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Passmed wrong > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

DKA resolution defined as

A

pH >7.3 and
blood ketones < 0.6 mmol/L and
bicarbonate > 15.0mmol/L

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2
Q

Tx once DKA resolved

A

Switch the patient to subcutaneous insulin so long as patient is eating and drinking normally

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3
Q

Insulin stress test:
insulinoma vs inappropriate exogenous insulin injection

A

Insulinoma- C-peptide levels do not fall
Inappropriate exogenous insulin injection: C-peptide levels fall

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4
Q

Medullary thyroid cancer gene association

A

RET oncogene

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5
Q

Endocrine parameters reduced in stress response:

A

Insulin
Testosterone
Oestrogen

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6
Q

DKA insulin dose

A

fixed rate IV insulin infusion at 0.1 unit/kg/hour

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7
Q

High dose dexamethasone suppression test- Cushings disease

A

suppressed cortisol and ACTH

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8
Q

falsely high HbA1c

A

due to increased lifespan of RBC:

Vitamin B12/folic acid deficiency
Iron-deficiency anaemia
Splenectomy

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9
Q

falsely low HbA1c

A

due to decreased lifespan of RBC:

Sickle-cell anaemia
GP6D deficiency
Hereditary spherocytosis
Haemodialysis

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10
Q

most common complication of thyroid eye disease

A

exposure keratopathy
(red and painful eye)

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11
Q

How to distinguish between primary adrenal failure and secondary adrenal insufficiency?

A

skin pigmentation

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12
Q

atypical features of T1DM that require further investigation (c-peptide levels, autoantibodies)

A

age 50 years or above
BMI of 25 kg/m² or above
slow evolution of hyperglycaemia or long prodrome

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13
Q

insulin vs gliclazide overdose

A

insulin: raised insulin levels, c-peptide normal

gliclazide: raised insulin and c-peptide levels

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14
Q

Insulinoma Whipple’s triad of symptoms

A

1) hypoglycaemia with fasting or exercise
2) reversal of symptoms with glucose,
3) recorded low BMs at the time of symptoms

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15
Q

Gradual withdrawal of steroids if:

A

received more than 40mg prednisolone daily for more than one week
received more than 3 weeks of treatment
recently received repeated courses

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16
Q

Cx of fluid resuscitation in DKA

A

cerebral oedema:

headache, irritability, visual disturbance, focal neurology etc.

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17
Q

Non-functioning pituitary adenomas

A

hypopituitarism and mass effect symptoms, (postural headache and visual loss)

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18
Q

serum osmolality

A

2Na + urea + glucose

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19
Q

phaeo Ix

A

urinary metanephrines

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20
Q

Thyroid nodules Ix

A

Ultrasonography

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21
Q

tender goitre

A

De Quervain’s thyroiditis

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22
Q

Sx specific to Graves

A

Eye signs (exophthalmos, ophthalmoplegia)
pre-tibial myxoedema
thyroid acropachy

23
Q

Drugs causing galactorrhea

A

metoclopramide, domperidone
phenothiazines
haloperidol
very rare: SSRIs, opioids

24
Q

De Quervains thyroiditis Tx

A

NSAIDs- self-limiting

25
Q

causes of raised Prolactin

A

pregnancy
prolactinoma
physiological
polycystic ovarian syndrome
primary hypothyroidism
phenothiazines, metoclopramide, domperidone

26
Q

Patients with type I diabetes and a BMI > 25

A

Metformin in addition to insulin

27
Q

first line insulin regimen in children with T1DM

A

multiple daily injection basal-bolus insulin regimen

28
Q

Gastroparesis Tx

A

metoclopramide

presents as upper gastrointestinal symptoms and erratic glucose control due to gastric emptying dysfunction

29
Q

Most important blood test to measure response to levothyroxine

A

TSH

30
Q

MODY Tx

A

sulphonylureas - gliclazide

31
Q

hypercalcaemia secondary to malignancy

A

PTH is low, although PTHrP may be raised

32
Q

high dose dexamethasone test: adrenal adenoma

A

cortisol not suppressed
ACTH suppressed

33
Q

secondary hypothyroidism Ix

A

MRI pituitary

34
Q

Acromegaly Ix

A

First line= IGF-1
gold standard= OGTT

35
Q

HHS risk

A

central pontine myelinolysis

36
Q

subclinical hypothyroidism in elderly

A

watch and wait if age>80
if <65–> trial of levothyroxine, and recheck TFT in 6 months

37
Q

drug induced gynaecomastia

A

spironolactone (most common drug cause)
cimetidine
digoxin
cannabis
finasteride
GnRH agonists e.g. goserelin, buserelin
oestrogens, anabolic steroids

38
Q

In type 1 diabetics, blood glucose targets:

A

5-7 mmol/l on waking and
4-7 mmol/l before meals at other times of the day

39
Q

high dose dexamethasone test adrenal adenoma

A

cortisol not suppressed
ACTH suppressed

tumour produces excess cortisol

40
Q

kallmann vs klinefelters

A

kallman= hypogonadotrophic hypogonadism
klinefelters= hypergonadotrophic hypogonadism

41
Q

Sick euthyroid syndrome =

A

low T3/T4 and normal TSH with acute illness

42
Q

hyperthyroidism in pregnancy

A

in the first trimester –> propylthiouracil

43
Q

C-peptide levels in T1 vs T2 DM

A

low in T1
high in T2

44
Q

MALT lymphoma associations

A

hashimotos
H.pylori

45
Q

gliclazide drug class

A

sulphonylurea

46
Q

subclinical hypothyroidism Investigation

A

Check thyroid peroxidase antibodies
–> can indicate patients who are more likely to progress to overt hypothyroidism

47
Q

pre-diabetes and BMI>35

A

liraglutide

48
Q

Cushing’s syndrome ABG

A

hypokalaemic metabolic alkalosis

49
Q

Erratic blood glucose control, bloating and vomiting

A

gastroparesis

50
Q

klienfelters

A

47XXY
high LH FSH low testosterone
gynaecomastia
tall
small firm testes
infertile

51
Q

-gliptins mechanism of action

A

DPP-4 inhibitors
reduce peripheral breakdown of incretins such as GLP-1

52
Q

metformin contraindicated if

A

eGFR of less than 30 ml/min.

53
Q

Thyrotoxic storm is treated with

A

beta blockers, propylthiouracil and hydrocortisone

54
Q

diabetes medication contraindicated in HF

A

pioglitazone

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