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Endocrinology Flashcards

1
Q

Drug causes of gynaecomastia?

A

Spironolactone
Cimetidine
Digoxin
Cannabis
Finasteride
GnRH agonists (goserelin, buserelin)
Oestrogens

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2
Q

Examples of SGLT2 Inhibitors?

A

Dapagliflozin

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3
Q

Gene associated with medullary thyroid cancer?

A

RET Oncogene

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4
Q

What type of TSH, T3/T4 level would a patient with pneumonia have?

A

TSH: Normal/low
Thyroxine: low
T3: Low

Euthyroid sick syndrome

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5
Q

1st line treatment of diabetic neuropathy?

A

Duloxetine
Amitriptyline
Gabapentin
Pregablin

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6
Q

SEs of piaglitazone?

A

Wt gain
Liver impairment
Fluid retention
Bladder cancer

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7
Q

Globally recued uptake on technetium thyroid scan indicative of?

A

Subacute thyroiditis

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8
Q

Drug used in residual symptoms of acromegaly?

A

Ocreotide

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9
Q

SEs of sulfonylureas (Gliclazide)?

A

Wt gain
Hypoglycaemic episodes
Hyponatraemia
Bone marrow suppression
Hepatotoxicity

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10
Q

Piaglitazone is contraindicated when?

A

Patients with CHF

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11
Q

Example of DPP4 inhibitor?

A

Sitagliptan

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12
Q

Drugs causing galactorrhoea?

A

Metaclopramide, domperidone
Phenothiazines
Haloperidol
SSRIs/opioids

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13
Q

What does over-replacement with thyroxine increase the risk of?

A

Osteoporosis

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14
Q

Interactions of drugs with levothyroxine?

A

Iron
Calcium carbonate

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15
Q

What auto antibody is most commonly found in Grave’s disease?

A

Anti-TSH receptor antibodies

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16
Q

Conditions which can give lower than expected levels of HbA1c and reason?

A

Sickle cell anaemia
GP6D deficiency
Hereditary spherocytosis
Haemodialysis

RBC decreased life span

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17
Q

Conditions giving higher than expected levels of HbA1c and reason?

A

Vit B12/Folic acid deficiency
Iron deficiency anaemia
Splenectomy

Increased RBC lifespan

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18
Q

What can an ABG be like in hyperaldosteronism?

A

Metabolic alkalosis
Hypokalaemia

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19
Q

Vomiting Addisons patient should take what?

A

IM hydrocortisone

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20
Q

Radioiodine treatment can precipitate what?

A

Hypothyroidism

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21
Q

1st line treatment for prolactinomas?

A

Cabergoline

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22
Q

Genetically male patient with phenotypically female genitalia?

A

Congenital androgen insensitivity syndrome

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23
Q

MEN Type 1 symptoms?

A

HyperParathyroidism
Pituitary disease
Pancreatic disease

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24
Q

In DKA what do you do if ketonaemia and acidosis have not been resolved within 24 hours?

