Brainscape's Knowledge GenomeTM

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


See full index

Cardiology > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

ADH is released by the?

A

Posterior pituitary

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

Pituitary adenoma causes what visual defect?

A

Upper bi-temporal quadrantanopia

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

What is PITS qaundrantonopia?

A

Parietal inferior
Temporal superior

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

Microadenoma?

A

<10
12 monthly MRI then 3 yearly

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

Macroadenoma?

A

10+
6 monthly MRI and yearly bloods

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

Investigations for pituitary adenoma?

A

MRI pituitary
Pituitary profile
Visual field testing

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

Treatment of prolactinoma?

A

Cabergoline
Bromocriptine
Surgery transphenoidal if medical management fails

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

What is cabergoline?

A

Dopamine receptor agonist to reduce tumour size

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

When do you use bromocriptine?

A

In pregnancy/ wanting to conceive in pituitary adenoma

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

What is Cushings disease?

A

Pituitary adenoma secreting ACTH -> cortisol

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

What are the screening tests for Cushings disease?

A

X2

24h urinary cortisol
Midnight salivary cortisol tests
Midnight overnight/ low dose dexamethasone suppression test

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

How do you diagnose Cushings disease?

A

Low dose dexamethasone suppression test- cortisol high

High dose dexamethasone test- suppresses

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

Treatment of Cushings disease?

A

Trans-sphenoidal resection
Replace corticosteroids

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

How do you treat Cushings disease if surgery is contraindicated?

A

Metyrapone

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

What is pseudo-cushings syndrome?

A

Features secondary to alcohol excess

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

What is acromegaly?

A

Pituitary adenoma secreting GH

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

Screening of acromegaly?

A

IGF-1

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

Diagnosis of acromegaly?

A

OGTT

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

Investigations of acromegaly?

A

Prolactin, IGF-1, OGTT, HbA1c, CT/MRI pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Treatment of acromegaly?

A

Transphenoidal surgery +/- radiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do you treat acromegaly if surgery fails?

A

Octreotide
Pegvisomant (GH antagonists)
Bromocriptine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Follow up to detect acromegaly recurrence?

A

IGF-1, GH, prolactin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Increased risk of what in acromegaly?

A

bowel malignancy (colonoscopy)
HF (ECHO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is SIADH?

A

Excess ADH causing euvolaemic hyponatraemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does ADH do?

A

up-regulates aquaporin-2 channels to CD’s allowing concentration of urine, increasing BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Causes of SIADH?

A

Pituitary adenoma
SCLC
Pulmonary disease
SSRIs, tricyclics, carbamazepine
meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Investigations of SIADH?

A

Euvolaemic hyponatraemia with high urinary sodium >20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Management of SIADH?

A

Fluid restriction 750ml
if in effective Domeclocylcine or vaptans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is arginine vasopressin disorder?

A

Diabetes insipidus, deficiency of ADH production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Forms of diabetes insipidus?

A

Craniogenic (deficiency)
Nephrogenic (resistance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How is diabetes insipidus seen?

A

thirst and excessive urination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Causes of craniogenic DI?

A

Inherited (AD neurohypohyseal)
Hypopituitarism- trauma, stroke, meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are causes of nephrogenic DI?

A

Wolframs syndrome
Lithium
Domoclocycline
Electrolyte disturbances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Investigation signs of diabetes insipidus?

A

Urine osmolality LOW <300
Serum osmolality HIGH >300

HyperNa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Diagnostic test for DI?

A

Fluid deprivation test
+
Desmopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is fluid deprivation test?

A

Increases serum osmolality but wont increase urine osmolality (will not concentrate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Why then give desmopressin after fluid deprivation test in DI?

A

Craniogenic will concentrate urine (increase urine osmolality)

Nephrogenic urine osmolality still low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Treatment of craniogenic DI?

A

Desmopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Treatment of nephrogenic DI?

A

Treat underlying cause: electrolytes, drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is Cushings syndrome?

A

High cortisol from:
- Cushings disease
- Ectopic ATCH lung/thymic carcinomas
- Adrenal adenoma/
Adrenal carcinomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Diagnosis of cushing syndrome?

A

Low dose dexamethasone suppression test- doesnt suppress

High dose dexamethasone test- doesnt suppress

ACTH low in adrenal adenoma, high in ectopic/pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Further investigation of cushing syndrome?

A

MRI pituitary
CT TAP
Inferior petrosal sinus sampling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Screening for cushing syndrome?

A

24h urinary free cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Management of cushing syndrome?

A

Metyrapone
Ketoconazole

+ steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Adrenal gland is divided into the?

A

Glomerulusa
Fasciculate
Reticularis

Medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Glomeruluosa produces?

A

Aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Fasciculata produces?

A

Cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Reticularis produces?

A

Androgens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Medulla produces?

A

Adrenaline and noradrenaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is waterhouse-friedrichsen syndrome?

A

Haemorrhage and destruction of adrenals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Why can primary adrenal insufficiency occur?

