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Medicine Year 3 > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

What is MODY

A

Maturity onset diabetes in the young

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2
Q

Cause and treatment of mody

A

HNF alpha

Glicazide

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3
Q

2 positives to DPP4

A

No weight gain

No hypoglycaemia

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4
Q

2 hormone changes in klinefelters

A

Increased LH

Reduced testosterone

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5
Q

2 hormone changes in Kallman syndrome

A

Reduced FSH/LH

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6
Q

Hyperglycaemia and dehydration

A

Give IV fluids

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7
Q

What is prolactin inhibited by

A

Dopamine (carbergoline)

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8
Q

Insulin during sick days

A

Never stop
Check sugar regularly
You may need to increase

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9
Q

3 changes stress can cause to hormones (e.g. surgery)

A

Reduced insulin
Reduced testosterone
Reduced oestrogen

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10
Q

Treatment of diabetic neuropahty

A

1st: Duloxetine, Amitriptyline, Gabapentin, Pregabalin

Tramadol - rescue
Capsacin - topical
Pain management clinic

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11
Q

Risk factor for graves

A

Smoking

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12
Q

Where is a papillary carcinoma found and what is its prognosis

A

Thyroid

Good prognosis

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13
Q

3 SGLT-2 inhibitor side effects

A

Increased urinary excretion
Weight loss
Can cause UTI

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14
Q

Diagnosis of pheochromocytoma

A

24hr metanephrins (HTN)

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15
Q

Thyrotoxicosis with tender goitre

A

Subacute thyroiditis

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16
Q

Diagnosis of acromegaly

A

1st: Increased IGF-1
2nd: OGTT and serial GH

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17
Q

What is trosseaus sign

A

Carpal spasm on bp cuff inflation

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18
Q

Side effect of spironolactone and goserelin

A

Enlarged breasts

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19
Q

What is goserelin used for

A

Prostate

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20
Q

Side effect of metoclopramide

A

Galactorrhoea

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21
Q

3 features of multiple endocrine neoplasia T1

A

Peptic ulceration
Galactorrhoea
Hypercalcaemia

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22
Q

Treatment of bladder cancer

A

Thiazolindinediones (Pioglitazone)

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23
Q

Addisons and illness

A

Double glucocorticoids

Keep fludrocortisone the same

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24
Q

What is myxoedema

A

In hypothyroid

Confusion and hypothermia

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25
Q

What is acropachy

A

Clubbing

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26
Q

What thyroid condition is clubbing found in

A

Graves

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27
Q

Side effect of pioglitazine

A

Fluid retention

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28
Q

What should you monitor in hyperosmolar hyperglycaemia state

A

Serum osmolarity

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29
Q

2 electrolyte disturbances in malabsorption

A

Reduced calcium
Reduced magnesium
Increased phosphate

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30
Q

When should you withdraw corticosteroids

A

Increased 40mg for 1+ week
3+ w treatment
Repeated courses

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31
Q

Treatment of hypoglycaemia and impaired GCS

A

IV glucose if access

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32
Q

Insulin dependent diabetic and driving

A

Check glucose every 2 hours when driving
Inform the DVLA

Commercial = stop

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33
Q

Most common exogenous and endogenous cause of cushings syndrome

A

Exogenous steroids

Endogenous pituitary adenoma

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34
Q 
What is the name for subacute thyroiditis 
What is it caused by
Presenting feature
2 findings
Prognosis
A

DeQuervain’s

Reduced iodine uptake

Painful goitre

Increased ESR
Hyperthyroid

Good prognosis

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35
Q

T1DM

A

C-peptide

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36
Q

Treatment of hypothyroidism

A

Increased thyroxine 50%

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37
Q

Treatment of galactorrhoea

A

Bromocriptine

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38
Q

Class and MOA of gliptins

A

DDP4 inhibitors

Reduce peripheral breakdown of incretins

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39
Q

Diabetic targets

A

48: diet/lifestyle/1 drug
53: single hypoglycaemic drug/ 2 diabetic drugs

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40
Q

Hyperosmolar hyperglycaemic state

A

Hypovolaemia and hyperglycaemia

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41
Q

Side effect of SGLT2 inhibitors

A

UTI

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42
Q

Most common cause of primary hyperaldosteronism

A

Bilateral idiopathic adrenal hyperplasia

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43
Q

Hypertension with hypokalaemia and mild alkalosis

A

Primary hyperaldosteronism

44
Q

What does whipple’s triad diagnose

A

Insulinoma

Hypoglycaemia
Glucose below 2.5
Reversibility of sx on administration of glucose

45
Q

C-peptide on exogenous insulin stress test in pts with insulinoma

A

Will not fall

46
Q

Multiple endocrine neoplasia (MEN) type 1

A

parathyroid
pituitary
pancreas e.g. insulinoma

47
Q

MEN type 2a

A

medullary thyroid cancer
parathyroid
pheochromocytoma

48
Q

MEN type 2b

A

Medullary thyroid cancer
Phaeochronocytoma
Neurones
Marfanoid

49
Q

viral illness, raised ESR, reduced uptake of iodine, tender goitre and initial hyperthyroid phase

