypoglycaemia with diabetes?

A

beta blockers

35
Q

What enhances hypoglycaemic effect of insulin>

A

ACE inhibitors

Alcohol

36
Q

What is olanzapine associated with in diabetes?

A

high blood sugar levels in new onset or pre-existing diabetes mellitus and ketoacidosis which may be reversible after discontinuation of olanzapine

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