Endocrinology Flashcards
What are features of Kallman syndrome?
- Delayed pubtery
- Hypogonadism
- Loss of smell
- Low sex hormones
- Normal/above average height
How is Kallman syndrome managed?
- Testosterone supplementation
- Sex hormones supplementation for fertility
What is vitamin D deficiency associated with?
Hypocalcaemia
Patients with high calcium, low PTH with cancer risk factors?
Think malignancy
What hormones does anterior pituitary produce?
ACTH, TSH, LH, FSH, PRL. GH, MSH
What hormones does posterior pituitary produce?
ADH and oxytocin
What is the management of hypoglycaemia with impaired GCS?
IV Glucose if access
What characterises tertiary hyperparathyroidism?
- extremely high PTH
- moderately raised calcium
What is the management of new onset graves disease to control symptoms?
- Propranolol
- Carbimazole used to induce remission
Any change in vision for someone with thyroid eye disease needs what?
Urgent review by specialist
What is the target HBa1c for those on hypoglycaemic medications for T2DM?
53
What conditions make up MEN Type 2?
Medullary thyroid cancer, hypercalcaemia - parathyroid hyperplasia, phaeochromocytoma
What is the mode of action of orlistat?
inhibiting gastric and pancreatic lipase to reduce the digestion of fat
What should patients on long-term steroids do during intercurrent illness?
Double steroid doses
What adjunct can be used alongside orlistat for obese patients with one weight related co-mobidity?
Liraglutide
Subclinical hyperthyroidism is associated with what?
atrial fibrillation, osteoporosis and possibly dementia
What should be monitored to detect recurrence of medullary thyroid cancer?
Serum calcitonin
What is definitive management of primary hyperparathyroidism?
Total parathyroidectomy
What is primary hyperparathyroidism?
XS secretions of PTH resulting in hypercalcaemia.
When is primary hyperparathyroidism typically diagnosed?
Incidental finding of elevated serum Ca.
Causes of primary hyperparathyroidism?
85% parathyroid adenoma. Others: hyperplasia, multiple adenoma, carcinoma.
Primary hyperparathyroidism CP
- 80% asymptomatic
- ‘bones, stones, abdominal groans and psychic moans’
- polydipsia, polyuria, depression, anorexia, nausea, constip, peptic ulcer, pacreatitis, bone pain/fracture, renal stones, HTN
Primary hyperparathyroidism associations
HTN, multiple endocrine neoplasia (MEN I and II)
Primary hyperparathyroidism Ix
- Bloods
- Technetium-MIBI subtraction scan
- X-ray: pepperpot skull; osteoitis fibrosa cystica