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Year 6 Cross Section > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

symptoms of thyroid storm

A

hyperthermia
tachycardia
jaundice
altered mental state
cardiac (AF/high output HF)

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1
Q

symptoms of thyroid storm

A

hyperthermia
tachycardia
jaundice
altered mental state
cardiac (AF/high output HF)

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2
Q

Riedel’s thyroiditis

A

hypothyroidism caused by chronic inflammatory thyroid gland fibrosis

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3
Q

2 medications that interact with Levothyroxine

A

Iron
Calcium carbonate

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4
Q

symptoms of myxoedema coma

A

hypothermia
hyporeflexia
bradycardia
seizures

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5
Q

causes of pseudo-Cushing’s

A

alcoholism
severe depression
use insulin stress test to tell difference with Cushing’s

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6
Q

screening test for Cushing’s

A

11pm salivary cortisol (high)
LDDST

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7
Q

how to determine cause of hyperaldosteronism

A

HR-CT and adrenal vein samplinh

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8
Q

renal and non-renal causes of hypernatraemia

A

renal: osmotic diuresis (T2DM) or DI
non-renal: GI losses, sweat losses of water

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8
Q

renal and non-renal causes of hypernatraemia

A

renal: osmotic diuresis (T2DM) or DI
non-renal: GI losses, sweat losses of water

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9
Q

causes of pseudohyponatraemia

A

hyperlipidaemia
hyperproteinaemia

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10
Q

imaging in myeloma

A

whole body low dose CT

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11
Q

refeeding syndrome symptoms

A

rhabdo
low RR
arrythmias
shock
seizures
coma

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12
Q

management of fibromuscular dysplasia

A

stop smoking
anti-platelets
anti-HTN
surgical stenting

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13
Q

causes of hypoMg

A

diuretics/PPIs
diarrhoea
TPN
ETOH
HypoK, HypoCa

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14
Q

visual defect with lesion in optic radiation

A

superior quandrantopia

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15
Q

visual defect with lesion in optic tract

A

homonymous hemianopia

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16
Q

when do you switch the insulin infusion to SC insulin in DKA?

A

when blood ketones <0.3mmol/L

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17
Q

SE’s of carbimazole

A

maculopapular rash
bone marrow suppression = agranulocytosis
pruritis
jaundice

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18
Q

how should insulin regimes be managed pre-operatively

A

reduce dose insulin on day of operation and day before

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19
Q

what to do if you have subclinical hypothyroidism?

A

repeat TFTs in 6-8 weeks
1. if T4 normal, TSH> 10 = treat
2. TSH 5-10, thyroid Ab +ve = repeat annually, commence thyroxine when TSH >10
3. TSH 5-10, thyroid Ab -ve = check every 3-5 years

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20
Q

TSH dec/normal and low fT4, cause?

A

secondary hypothyroidism
?pituitary dysfunction - check cortisol

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21
Q

TSH dec/normal and low fT4, cause?

A

secondary hypothyroidism
?pituitary dysfunction - check cortisol

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22
Q

cause of a high Ca and low PTH

A

cancer

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23
Q

cause of a high Ca and high PTH

A

parathyroid disease

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24
Q

what is Chvostek’s sign?

A

tap facial nerve = facial muscle twitch

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25
Q

what is Trousseau’s sign?

A

inflate arm cuff = carpopedal spasm

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26
Q

when is hypoCa an emergency and how to treat?

A

if QT prolonged, signs of tetany
Tx: Ca gluconate 10%
Cardiac monitoring, check serum Mg and PTH

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27
Q

when it is not emergency, how to manage?

A

bloods for PTH/Vit D
Endo clinic
Calchichew tabs

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28
Q

causes of hypercalcaemia

A

primary hyperparathyroidism
malignancy
myeloma
sarcoid
thiazides

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29
Q

diabetic neuropathy abdo pain

A

gastroparesis = vagus neuropathy
management = metaclopramide

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30
Q

when do you start ACEi in T2DM if ACR

A

ACR >3.0mg/mmol

31
Q

insulin monitoring when sick?