A

Addison’s disease (autoimmune)
Surgical removal
Trauma
TB
Waterhouse-friedrichson

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What are causes of secondary adrenal insufficiency?

A

Base of skull fracture
neoplasms
Sheehan syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What causes tertiary adrenal insuffiency?

A

Long term steroids suppressing CRH from hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Signs of adrenal insufficiency?

A

Hypotension
HypoNa
Hypoglycaemia
Hyperkalaemia
Increased skin pigmentation
NAGMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Investigations for addisons?

A

Morning cortisol (or random)
ACTH
Renin/ aldosterone
Adrenal cortex antibodies
21-hydroxylase antibodies

56
Q

ATCH in primary and secondary adrenal insufficiency?

A

ACTH high in primary
ACTH low/normal in secondary

57
Q

Diagnosis of adrenal insufficiency?

A

Short synacthen test

58
Q

What is the short synacthen test?

A

Check blood cortisol then give synthetic ACTH, recheck cortisol after 30 mins, then 60 mins, in healthy should double

59
Q

What is Conns syndrome?

A

Adrenal adenoma causing primary hypoaldosteronism (too much aldoesterone)

60
Q

What is primary hyperaldosteronism?

A

Adrenal producing too much aldosterone due to:
- Adrenal hyperplasia
- Conn’s syndrome (adrenal adenoma)
- Functioning carcinoma

61
Q

What is secondary hyperaldoesteronism?

A

Too much renin due to:
- Renal artery stenosis
- Renin secreting tumours
- hypovolaemia

62
Q

How is hyperaldosteronism seen?

A

Treatment resistant hypertension
Hypokalaemia

63
Q

What is hyperaldoesteronism linked to?

A

Osteoporosis

64
Q

What does aldosterone do?

A

Increases Na reabsorption at DCT
Increases K+ secretion at DCT
Increases H+ secretion at collecting ducts

65
Q

Screening for hyperaldosteronism?

A

Aldosterone: Renin ratio when off anti HTN
then
Liqourice excess

66
Q

Diagnosis of hyperaldoesteronism?

A

Selective adrenal vein sampling
PET/ CT adrenals

67
Q

Management of hyperaldoesteronism?

A

Surgical removal if unilateral
Bilateral- spironolactone/ eplerenone/ amiloride

68
Q

What does amiloride do?

A

K sparing diuretic

69
Q

What is the RAAS system?

A

Renin angiotensin aldosterone system

70
Q

What secretes renin?

A

Juxtaglomerular cells in the afferent arterioles of the kidney due to low BP

71
Q

What does renin do?

A

Coverts angiotensinogen (from the liver) to angiotensin 1

72
Q

What does angiotensin 1 go on to?

A

Converted by ACE (from lungs) to angiotensin 2

73
Q

What does angiotensin 2 do?

A

Stimulates aldosterone to be secreted by the adrenals (zona glomerulosa)

74
Q

What is subclinical hyperthyroidism?

A

Normal T3/T4
Depressed TSH

75
Q

Monitoring/ treatment for subclinical hyperthyroidism?

A

TFTs 6 monthly
No treatment

76
Q

Causes of exogenous hyperthyroidism?

A

Strum ovarii- teratroma in ovaries
HCG excess in molar pregnancy

77
Q

What is Graves disease?

A

Anti TSH receptor antibodies

78
Q

What are TSH receptors on the thyroid gland?

A

GPCR signalling cAMP

79
Q

What is graves linked to?

A

HLA D3
HLA DR 4

80
Q

Goitre in graves disease?

A

Diffuse non tender goitre
Diffuse uptake on scans

81
Q

Signs of graves disease?

A

Clubbing
Pretibial myxoedema
Exophthalmos
Corneal ulcers
Optic atrophy with colour vision loss
Lid retraction
Hyperreflexia

82
Q

Risk of graves in pregnancy?

A

IgG crosses placenta causing neonatal graves disease

83
Q

Drug causes of hyperthyroidism?

A

Post amiodarone
Contrast

84
Q

Management of hyperthyroidism?

A

1- Titration
Carbimazole or propylthiouracil for 1-2 years then down titrate

85
Q

What does carbimazole and propythiorucil do?

A

Block thyroid peroxidase, preventing iodination and coupling in the hormone synthesis pathway

86
Q

Who cant take carbimazole?

A

Pregnant women as associated with aplasia cutis

87
Q

Important SE of carbimazole?

A

Agranulocytosis

88
Q

What can you give to pregnant women with hyperthyroidism?

A

Propylthiouracil in first trimester
Methimazole in 2-3rd trimester

89
Q

Second line in treatment for hyperthyroidism?

A

2- Block and replace

High dose carbimazole/ propylthiouracil
+
Levothyroxine (T4)

90
Q

Third line treatment of hyperthyroidism?

A

Medical ablation with radio-iodine (131)

91
Q

Who cant have radio-iodine?

A

Pregnant women
Breast feeding

92
Q

How long not to conceive after radio-iodine?