A

Senior endocrinology review

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25
Most common complication of papillary thyroid cancer?
Spread to cervical lymph nodes
26
Cushing's syndrome ABG?
Hypokalaemic metabolic alkalosis
27
Iodine uptake on scan (thyroid scintigraphy) is increased/decreased in de quervain's thyroiditis (subacute thyroiditis)?
DECREASED
28
Sitagliptan is a ?
DPP4 Inhibitor
29
Man with diabetic neuropathy + BPPH...what medication would you start him with?
Pregablin If he didn't have BPPH I would use amitriptyline, however in this case that would predispose to urinary retention
30
If a patient is on a drug which may cause hypoglycaemia (sulfonylurea), what is their HbA1c target?
53 mmol/mol
31
MEN 1 Common tumour?
Insulinoma
32
MODY inheritance pattern?
AD
33
Optimal treatment for HNF1A MODY?
Sulfonylureas (Gliclazide)
34
What syndrome causes High LH and FSH?
Klinefelter's syndrome
35
Low FSH & LH + Low testosterone?
Kallman syndrome
36
Patient with T1DM and BMI >25 consider what drug regimen?
Insulin + metformin
37
When do you add a second drug in T2DM?
If HbA1c rises to above 58mmol/mol(7.5%)
38
Flow diagram of treating diabetes type 2?
-Metformin If ineffective add SGLT2 Inhibitor (once established) (or if CVD, CHF If standard release not tolerated, use modified release trial ) -If metformin (CI due to CVD/CHF) use SGLT2 inhibitor and if that's not enough add sulfonylurea -If metformin not tolerated but not due to CVD: DPP-4 Inhibitor or piaglitazone or sulfonylurea -If none of these work it is time to try a GLP-1 mimetic (if BMI 35 or over) must be under specialist care
39
What is octreotide?
Synthetic form of natural hormone somatostatin
40
What is pegvisomant used for?
Treatment of acromegaly -Mainly used if the pituitary gland tumour cannot be controlled with surgery etc
41
Medication used in primary hyperthyroidism when patient is not fit for surgery?
Cinacalcet (calcimimetic drug) mimics action of calcium
42
In treating DKA what do you do when the BG goe sto <14 mmol/L?
Start infusion of 10% dextrose at 125mls/hr in addition to saline
43
WHat is PTH in myeloma?
Suppressed
44
Causes of hypoglycaemia + pneumonic?
EX ogenous drugs (sulfonylurea/insulin) P ituitary insufficiency L iver failure A ddison's disease I slet cell tumours (insulinomas) N on-pancreatic neoplasms
45
Tender Goitre?
Thyrotoxicosis (D Quervain's)
46
Criteria for T1DM and driving?
-Adequate hypoglycaemic awareness -No more than 1 episode of severe hypo while awake preceeding 12 months AND most recent was more than 3 months ago -Appropriate glucose monitoring -Not regarded as a risk -Meets visual acuity and field standards -Under regular review
47
What should you do with insulin in DKA? LA and SA?
Insulin should be fixed rate Continue regular injected long acting insulin Stop short acting injected insulin
48
Insulin regime for newly diagnosed T1DM adult?
Twice daily basal insulin detemir Insulin aspart bolus with meals
49
What do these blood levels indicate?
Suppressed TSH levels Normal Serum thyroxine (T4)
50
Cpeptide levels are low in which pateints?
T1DM
51
What is C peptide a result of?
Cleavage of proinsulin into insuli so in v low levels that idnicates the absolute absence of insulin >> T1DM
52
Primary hyperaldosterinism management?
Spironolactone
53
Clinic reading target BP in T2DM <80 years old?
<140/90
54
How does myxoedema coma typically present?
Confusion + hypothermia
55
What should very person with insulin treatment have?
Glucagon kit
56
Glucocorticoid treatment can give you neutropaenia/neutrophilia?
Neutrophilia
57
Commonly inherited thyroid cancer?
Medullary carcinoma (autosomal dominant)
58
Hot solitary nodule?
Toxic adenoma
58
Criteria about MODY relating to -BMI -Fam History - Inheritance -DKA?
BMI typically low or normal (distinguishes from T2DM) Usually a strong family history Autosomal dominant inheritance DKA not so common
58
What can be a common electorylyte imbalance once a DKA is treated with insulin?
Hypokalaemia - Untreated DKA causes potassium efflux and H+ influx, and additionally insulin deficiency adds to this -Therefore once treated with insulin potassium moves from extracellular space into intracellular space
59
In acromegaly if patient has raised IGF-1 levels what tests should you do next?
OGTT with serial GH measurements to confirm diagnosis
59
1st line treatment for phaeochromocytoma?
PHenoxybenzamine before B blockers
60
If a patient is unconcious with impaired GCS and in hypo what you wanna give them?
IV 20% glucose
61
Which diabetes drug is linked to nec fash of genitalia or perineum and what is the term for that?
Fournier's gangrene SGLT-2 inhibitors dapagliflozin
62
Triad of symptoms in MEN IIa?
Parathyroid hyperplasia and phaeochromocytoma
63
XS parathyroid hormone excretion results in _______phosphate excretion?
Excess (rule of E's)
64
Hypertension treatment in diabetics?
ACEis (renoprotetective)
65
Hyponatraemia + hyperkalemia + wt loss =
Addison's disease
66
What diabetic drug poses greater risk to the kebs and has a drug warning?
Canagliflozin
67
Symptoms in MEN I?
Peptic ulceration, galactorrhoea, hypercalacaemia
68
Which diabetes drug is CI-ed in bladder cancer and can cause weight increase?
Pioglitazone
69
Features of Klinefelter's?
Small testes Infertility Gynaecomastia Above average height Lack of 2ndary sexual characteristics
70
Criteria for T2DM diagnosis?
Fasting glucose = or >7.0 mmol/L Random glucose = > 11.1mmol/L (or after 75g oral glucose tolerance test)
71
MALT lymphoma is associated with which endocrine condition?
Hashimotos thyroiditis
72
Common cause of Cranial DI?
Recent transphenoidal pituitary surgery
73
What DI is Lithium a RF for?
Nephrogenic diabetes
74
Schizophrenia cause what type of DI?
Psychogenic polydipsia
75

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