A

De Quervains subacute thyroiditis

50
Q

Treatment for Dequav

A

naproxen

51
Q

Sick euthyroid syndrome

A

low T3/T4
normal TSH
acute illness

52
Q

Which diabetic drug causes weight gain

A

Gliclazide

Sulfonylureas

53
Q

Risk of LT steroids

A

Avascular necrosis, osteopaenia and osteoporosis

54
Q

What metabolic disturbance does cushings cause

A

Hypokalaemic metabolic alkalosis

55
Q

DIABETES BLOOD PRESSURE IS DIFFERENT TO NORMAL

A

TARGET BELOW 140/80

56
Q

MOA of DPP-4 inhibitors

A

Increase levels of incretins

e.g. sitagliptin

57
Q

Treatment of hypoglycaemia if the patient is conscious and able to swallow

A

Fast acting carbohydrate by mouth e.g. glucose liquids, tablets or gels

58
Q

Assessing diabetic neuropathy in the feet

A

10G monofilament

59
Q

Elevated T4 and low TSH

A

thyrotoxicosis

60
Q

AB in hashimotos

A

Antithyroid peroxidase AB

61
Q

Fasting glucose not quite DM then diagnosed with

A

Impaired fasting glycaemia

62
Q

Diagnostic criteria for T2DM with Sx

A

Fasting glucose higher than 7

Random glucose higher than 11.1

63
Q

Presentation of myxoedema coma

A

Confusion and hypothermia

64
Q

Adrenal venous sampling (AVS) can be used to distinguish between unilateral adenoma and bilateral hyperplasia in primary hyperaldosteronism

A
65
Q

How is iodine taken up in graves disease

A

Homegenous uptake

66
Q

BMI ranges

A

Under 18.5 - underweight
18.5-25 normal
25-30 overweight
(then obese in 5’s)

67
Q

Primary hypoaldosteronism

A

Addisons

68
Q

test for addisons

A

Short synacthen test

69
Q

Hyponatraemia and hyperkalaemia in a patient with lethargy

A

Addisons

70
Q

DKA IV insulin

A

0.1 unit/kg/hour

71
Q

PTH in primary hyperparathyroidism

A

Can be normal as the hypercalcaemia supresses it

72
Q

Medication to control Sx in graves

A

Propanolol

73
Q

Diagnosis of cushings

A

Low dose dexamethasone supression test

74
Q

What does a high serum parathyroid hormone do to calcium and phosphate

A

High calcium and low phosphate (causes phosphate excretion)

75
Q

Action of steroids

A

Fludrocortisone: high mineralocorticoid
Hydrocortisone: glucocorticoid and mineralocorticoid
Prednisolone, Dexamethasone and Betamethasone: high glucocorticoid

76
Q

Ectopic source of ACTH with high dose dexamethasone

A

Neither cortisol or ACTH suppressed

77
Q

What medication can worsen diabetes control

A

Corticosteroids

78
Q

rules for taking levothyroxine

A

empty stomach 30-60 mins before food

take calcium/iron supplements 4 horus llater

79
Q

medication for acromegaly

A

octreotide

80
Q

Definite management of hyperparathyroidism

A

Total parathyroidectomy

81
Q

First line treatment for most patients with a pituitary tumour causing acromegaly

A

Trans sphenoidal surgery

82
Q

Common cause of primary hyperparathyroidism

A

Solitary parathyroid adenoma

83
Q

Patchy uptake of iodine

A

Toxic multinodular goitre

84
Q

The standard HbA1c target in type 2 diabetes mellitus

A

48 mmol/mol

85
Q

What does over replacement of thyroxine increase the risk of

A

Osteoporosis

86
Q

Water deprivation test: nephrogenic DI

A

urine osmolality after fluid deprivation: low

urine osmolality after desmopressin: low

87
Q

Erratic blood glucose control, bloating and vomiting

A

Gastroparesis

88
Q

Klinefelter’s syndrome
Kallmann syndrome
Kartagener’s syndrome

A

Klinefelter’s Above average height and infertility
Kallmann: failure of GnRH, anosmia and infertility
Kartagener’s dextrocardia, recurrent sinusitis, bronchiectasis and infertility

89
Q

Levothyroxine is not associated with inducing diabetes

A
90
Q

LADA

A

Latent autoimmune diabetes of adulthood

91
Q

Orlistat MOA

A

Pancreatic lipase inhibitor

92
Q

What is cinacalecet

A

Drug that mimics calcium

Used in parathyroid adenoma that can’t have surgery

93
Q

LH and FSH in kallmann

A

LH and FSH low-normal

94
Q

Thyrotoxicosis with tender goitre

A

De quervains

95
Q

Does graves or hashimotos cause a tender goitre

A

No

96
Q

Treatment of myxoedema coma

A

IV thyroid hormone replacement and IV hydrocortisone

97
Q

What haem disorder can give falsely low HbA1c

A

Sickle cell

98
Q

What is nelsons syndrome

A

Rapid enlargement of a pituitary corticotroph adenoma (ACTH producing adenoma) that occurs after the removal of both adrenal glands (bilateral adrenalectomy) which is an operation used for Cushing’s syndrome

99
Q

Hypoglycaemia with impaired GCS

A

Give IV GLUCOSE

100
Q

How to distinguish between T2DM and T1DM

A

C-peptide levels and diabetes autoantibodies e.g. Anti-GAD

101
Q

Presentation of phaeochromocytoma

A

Sweating
headaches
palpitations

102
Q

First line investigation for phaeochromocytoma

A

Plasma and urinary metanephrines

103
Q

First line antihypertensive for black T2DM patients with HTN

A

ARB blocker (sartan)

104
Q

thyroids and periods

A

Hyperthyroidism is associated with oligomennorhoea, or amennorhoea, whereas hypothyroidism is associated with menorrhagia

105
Q

Headaches, amenorrhoea, visual field defects

A

Prolactinoma

Medicine Year 3 (8 decks)

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