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PPQ Learning > Endocrinology > Flashcards

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
Q

Most common complication of papillary thyroid cancer?

A

Spread to cervical lymph nodes

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26
Q

Cushing’s syndrome ABG?

A

Hypokalaemic metabolic alkalosis

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27
Q

Iodine uptake on scan (thyroid scintigraphy) is increased/decreased in de quervain’s thyroiditis (subacute thyroiditis)?

A

DECREASED

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28
Q

Sitagliptan is a ?

A

DPP4 Inhibitor

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29
Q

Man with diabetic neuropathy + BPPH…what medication would you start him with?

A

Pregablin

If he didn’t have BPPH I would use amitriptyline, however in this case that would predispose to urinary retention

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30
Q

If a patient is on a drug which may cause hypoglycaemia (sulfonylurea), what is their HbA1c target?

A

53 mmol/mol

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31
Q

MEN 1 Common tumour?

A

Insulinoma

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32
Q

MODY inheritance pattern?

A

AD

33
Q

Optimal treatment for HNF1A MODY?

A

Sulfonylureas (Gliclazide)

34
Q

What syndrome causes High LH and FSH?

A

Klinefelter’s syndrome

35
Q

Low FSH & LH + Low testosterone?

A

Kallman syndrome

36
Q

Patient with T1DM and BMI >25 consider what drug regimen?

A

Insulin + metformin

37
Q

When do you add a second drug in T2DM?

A

If HbA1c rises to above 58mmol/mol(7.5%)

38
Q

Flow diagram of treating diabetes type 2?

A

-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
Q

What is octreotide?

A

Synthetic form of natural hormone somatostatin

40
Q

What is pegvisomant used for?

A

Treatment of acromegaly
-Mainly used if the pituitary gland tumour cannot be controlled with surgery etc

41
Q

Medication used in primary hyperthyroidism when patient is not fit for surgery?

A

Cinacalcet (calcimimetic drug) mimics action of calcium

42
Q

In treating DKA what do you do when the BG goe sto <14 mmol/L?

A

Start infusion of 10% dextrose at 125mls/hr in addition to saline

43
Q

WHat is PTH in myeloma?

A

Suppressed

44
Q

Causes of hypoglycaemia + pneumonic?

A

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
Q

Tender Goitre?

A

Thyrotoxicosis (D Quervain’s)

46
Q

Criteria for T1DM and driving?

A

-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
Q

What should you do with insulin in DKA? LA and SA?

A

Insulin should be fixed rate
Continue regular injected long acting insulin
Stop short acting injected insulin

48
Q

Insulin regime for newly diagnosed T1DM adult?

A

Twice daily basal insulin detemir
Insulin aspart bolus with meals

49
Q

What do these blood levels indicate?

A

Suppressed TSH levels
Normal Serum thyroxine (T4)

50
Q

Cpeptide levels are low in which pateints?

A

T1DM

51
Q

What is C peptide a result of?

A

Cleavage of proinsulin into insuli so in v low levels that idnicates the absolute absence of insulin&raquo_space; T1DM

52
Q

Primary hyperaldosterinism management?

A

Spironolactone

53
Q

Clinic reading target BP in T2DM <80 years old?

A

<140/90

54
Q

How does myxoedema coma typically present?

A

Confusion + hypothermia

55
Q

What should very person with insulin treatment have?

A

Glucagon kit

56
Q

Glucocorticoid treatment can give you neutropaenia/neutrophilia?

A

Neutrophilia

57
Q

Commonly inherited thyroid cancer?

A

Medullary carcinoma (autosomal dominant)

58
Q

Hot solitary nodule?

A

Toxic adenoma

58
Q

Criteria about MODY relating to
-BMI
-Fam History
- Inheritance
-DKA?

A

BMI typically low or normal (distinguishes from T2DM)

Usually a strong family history

Autosomal dominant inheritance

DKA not so common

58
Q

What can be a common electorylyte imbalance once a DKA is treated with insulin?

A

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
Q

In acromegaly if patient has raised IGF-1 levels what tests should you do next?

A

OGTT with serial GH measurements to confirm diagnosis

59
Q

1st line treatment for phaeochromocytoma?

A

PHenoxybenzamine before B blockers

60
Q

If a patient is unconcious with impaired GCS and in hypo what you wanna give them?

A

IV 20% glucose

61
Q

Which diabetes drug is linked to nec fash of genitalia or perineum and what is the term for that?

A

Fournier’s gangrene
SGLT-2 inhibitors dapagliflozin

62
Q

Triad of symptoms in MEN IIa?

A

Parathyroid hyperplasia and phaeochromocytoma

63
Q

XS parathyroid hormone excretion results in _______phosphate excretion?

A

Excess (rule of E’s)

64
Q

Hypertension treatment in diabetics?

A

ACEis (renoprotetective)

65
Q

Hyponatraemia + hyperkalemia + wt loss =

A

Addison’s disease

66
Q

What diabetic drug poses greater risk to the kebs and has a drug warning?

A

Canagliflozin

67
Q

Symptoms in MEN I?

A

Peptic ulceration, galactorrhoea, hypercalacaemia

68
Q

Which diabetes drug is CI-ed in bladder cancer and can cause weight increase?

A

Pioglitazone

69
Q

Features of Klinefelter’s?

A

Small testes
Infertility
Gynaecomastia
Above average height
Lack of 2ndary sexual characteristics

70
Q

Criteria for T2DM diagnosis?

A

Fasting glucose = or >7.0 mmol/L
Random glucose = > 11.1mmol/L (or after 75g oral glucose tolerance test)

71
Q

MALT lymphoma is associated with which endocrine condition?

A

Hashimotos thyroiditis

72
Q

Common cause of Cranial DI?

A

Recent transphenoidal pituitary surgery

73
Q

What DI is Lithium a RF for?

A

Nephrogenic diabetes

74
Q

Schizophrenia cause what type of DI?

A

Psychogenic polydipsia

75
Q
A

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