Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RACP Written Exam > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Raised PTH leads to:

A

increased bone resorption -> increased Ca and phos
Increased Ca reabsorption from kidney
increase in active vit D production in kidneys

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

factors that increase GH secretion

A

stress
exercise
hypoglycaemia
Glucagon

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

incidentaloma f/u

A

check if functioning
if not and >1cm repeat MRI in6mo-1yr

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

negative feedback on GH

A

glucose
somatostatin
obesity

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

Bests creening test for acromegaly

A

IGF1

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

Most common cause of acromegaly

A

98% GH producing pit tumour
most >1cm

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

Treatment for acromegaly

A

surgery 1st line (50% cure rate with macroadenomas)
if not cured -> medical therapy (octreotide, lanreotide or pasireotide binding to SST2) rarely dopamine antagonists
if not succesful -> Rdx

Pasireotide causes new onset DM in 60% (also binds to SST5 on beta islet cells)

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

Mortality in acromegaly

A

CVD in uncontrolled

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

Most common cause of GH deficiency

A

pituitary tumour 50%

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

First line treatment for prolactinoma

A

cabergoline (dopamine agonists)
- side effects: valvular heart disease, impuse control

surgery if doesn’t respond

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

How does TBG (thyroid binding globulin) levels effect T4 levels

A

Free T4 the same
total T4 increased or decreased

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

conditions which can effect TBG levels

A

Increased TBG -> OCP, preganacy , acute hepatitis
decreased TBG -> testosterone tx, steriods, anything which reduced general protein amounts

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

MOst common cause of thyrotoxicosis

A

grave’s disease

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

HLA with highest risk for Graves

A

HLA DR3

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

Graves disease pathogenesis important surface markers

A

T cells present antigen to B cells
uses CD 40 to CD 154 (can be targeted by Iscalimab) -> inhibits autoreactive B cell activation
works in 50%

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

Antibody markers for graves disease

A

TSH receptor antibodies
if they are negative can do scinti scan -> diffuse uptake over whole gland

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

Treatment of graves

A

carbimazole 12-15mo (50% remission rate)
if relapse or dont go into remission -> radioactive iodine or thyroidectomy

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

Side effects of carbimazole

A

most common rash and arthralgias
agranulocytosis (if repeat infections need CBE)
PTU -> hepatotoxicity, ANCA vasculitis

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

Antithyroid medication in pregnancy

A

PTU in 1st trimester (carbimazole can cause issues)

20
Q

Antithyroid treatment in thyroid storm

A

PTU -> slows down thyroid hormone production and reduces peripheral conversion

21
Q

Risk factors for graves orbitopathy

A

smoking
radioiodine
letting pt become hypothyroid

22
Q

Treatment of severe graves orbitopathy

A

IV methylpred
can add cyclosporin, rituximab, RTx
tocilizumab
teprotumumab (anti-IGF1)
if still unresponsive -> surgery

23
Q

Treatment of choice in toxic multinodular goitre

A

radioactive iodine
Not likely to leave hypothyroid due to only targeting goitres

24
Q

Symptoms of hyperthyroidism next step

A

if TSH receptors negative
do scinti scan -> diffuse uptake graves
if no uptake -> thyroiditis

25
Q

Thyroiditis ab

A

TPO ab

26
Q

How to tell between T1 and T2 amiodarone

A

T1 - increased vascularisation on doppler
T2 - reduced

27
Q

Hasimoto’s ab

A

TPO antibodies

28
Q

Half life of thyroxine

A

7 days

29
Q

What to do with thyroxine dose when pregnant

A

incease by 30%
(HCG can bind to TSh receptor and increase thyroid hormone and reduce TSH)

30
Q

Most common thyroid ca

A

pappilary
arises from follicular cells
Next most common follicular

31
Q

Monitoring ab in thyroid cancer

A

thyroglobulin

32
Q

Most comon cause of adrenal insuffiency in developed and developing

A

developed - autoimmune adrenalitis
developing -> TB

33
Q

Risks and mechanism of autoimmune adrenalitis

A

DR3 and DQ2 and DR4 and DQ8 give 30x risk
CD8 T cells and CD4 t cells react against 21-hydroxylase

34
Q

autoimmune polyendocrine syndrome 1

A

only in 15%
adrenal insufficency
hypoparathryroidism
chronic mucocutaenous candidiasis
AIRE gene mutation

35
Q

autoimmune polyendocrine syndrome 2

A

85%
adrenal insuffiency
autoimmune thyroid
T1DM

36
Q

Diagnosis of adrenal insuffiency

A

Synacthen test abnormal <400
ACTH very high
aldosterone low, renin raise
DHEA low
21 hydroxase ab +ve

37
Q

Most comon enzyme deficiency in congential adrenal hyperplasia

A

21-hydroxylase

38
Q

Most common causes of mineralocorticoid excess

A

60% bilateral adrenal hyperplasia
27% adrenal adenoma

39
Q

Timing to stop medication when interpreting renin tests

A

6 weeks for diuretics and spiro
2-4 weeks all others

40
Q

Drugs that increase renin

A

ACEi
Diuretics
DHP CCB

41
Q

drugs that decrease renin

A

beta blockers

42
Q

Treatment for bilateral adrenal hyperplasia

A

Spironolactone, aim normal renin

43
Q

Most common types of adrenal incidentaloma

A

non-functioning 75%
of functioning cortisol producing most common

44
Q

Concerning features for adrenal incidentalomas on imaging

A

HU >10
Slow washout <60%
>4 cm

45
Q

How is calcium absorbed in the gut

A

passive between gap junctions
active through TRP channels

46
Q

VItamin D function to calcium in gut

A

increased TRP and Ca APTase synthesis to aid uptake of calcium from gut

47
Q

Site of most calcium reabsorption in the kidney

A

proximal tubule

RACP Written Exam (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions