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Clinical Medicine > Endocrinology 🚦 > Flashcards

Endocrinology 🚦 Flashcards

1
Q

what is cushings syndrome

A

refers to signs and symptoms that develop after prolonged abnormal elevation of cortisol

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2
Q

What are brown tumours

A

Tumours of bone that arise in settings of excess osteoclast activity such as hyperparathyroidsim
Consists of fibrous tissue woven bone and supporting vasculature

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3
Q

Adverse effects of SGLT-2 inhibitors

A

Urinary and genital infection secondary to Glycosuria
Normoglycaemic ketoacidosis
fornier gangrene
Increased risk of lower limb amputation - feet should be closely monitored

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4
Q

Where is prolactin secreted from

A

Anterior pituitary

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5
Q

Why would testicular tumours cause gynaecomastia

A

Testicular tumours secrete beta HCG which increases oestrogen levels promoting the proliferation of breast tissue

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6
Q

Tx polymyalgia rheumatica

A

Corticosteroids

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7
Q

What is Kallmans syndrome

A

Recognised cause of delayed liberty secondary to hypogonadotropic hypogonadism
X linked recessive

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8
Q

Features of kallmans syndrome

A

Delayed puberty
Hypogonadism
Ansomia - usually the clue given in many questions “lack of smell in a bit with delayed puberty”
LH, FSH levels inappropriately low
Patients normal or above average height
Cleft lip/palate seen in some

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9
Q

Management of kallmans syndrome

A

Testosterone supplementation
Gonadotropin supplementation

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10
Q

adverse effects of sulfonylureas

A

weight gain
hypoglycaemia

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11
Q

adverse effects of pioglitazone

A

weight gain
fluid retention
anaemia
heart failure

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12
Q

adverse effects of DPP-4 inhibitors

A

GI upset
symptoms of URTI
pancreatitis

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13
Q

adverse effects of biguanides - metformin

A

lactic acidosis
GI disturbance

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14
Q

adverse effects of thiazolidinediones - gliclazide

A

fluid retention
weight gain
worsening heart failure

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15
Q

adverse effects of GLP-1 Analogues

A

hypoglycaemia
GI upset

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16
Q

diagnosis of type 2 diabetes

A

if symptomatic one of the following results:
random blood glucose = 11.1
fasting blood glucose = 7
2 hour glucose tolerance = 11.1
HbA1C= 48mmol/mol

17
Q

what is gastroparesis

A

caused by autonomic dysfunction of the vagus nerve leading to delayed gastric emptying and presents with
morning nausea
offensive egg-smelling burps
early satiety
abnormal stomach movements

a complication of type 2 diabetes

18
Q

cushing’s syndrome features

A

picture the patient as very round in the middle with thin weak limbs and then imagine the effects of high levels of stress hormone:

round in the middle with thin limbs:
round moon face
central obesity
abdominal striae
buffalo hump
proximal limb muscle wasting

high levels of stress hormone:
hypertension
cardiac hypertrophy
hyperglycaemia
depression
insomnia

extra effects:
osteoporosis
easy bruising and poor skin healing

19
Q

test of choice for diagnosing cushing’s syndrome

A

dexamethasone suppression test
initially giving the patient the low dose test if its normal cushings can be excluded, if not then high dose test

to perform the test pt takes dose of dexamethasone at night and their cortisol and ACTH is measured the morning

20
Q

what is cortisol

A

primary stress hormone that increases blood sugars

21
Q

what is ACTH

A

a hormone released by the pituitary gland that triggers the adrenal gland to release cortisol

22
Q

what is cushings disease

A

refers to the specific condition where a pituitary adenoma (tumour) secretes excessive ACTH

23
Q

normal result for the dexamethasone suppression test

A

normally dexamethasone suppresses the release of cortisol

24
Q

most common cause of cushings syndrome

A

exogenous corticosteroid exposure

25
Q

causes of pseudo-Cushings syndrome

A

chronic alcoholism

26
Q

results of dexamethasone suppression test that would indicate ectopic ACTH secretion and what does that mean

A

when neither cortisol and ACTH have been suppressed

ectopic ACTH secretion is most common in small cell lung cancer and carcinoid tumours

27
Q

results of dexamethasone suppression test that indicates adrenal adenoma

A

cortisol not being suppressed but ACTH is

28
Q

results of dexamethasone suppression test that indicates pituitary adenoma

A

both cortisol and ACTH become suppressed

29
Q

what other symptoms would a patient present with if ectopic ACTH release was the cause of their “cushings symptoms” e.g purple striae

A

any features suggestive of lung cancer
smoking history
haemoptysis
clubbing

30
Q

what is De Quervain’s (subacute) thyroiditis

A

describes the presentation of a viral infection with fever, neck pain and tenderness, dysphagia and features of HYPERTHYROIDISM

self-limiting condition and only requires supportive treatment with NSAIDs

31
Q

management of hyperthyroidism

A

first-line carbimazole
second line propylthiouracil

propanolol for sx relief

radioactive iodine

surgery

32
Q

hyperthyroidism features specific to graves disease

A

positive TSH antibodies
eye involvement
pretibial myxoedema

33
Q

blood results that show hyperthyroidism

A

raised T3 AND T4
suppressed TSH

34
Q

blood results that show hyperthyroidism

A

raised T3 AND T4
suppressed TSH

35
Q

complications of hyperthyroidism

A

thyroid storm
atrial fibrillations
high output heart failure

36
Q

what is toxic multinodular goitre

A

nodules develop on thyroid gland that act independently and continuously produce excessive thyroid hormone

presents commonly in pts aged over 50 with numerous firm nodules in the goitre

second most common cause of hyperthyroidism

37
Q

most serious side effect of carbimazole

A

agranulocytosis

38
Q

first line treatment for a thyrotoxic storm

A

PO proplythirouracil

39
Q

complication of thyroid storm
presents with tachycardia
confusion
nausea
vomiting
high fever

A

thyroid storm

Clinical Medicine (26 decks)

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