Endocrinology Flashcards
Most common cause of primary hyperaldosteronism
Bilateral adrenal hyperplasia
Primary hyperaldosteronism features
Hypertension
Hypokalaemia
Acidosis
Autoantibodies in graves disease
TSH receptor antibodies (90%)
Anti-thyroid peroxidase antibodies (75%)
Ectopic ACTH investigations
High dose dex supression test
ACTH and cortisol not supressed
Primary hyperaldosteronism management
Spironolactone
Hyperparathyroidism Investigation
Primary - high PTH, high Ca2+, low phosphate
Secondary - high PTH, low or normal Ca2+, high phosphate, low vit D
Tertiary - high PTH, normal or high Ca2+, low or normal phosphate, low or normal vit D, high ALP
Acromegaly first line investigations
Serum IGF1
Cushing’s syndrome investigation
Low dose dex supression test
Hyperosmolar hyperglycaemic state characteristics
- Severe hyperglycaemia
- Dehydration and renal failure
- Mild/absent ketonuria
Cushing’s syndrome ABG
Hypokalaemic metabolic alkalosis
Addisonian crisis electrolytes
Low Na+
High k+
Low bicarb
Cushings disease investigations
Low dose dex supression test - cortisol not supressed
High dose dex supression test - cortisol supressed
Antibodies in Addison’s disease
adrenal cortex antibodies or anti-21-hydroxylase
Investigations in Addison’s
Short-synacthen test is usually the diagnostic test of choice, synthetic ACTH is given in the morning and the levels of cortisol are measured after 30-60 mins. A failure in the rise of cortisol indicates primary adrenal insufficiency (Addison)