A

continue normal insulin (more monitoring)

32
Q

examples of sulphonylureas

A

Glibenclamide
Gliclazide

33
Q

examples of DPP4 inhibitor

A

Sitagliptin

34
Q

classification of thyroid

A

Thy 1 classification

35
Q

low uptake thyroiditis

A

subacute thyroiditis
post-partum thyroiditis

36
Q

thyroid storm management

A

IV propanolol = thionamides
Hydrocortisone = Iodine

37
Q

Interactions of thyroxine

A

Iron
CaCO3

38
Q

Addison’s

A

9am plasma cortisol
synACTH test

39
Q

ACTH dependent causes

A

Cushing’s disease
ectopic ACTH

40
Q

ACTH independent causes

A

steroids
adenoma/carcinoma

41
Q

Pseudo-Cushing’s causes

A

alcohol excess
severe depression
detect by insulin stress test

42
Q

Cushing’s test

A

11pm salivary cortisol
LDDST

43
Q

Hypernatraemia - increase in Na causes

A
  • medical/dietary high intake
  • Conn’s
  • RAS
44
Q

Hypernatremia - loss of water

A

renal losses: osmotic diuresis, DI
non-renal losses: GI loss, sweat loss

45
Q

SIADH drug causes

A

SSRI
TCA
PPI
Carbamazepine

46
Q

SIADH investigations

A

plasma and urine osmolality

47
Q

main causes of hyperkalaemia

A

renal impairment
Drugs (ACEi, ARBs, spirnolactone)
Low aldosterone (Addison’s, T4RA)
Release from cells - Rhabo

48
Q

Main causes of hypokalaemia

A

GI losses
Renal losses (MR excess, osmotic diuresis)
Redistribution in cells (insulin, alkalosis)
Rare (RTA, T1+T2, hypoMg)

49
Q

HyperCa and QT

A

short QT

50
Q

HypoCa and QT

A

low QT, low Mg

51
Q

Management of myeloma

A

induction = thalidomide + dexa
bone disease = bisphosphonate + analgesia

52
Q

Refeeding syndrome S/S

A

Rhabdo, low RR, arrhythmias, shock, seizures

53
Q

Refeeding management

A

phosphate supplements

54
Q

common causes of polyuria

A

diuretics, caffeine, ETOH, DM, Lithoum, HF

55
Q

infrequent causes of polyuria

A

HyperCa, Hyperthyroidism

56
Q

rare causes of polyuria

A

CRF, primary polydipsia, dec potassium

57
Q

investigations in polyuria

A

bloods (including paired serum + urine osmolarity)
water deprivation test

58
Q

Abs in Vit B12

A

Anti-IF AB

59
Q

Causes of HypoMg

A

Drugs (diuretics, PPI)
Diarrhoea
TPN
ETOH
dec K, dec Ca

60
Q

S/S of HypoMg

A

paraesthesia, seizures, tetany, arryhtmias

61
Q

ECG of HypoMg

A

similar to HypoKa

62
Q

when to use Mg IV replacement?

A

<0.4

63
Q

complications of diabetes

A

Macrovascular (MI, CVA)
Microvascular (Eyes, Kidneys, Nerves)
These need monitoring

64
Q

when is metformin contraindicated?

A

GFR < 30

65
Q

what is exanatide?

A

GLP-1 agonist

66
Q

how do you know when DKA is resolved?

A

ketones < 0.3 mM + venous pH > 7.3

67
Q

hypoglycaemia symptoms

A

autonomic (2.5-3): sweating, anxiety, hunger, tremor, palpitations
neuroglycopenic (<2.5): confusion, drowsiness, seizures, personality change

68
Q

important treatment in thyrotoxicosis

A

first carbimazole then Lugol’s iodine 4 hours later to inhibit thyroid

69
Q

early complications of thyroid surgery

A

haematuria
laryngeal oedema
recurrent laryngeal nerve palsy
hypoparathyroidism
thyroid storm

70
Q

hypokalaemia symptoms

A

weakness
hypotonia
hyperreflexia
cramps

71
Q

what is secondary hyperaldosteronism?

A

increase renin from decrease renal perfusion

72
Q

MEN 1

A

pitutary adenoma
parathyroid adenoma
pancreatic tumour

73
Q

MEN 2

A

thyroid Ca, phaeo
A: hyperthyroid
B: Marfanoid

74
Q

what cranial nerve palsies can pituitary tumours cause?

A

CN 3, 4, 5, 6 palsies

75
Q

normal relationship between PTH, Ca and PO4

A

PTH causes inc Ca and dec PO4

76
Q

causes of hypoCa with increased PO4

A

CKD
inc PTH
dec Mg

77
Q

causes of hypoCa with decreased or normal PO4

A

osteomalacia
pancreatitis

Year 6 Cross Section (23 decks)

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