A

Women 6 months
Men 4 months

93
Q

How long to avoid young children and elderly with radio-iodine?

94
Q

Issue with radio iodine?

A

Can worsen graves opthalmopathy in first 3 months

95
Q

Who gets radio iodine?

A

Toxic adenoma
MNG

96
Q

If medical management unsuccessful or goitre causing compression do?

A

Surgical ablation and thyroidectomy

97
Q

Complications of thyroidectomy?

A

Parathyroid removal accidentally
HypoCa
Haemorrhage
Recurrent laryngeal nerve damage

98
Q

Thyrotoxic crisis precipitants?

A

Surgery
radioiodine
Gastric losses
Intercurrent illness

99
Q

Symptoms of thyrotoxic storm?

A

Hyperpyrexia
Sweating
D+V
Severe hypertension
AF
Psychosis

100
Q

Management of thyrotoxic storm?

A

Propylthiouracil
Prednisolone (reduces T4-T3 conversion)
Propranolol
Active cooling

101
Q

What is amiodarone induced thyrotoxicosis?

A

Hyperthyroidism/hypothyroidism secondary to amiodarone as it contains iodine as it has a long half life

102
Q

What is type 1 AIT?

A

In pre-existing hyperthyroidism iodine increases hormone production via Jod-basedow phenomenon

103
Q

Uptake scan in T1 AIT?

A

Increased uptake

104
Q

IL-6 in AIT T1?

105
Q

What is Type 2 AIT?

A

Patients without pre-exisiting disease, amiodarone causes toxic effect

106
Q

Uptake scan and IL-6 in T2 AIT?

A

Reduced uptake
IL-6 raised

107
Q

Treatment of T2 AIT?

108
Q

Treatment of T1 AIT?

A

Carbimazole

109
Q

When can AIT cause hypothyroidism?

A

Most common via Wolff-Chiakoff effect

110
Q

What is subclinical hypothyroidism?

A

Normal T3/T4
Raised TSH

111
Q

What is sick euthyroid syndrome?

A

When unwell low T3/4 and normal TSH
Repeat 3 months after recovery
Levo if symptomatic, TSH >10, high risk CV disease or autoimmunity

112
Q

Causes of hypothyroidism?

A

Iodine deficiency
Hashimoto thyroiditis
De Quervains thyroiditis
Damage

113
Q

Drugs that may cause hypothyroidism?

A

Amiodarone
Iodine
Lithium

114
Q

What is Hashimoto’s thyroiditis?

A

Autoimmune hypothyroidism with a painless firm goitre

115
Q

What are the antibodies in hashimotos?

A

Anti TPO
Anti thyroglobulin
Anti TSH receptor (blocking)

116
Q

What is De Quervain’s thyroiditis?

A

Subacute granulomatous thyroiditis
Painful goitre due to infection

117
Q

Infections common in De Quervains thyoiditis?

A

Viral URTI
Cocksakie
Mummps
Measles
Adenovirus

118
Q

Treatment of De Quervains thyroiditis?

A

NSAID and supportive, self limiting

119
Q

What is subacute lymphocytic thyroiditis?

A

Silent and painless hypothyroidism 6 months post partum

120
Q

Why start levothyroxine slowly?

A

Long half life and increased risk of MI

121
Q

What to check before starting levothyroxine?

A

Cortisol as can predicate addisonian crisis

122
Q

When to recheck TFTs?

123
Q

Psammoma bodies, Orphan-Annie ground glass nuclei

A

Papillary adenocarcinoma of thyroid

124
Q

Tumour marker for papillary adenocarcinoma of the thyroid?

A

Thyroglobulin

125
Q

Management of papillary adenocarcinoma of thyroid?

A

> 1cm = thyroidectomy
<1cm = hemithyroidectomy + LN dissection

+/- radio-iodine
Thyroxine to suppress TSH to <0.1

126
Q

Hurthle cell change, younger patient?

A

Follicular adenocarcinoma

127
Q

Follicular adenocarcinoma tumour marker/

A

Thyroglobulin

128
Q

Worst prognosis for thyroid cancer?

A

Anaplastic carcinoma (older patients)

129
Q

Anaplastic thyroid cancer tumour marker?

130
Q

Giant osteoclastic liek cells with sarcomatous spindles?

A

Anaplastic carcinoma

131
Q

Management of anaplastic thyroid cancer?

A

Usually inoperable and causes local compression palliative tracheostomy/ radiotherapy

132
Q

Medullary carcinoma is?

A

Endocrine tumour of C-cells parafollicular cells

133
Q

Tumour marker for medullary carcinoma?

A

Calcitonin
CEA

134
Q

Management of medullary carcinoma?

A

Total thyroidectomy + LN dissection
Rule out phaeo as MEN2

135
Q

Tumour marker follow up for medullary carcinoma?

A

calcitonin

136
Q

Management of follicular adenoma?

A

Benign but cant tell apart for hemithyroidectomy

Cardiology (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions