Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Alice's finals cards > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Which hormone is elevated in cushing’s syndrome?

A

cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the features of cushing’s syndrome?

A

Round “moon” face
Central obesity
Abdominal striae
Buffalo hump
Proximal limb weakening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the causes of cushing’s?

A

Exogenous steroids
Cushing’s disease
Adrenal adneoma
Paraneoplastic cushing’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which test is used to diagnose Cushing’s

A

Dexamethasone suppression test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the result of the low dose dexamethasone suppression test in Cushing’s?

A

1mg of dexamethasone is given at night. In healthy people this should suppress the early morning spike of cortisol, in cushing’s it does not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does the different results of the high dose dexamethasone suppression test mean?

A

8mg of dexamethasone is given.

In cushing’s disease (pituitary adenoma) this is enough to cause negative feedback and suppress the cortisol

In adrenal adenoma the cortisol is not suppressed but the ACTH is suppressed due to negative feedback

Where there is ectopic ACTH (eg SCLC) neither cortisol or ACTH are supressed because the ACTH release is independent of the hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What investigations can be done for cushing’s disease?

A

Dexamethasone suppression test
24 hour urinary free cortisol
FBC
MRI brain, Chest CT, Abdo CT for tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the management of cushing’s disease?

A

Trans-sphenoidal removal of pituitary adenoma
Surgical removal of adrenal tumour
Surgical removal od tumour producing ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is addison’s disease?

A

Adrenal glands have been damaged which results in a reduction in the secretion of cortisol and aldosterone. This is primary adrenal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is secondary adrenal insufficiency?

A

There is inadequate ACTH. It is a problem in the pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is tertiary adrenal insufficiency?

A

Inadequate CRH release by the hypothalamus. Usually the result of patients being on long term oral steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the features of adrenal insufficiency?

A

Fatigue
nausea
Cramps
Abdominal pain
Bronze hyperpigmentation
Hypotension
Hypoglycaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is seen on blood tests in adrenal insufficiency? In terms of ACTH and electrolyte abnormalities

A

Hyponatraemia
Hyperkalaemia
ACTH is high in primary and low in secondary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which autoantibodies are present in adrenal insufficiency?

A

Adrenal cortex antibodies
21-hydroxylase antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the test used to assess for adrenal insufficiency?

A

The short synacthen test

Give synacthen (synthetic ACTH) which would stimulate healthy adrenal glands to produce cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the management of adrenal insufficiency?

A

Replace the steroids. Hydrocortisone to replace cortisol and fludrocortisone to replace aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the sick day rules for steroid therapy?

A

Double when ill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the presentation of an addisonian crisis?

A

Reduced consciousness
Hypotension
Hypoglycaemia, hyponatraemia and hyperkalaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the management of an addisonian crisis?

A

Intensive monitoring
Steroids
IV fluids
Correct hypoglycaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are TSH and T3/4 levels in primary hyperthyroidism?

A

TSH= Low
T3/4= high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are TSH and T3/4 levels in primary hypothyroidism?

A

TSH= high
T3/4= low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are TSH and T3/4 levels in secondary hypothyroidism?

A

TSH= low
T3/4= low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What antibodies are present in thyroid disease?

A

Anti- TPO (graves and hashimotos)

Anti-thyroglobulin antibodies (graves and hashimotos)

TSH receptor antibodies (graves)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What can a radioisotope scan show of the thyroid?

