Endocrinology Flashcards

1
Q

Graves specifc features

A

Unique to Graves -
1)Ex“opathalmo”s+“ Opthalmo”plegia [ NOT lid lag]
2) Pretibial myxedema
3) Thyroid acropachy (clubbing)

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2
Q

Liddle’s syndrome

A

hypokalaemia + hypertension

Liddle’s syndrome is an autosomal dominant disorder that mimics hyperaldosteronism, resulting in hypokalaemia associated with hypertension.

Liddle Cushing Conn’d 11 people with a hyperlink (Hypertension)

Shopping at Lidl is stressful but bartering with a gentleman is not
(Liddles= HTN, Bartters and Gitelmans = no HTN)

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3
Q

Metoclopramid causes what SE related to breast tissue

A

GALATORREHEA (not gynaaecomastia) due to dopaamine aanatagonism.
It is known to cause galactorrhoea - secretion of milk from the nipples - but not gynaecomastia. Dopamine normally inhibits prolactin, which is responsible for milk secretion, and so antagonising dopamine results in increased prolactin levels.

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4
Q

first-line pharmacological treatment in patients with MODY type 1

A

the underlying genetic defect results in reduced endogenous insulin secretion

Sulpholyureas

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5
Q

Causes of pseudohyponatraemia

A

hyperlipidaemia (increase in serum volume) or a taking blood from a drip arm

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6
Q

RET oncogene throid CA

A

Medullary

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7
Q

Tender goitre =

A

Subacute dequervians thyroiditis

There is an initial period of hyperthyroid, due to the release of thyroid hormone from damaged cells. Following the hyperthyroid state, a period of hypothyroid then ensues, eventually resolving back to a euthyroid state.

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8
Q

Systemic glucocorticoids can cause drug-induced acne

A

This is characterised as monomorphic papular rash without comedones or cysts. This does not respond to acne treatment but improves on drug discontinuation

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9
Q

Osteoporosis Normal Normal Normal
Pagets Normal Normal High
Myeloma High Nor/ High Normal
Bone Mets High Nor/ High High
Osteomalacia Low Low High
Hypoparathyroid Low High Normal
Renal Failure Low High Normal

A
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10
Q

pioglitazone SE

A

Pioglitazone may cause fluid retention

weight gain
liver impairment: monitor LFTs
fluid retention - therefore contraindicated in heart failure. The risk of fluid retention is increased if the patient also takes insulin
recent studies have indicated an increased risk of fractures
bladder cancer: recent studies have shown an increased risk of bladder cancer in patients taking pioglitazone (hazard ratio 2.64)

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11
Q

most aggressive thyroiid ca

A

anaplastic

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12
Q

most common thyroid ca

A

Papillary 70% Often young females - excellent prognosis

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13
Q

MODY inheritance pattern

A

autosomal dominantt

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14
Q

thyroid lymphoma associated with

A

Lymphoma Rare Associated with Hashimoto’s thyroiditis

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15
Q

insulin stress test (IST) is primarily used to assess

A

hypopituitaryism

insulin stress test (IST) is primarily used to assess the integrity of the hypothalamic-pituitary-adrenal axis, and it is considered the gold standard for diagnosing hypopituitarism. In this test, insulin-induced hypoglycaemia should stimulate the pituitary gland to secrete adrenocorticotropic hormone (ACTH), which in turn stimulates the adrenal glands to produce cortisol. If there’s a deficiency in ACTH due to hypopituitarism, cortisol response will be inadequate.

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16
Q

Sulfonylureas have been associated with an increased risk of developing

A

heart failure

17
Q

pendred syndrome

A

Pendred is an autosomal recessive genetic disorder that is characterised by bilateral sensorineural deafness, with mild hypothyroidism and a goitre.

18
Q

Familial hypercholesterolaemia inheritance

A

autosoma dominant q

19
Q

impaired fasting glycaemia (IFG) is defined as

A

fasting plasma glucose level between 6.1 mmol/l and 6.9 mmol/l,

20
Q

normal fasting plasma glucose levels are typically between

A

3.9 and 6.0 mmol/l

21
Q

symptomatic hypokalaemia and maintains normotension, which are characteristic features

A

xBartter’s syndrome. This disorder stems from a dysfunction in the NKCC2 channel located in the ascending loop of Henle. Typically presenting during childhood, Bartter’s syndrome is defined by normal blood pressure levels, setting it apart from other conditions commonly associated with hypertension.

22
Q

Impaired glucose tolerance

A

Impaired glucose tolerance (IGT) is defined as fasting plasma glucose less than 7.0 mmol/l and OGTT 2-hour value greater than or equal to 7.8 mmol/l but less than 11.1 mmol/l

23
Q

Acromegaly: investigations

A

Serum IGF-1 levels have now overtaken the oral glucose tolerance test (OGTT) with serial GH measurements as the first-line test. The OGTT test is recommended to confirm the diagnosis if IGF-1 levels are raised.

24
Q

The first-line treatment in remnant hyperlipidaemia (dysbetalipoproteinaemia) is

25
MODY gene
HNF-1 alpha
26
oral steroid has the least amount of mineralocorticoid activity
dex MRCPI Jan/21 - Question about use of a steroid agent in heart failure patient - answer : dexamethasone
27
Gestational diabetes targets for Dx and Mx
Dx: (5,6,7,8) Fasting > 5.6 2-hour >7.8 Targets: Fasting - 5.3 1h - 7.8 2h - 6.4
28
Normal anion gap
4-12 mmol/L
29
Drugs causing Gynaecomastia
D- Digoxin I- Isoniazid S- Spironolactone C- Cimetidine O- Oestrogen
30
Hypokalaemia with Hypertension caauses
''Little Cushing Conned 11 Russian by High Tension'' Liddle's, Cushing's , Conn's , 11-beta Hydroxylase deficiency and RAS
31
Seious SEs of GLP1 mimetics
Severe pancreatitis & renal impairement
32
Serum osmo for HHS
>320 o precise diagnostic criteria but the following are typically seen hypovolaemia marked hyperglycaemia (>30 mmol/L) significantly raised serum osmolarity (> 320 mosmol/kg) can be calculated by: 2 * Na+ + glucose + urea no significant hyperketonaemia (<3 mmol/L) no significant acidosis (bicarbonate > 15 mmol/l or pH > 7.3 - acidosis can occur due to lactic acidosis or renal impairment)
33
Pheocystochroma associated with whaat syndomes?
Phaeochromocytoma is associated with 1,2,3 NF-1, MEN 2, VHL (chromosome 3)
34
Main androgen in females
Dehydroepiandrosterone is the most abundant circulating adrenal steroid. Adrenal glands are the main source of dehydroepiandrosterone in females - loss of functioning adrenal tissue as in Addison's disease may result in symptoms secondary to androgen deficiency, such as loss of libido. Research is ongoing as to whether routine replacement of DHEA is beneficial
35
Diabetes meliitus diagnosis
fasting > 7.0, random > 11.1 - if asymptomatic need two readings You can buy lots of unhealthy snacks at a 7/11, which might give you diabetes. 7 = cutoff for fasting flucose 11 = cutoff for random or after glucose load
36
Impaired glucose tolerance (IGT) is defined as
fasting plasma glucose less than 7.0 mmol/l and OGTT 2-hour value greater than or equal to 7.8 mmol/l but less than 11.1 mmol/l
37
impaired fasting glucose (IFG)
a fasting glucose greater than or equal to 6.1 but less than 7.0 mmol/l implies impaired fasting glucose (IFG)
38
Thyrotoxic storm is treated with
beta blockers, propylthiouracil and hydrocortisone
39