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MSRA > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

What condition causes a phaeochromocytoma + hyperparathyroidism (high Ca2+ and low Mg2+)?

A

MEN2a - Sipple Syndrome

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2
Q

What is the most common cause of Cushings syndrome?

A

Iatrogenic, related to corticosteroid use usually

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3
Q

How should HHS be manged?

A

With cautious rehydration with IV fluids

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4
Q

Do all cases of multinodular goitre result in biochemical changes?

A

No

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5
Q

What is first-line management for pheochromocytoma?

A

Alpha-blockers –> surgery

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6
Q

What is another name for DeQuervain’s thyroiditis?

A

Viral thyroiditis –> thyroid becomes swollen, erythematous and tender to touch. There is an initial phase of hyperthyroidism, followed by hypothyroidism as it recovers, before returning to euthyroid state. Thyroxine is not usually given during the hypothyroid state due to quick return to euthyroid state

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7
Q

What is the most specific marker for Graves disease?

A

Anti-TSH receptor stimulating antibodies

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8
Q

How is DeQuervain’s thyroiditis diagnosed?

A

TFTs + radioactive iodine test

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9
Q

Which test might be useful for distinguishing between T1Dm and T2DM?

A

C-peptide (low = T1DM, high = T2DM)

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10
Q

What is the target HbA1c in T2DM?

A

48

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11
Q

What are the causes of hyperprolactinaemia?

A

The p’s:

  1. Pregnancy
  2. Prolactinoma
  3. Physiological
  4. PCOS
  5. Primary hypothyroidism
  6. Phenothiazines/metocloPramide/domPeridone
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12
Q

Which condition can cause hyperpigmentation, especially to the palmar creases?

A

Addison’s disease

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13
Q

What do you do with the meds for Addison’s disease in periods of illness/

A

Double the hydrocortisone, keep the fludrocortisone the same

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14
Q

What are the causes of lower than expected HbA1c?

A

Sickle cell anaemia
G6PD
Hereditary spherocytosis

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15
Q

What are the causes of higher than expected HbA1c?

A

Vitamin B12/folic acid deficiency
Iron deficiency anaemia
Splenectomy

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16
Q

Which is the drug that most commonly causes gynaecomastia?

A

Spironolactone

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17
Q

At what HbA1c should you add another drug in the control of T2DM?

A

When HbA1c >58

18
Q

How do you diagnose Addison’s disease?

A

Short synacthen test

19
Q

How is Conn’s syndrome (primary hyperaldosteronism) treated?

A

Spironolactone (adrenalectomy if the underlying cause is unilateral adrenal adenoma)

20
Q

How do you calculate serum osmolality?

A

2NA + urea + glucose

21
Q

What rate of insulin should be used in HHS?

A

0.05units/kg/hr

22
Q

What is primary hyperparathyroidism?

A

High PTH (usually due to secreting adenoma) - causing hight calcium and low phosphate

23
Q

What is secondary hyperparathyroidism?

A

High PTH (usually due to renal disease, in response to…) low calcium (due to the renal disease (and high phosphate

24
Q

What is tertiary hyperparathyroidism?

A

Occurs following a long period of secondary hypoparathyroidism –> high PTH, and calcium eventually becomes high

25
Q

Which electrolyte disturbance is associated with Conn’s syndrome?

A

Hypokalaemia

26
Q

What is the difference in pigmentation pattern in Addison’s vs. hemochromatosis?

A

Pigmentation associated with hemochromatosis rarely affects the mucosa

27
Q

How does MEN1 present?

A

Hyperparathyroidism (from adenoma)
Pituitary tumour
Bronchial carcinoma
Enteropancreatic tumours

28
Q

How does MEN2 present?

A

Hyperparathyroidism (from adenoma)
Thyroid C-cell tumours
Pheochromocytoma

29
Q

What is the most reliable measure of thyroid function?

A

TSH level

30
Q

How is anion gap calculated?

A

(Na2+ + K+) - (HCO3- + Cl-)

31
Q

What is Chvostek sign?

A

A tetany - abnormal reaction to the stimulation of the facial nerve - seen in response to hypocalcaemia

32
Q

How may medullary thyroid cancer present?

A

Diarrhoea and facial flushing (due to elevated calcitonin)

33
Q

How do you distinguish between Cushing’s disease and Cushing’s syndrome?

A

Cushing’s disease - suppression in high-dose dexamethasone suppression test

Cushing’s syndrome - no suppression in high-dose dexamethasone suppression test

34
Q

What DM medication may cause excessive flatulance?

A

Acarbose (by delayed absorption of sucrose and starch)

35
Q

Which medication used in HTN can cause an increase in blood DMs?

A

Bendroflumethiazide

36
Q

Which medication can cause upset tummy, poor sleep and cold fingers and toes?

A

Propanalol

37
Q

In what proportion of Graves patients does Graves ophthalmology occur?

A

1/3rd

38
Q

How is Graves ophthalmology (pain in eye, photophobia, diplopia) treated?

A

Corticosteroids

Orbital decompression only if it has proves refractory to treatment

39
Q

What are the side effects of sulphonylureas?

A

Hypoglycaemia and weight gain –> if these are a problem, and BMI >35, may be worth trying pioglitazone

40
Q

What is the prolactin threshold difference between micro and macroadenoma?

A 
Microadenoma = prolactin up to 2000
Macroadenoma = prolactin >2000

MSRA (18 decks)

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