A

Diffuse high uptake= graves
Focal high uptake= toxic multinodular
Cold= cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is plummer's disease?
Toxic multinodular goitre
26
What is exophthalmos a sign of?
Grave's disease
27
Which antibody causes grave's disease?
TSH receptor antibodies
28
What are signs of grave's disease?
Anxiety and irritability Sweating tachycardia weightloss Fatigue Frequent loose stools Diffuse goitre Exophthalmos Pretibial myxoedema
29
What is de Quervain's thyroiditis?
Presents with a viral fever, neck pain, dysphagia and tenderness. There is a hyperthyroid phase and then a hypothyroid phase. It is a self limiting condition which can be managed with NSAIDs for pain and beta blockers for the features of thyroiditis
30
How does thyroid storm present?
Hyperthyroidism, pyrexia, tachycardia and delierium
31
How is thyroid storm managed?
Fluid resus Anti-thyroid meds e.g. propylthiouracil beta blockers
32
How is hyperthyroidism managed?
Carbimazole (either titration block or block and replace regime) Propylthiouracil is 2nd line Radio iodine Beta-blockers for symptom relief Surgery is definitive
33
Which antibodies are associated with hashimotos thyroiditis?
Anti-TPO and antithyroglobulin antibodies
34
Which medications can cause hypothyroidism?
Lithium Amiodarone
35
Whats is the presentation of hypothyroid disease?
Weight gain Fatigue Dry skin Coarse hair and hair loss Fluid retention heavy or irregular periods Constipation
36
What is the management of hypothyroid disease?
levothyroxine
37
What is the ideal concentration of glucose in the blood?
Between 4.4 and 6.1mmol/l
38
What are the 3 main problems in DKA?
Ketoacidosis Dehydration Potassium imbalance (serum potassium high, whole body potassium low)
39
What is a possible adverse effect of insulin therapy in DKA?
severe hypokalaemia leading to arrythmias
40
How does diabetic ketoacidosis present?
Polyuria Polydipsia N&V Acetone smell to breath Dehydration and hypotension Altered consciousness
41
How is DKA diagnosed?
Hyperglycaemia Ketosis Acidosis
42
How is DKA managed?
FIG-PICK F-fluids I-insulin (actrapid 0.1 unit/kg/hour) G-glucose P-potassium I-infection C-chart fluid balance K-ketone monitoring
43
What is the general rule regarding potassium infusion?
Dont infuse at a rate of >10mmol/hour
44
Why should diabetic patients cycle their injection sites?
Injecting into the same spot can cause lipodystrophy where the subcutaneous fat hardens and the patients cannot absorb insulin properly
45
What are the typical symptoms of hypoglycaemia?
Tremor, sweating, irritabilty, dizziness and pallor
46
What are the management options for hypoglycaemia?
If mild, rapid acting glucose such as lucozade and slower acting carbohydrates If severe, IV dextrose and intramuscular glucagon
47
How often should HbA1c be measured?
every 3-6 months
48
When should type 1 diabetics measure their blood sugar?
Waking, at each meal and before bed
49
What is the pathophysiology (simplified) of type 2 diabetes?
Repeated exposure to glucose and insulin makes cells resistant to the effects of insulin. Beta cells become damaged by producing so much insulin that they start to produce less. This leads to chronic. hyperglycaemia
50
How is an oral glucose tolerance test undertaken?
Take a fasting plasma glucose level, give 75g glucose drink then measure the plasma glucose 2 hours later
51
What is the HbA1c range for pre-diabetes?
42-47mmol/mol
52
What is the impaired fasting glucose range for pre-diabetes?
6.1-6.9 mmol/l
53
What is the HbA1c level for a diabetes diagnosis?
>48mmol/mol
54
What is the random glucose level for a diagnosis of diabetes?
>11mmol/l
55
What is the fasting glucose level for a diagnosis of diabetes?
>7mmol/l
56
What is the OGTT level for a diagnosis of diabetes?
>11mmol/l
57
What is the HbA1c target for a new type 2 diabetic?
48mmol/mol
58
What is the HbA1c target for diabetics who are beyond metformin treatment?
53mmol/mol
59
What is the first line treatment for diabetes?
Metformin titrated from 500mg OD as tolerated
60
What is the second line treatment for diabetes?
Metformin + Sulfonylurea, pioglitazone, DPP-4 inhibitor and SGLT-2 inhibitor
61
What is third line treatment for diabetes?
Triple therapy with metformin or metformin and insulin
62
What type of drug is metformin?
Biguanide
63
What effect does metformin have on weight?
It is considered to be a weight neutral drug so does not effect a patient's weight
64
What are the notable side effects of metformin?
Diarrhoea and abdo pain Lactic acidosis
65
What kind of drug is pioglitazone?
Thiazolidinedione
66
What are the notable side effects of pioglitaozne?
Weight gain Fluid retention Anaemia Heart failure Extended use may increase the risk of bladder cancer
67
What is the most common sulfonylurea?
Gliclazide
68
What are the notable side effects of sulfonylureas?
Weight gain Hypoglycaemia Increased risk of CVD and MI
69
What is the most common DPP-4 inhibitor?
Sitagliptin
70
What are the notable side effects of DPP-4 inhibitors
Increased risk of pancreatitis
71
What is a common GLP-1 mimetic?
Exanatide
72
What are the notable side effects of GLP-1 mimetics?
GI tract upset Weight loss dizziness Hypoglycaemia
73
What is a common SGLT-2 inhibitor?
Empagliflozin
74
What are notable side effects of SGLT-2 inhibitors?
Glucoseruria - causing UTI Weight loss
75
Name 3 rapid acting insulins
Novorapid Humalog Apidra
76
Name 3 short acting insulins
Actrapid Humalin S Insuman Rapid
77
Name 3 long acting insulins
Lantus Levemir Degludec
78
Name 3 combination glucose
Humalong 25 Humalog 50 Novomix 30
79
What causes acromegaly?
Excessive growth hormone most commonly due to unregulated hormone secretion by a pituitary adenoma
80
Which visual field defect can occur in acromegaly?
Bitemporal hemianopia
81
What are the presenting features of acromegaly?
Prominent forehead and brow Large nose, tongue, hands and feet Arthritis HTN Hypertrophic heart Type 2 diabetes Colorectal cancer
82
Which investigations should be done for acromegaly?
Insulin like growth factor OGTT MRI brain
83
What is the management for acromegaly which is caused by a pituitary adenoma?
Trans-sphenoidal surgical removal
84
Which medications can be used to block growth hormone?
Pegvisomant - most effetive (GH receptor antagonist) Somatostatin analouges (octreotide) Dopamine agonists (bromocriptine)
85
Which cells produce parathyroid hormone?
Chief cells
86
How does parathyroid hormone raise blood calcium levels?
Increases osteoclast activity Increases calcium absorption from the gut Increases calcium Increasing vitamin D activity
87
What are the symptoms of hypercalcaemia?
Renal stones Painful bones Abdominal groans (N+V. constipation) Psychiatric moans (depression, psychosis and fatigue)
88
What causes primary hyperparathyroidism?
Uncontrolled parathyroid hormone PTH=high Calcium= high
89
What causes secondary hyperparathyroidism?
Insufficient vitamin D, chronic renal failure which causes hyperplasia of the parathyroid glands PTH=high Calcium= low
90
What is the role of aldosterone?
It is a mineralcorticoid Increases sodium reabsorption for the distal tubule Increases potassium secretion from the distal tubule Increases hydrogen secretion from the collecting ducts
91
What is conn's syndrome?
Primary hyperaldosteronism. Adrenal glands produce too much aldosterone which causes low serum renin
92
What causes secondary hyperaldosteronism?
Excessive renin stimulates the adrenal gland to produce more aldosterone
93
What is the main cause for excessive renin production
The BP in the kidneys is significantly lower than in the rest of the body. Usually due to renal artery stenosis
94
What are the investigations for hyperaldosteronism?
Renin/aldosterone ratio: High aldosterone, low renin= primary High aldosterone, high renin= secondary Hypokalaemia and alkalosis on bloods
95
What is the management of hyperaldosteronism?
Aldosterone antagonists: eplerenone and spironolactone Treat the underlying cause (surgical removal of adenoma or renal artery angioplasty)
96
What is the role of ADH?
Stimulates water reabsorption from the collecting ducts of the kidneys
97
what electrolytes changes are caused by SIADH?
euvolaemic hyponatraemia
98
What are the symptoms of SIADH?
Headache Fatigue Muscle aches and cramps Confusion Severe hyponatraemia
99
What are some causes of SIADH?
Malignancy (SCLC) Neuro - stroke & haemorrhage Infection - TB & pneumonia Drugs - Sulfonylureas, SSRIs, carbamazepine
100
How is SIADH diagnosed?
It is a diagnosis of exclusion
101
How is SIADH managed?
Correct sodium slowly to prevent central pontine myelinolysis Fluid restriction Tolvaptan (ADH receptor blockers)
102
What causes diabetes insipidus?
Lack of ADH, lack of response to ADH Can be nephrogenic or cranial
103
What are causes of nephrogenic diabetes insipidus?
Drugs (lithium) Intrinsic kidney disease Electrolyte disturbances
104
What are causes of cranial diabetes insipidus?
Hypothalamus does not produce ADH Brain tumours head injury brain infections brain surgery or radiotherapy
105
What is the presentation of diabetes insipidus?
Polyuria Polydipsia Hypernatraemia
106
What investigation results would be indicative for diabetes insipidus?
Low urine osmolality High serum osmolality water deprivation test
107
How does the water deprivation test diagnose diabetes insipidus
Patient is deprived of water for 8 hours, urine osmolality is measures. Synthetic ADH is provided and urine osmolality is measured again after 8 hours Cranial= low after deprivation, high after ADH Nephrogenic= low and low Primary polydipsia= high and high
108
How is diabetes insipidus managed?
Desmopressin
109
What is a phaeochromocytoma?
A tumour of the chromaffin cells which secretes unregulated and excessive amounts of adrenaline
110
How is phaeochromocytoma diagnosed?
24 hour urine catecholamines Plasma free metanephrines (breakdown product of adrenaline
111
What are the symptoms of phaeochromocytoma?
Anxiety Sweating Headache HTN Palpitations
112
What is the management of phaeochromocytoma?
Alpha blockers Beta blockers (once established on alpha blockers) Adrenalectomy

Alice's finals cards (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions