Endocrinology Flashcards

1
Q

PTH level in primary hyperparathyroid?

what is calcium and phosphate?

A

PTH can be normal / high

calcium is high
phosphate is low

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2
Q

causes of primary Hyperparathryoidism?

A

pituitary adenoma

bilateral hyperplasia
multiple adenoma

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3
Q

management of acute DKA?

what should insulin be?

A

fixed rate insulin

continue long acting
hold short acting

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4
Q

intravenous infusion rate of insulin for DKA includes?

A

0.1 unit/kg/hour of insulin
aim is to reduce ketones

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5
Q

when should you add dextrose infusion

A

once glucose <14mmol

start 10% dextrose infusion rate of 125ml / hour

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6
Q

primary hyperaldosteronism

how to differentiate between bilateral hyperplasia and conns?

A

Adrenal venous sampling

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7
Q

T2DM
mx

if triple therapy fails?

A

switch a drug to either
GLP-1 mimetic

insulin

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8
Q

2nd line T2DM

A

if not able to get under 58 mmol
7.5%

dual therapy

metformin

metformin + DPP-4 inhibitor
metformin + pioglitazone
metformin + sulfonylurea
metformin + SGLT-2 inhibitor

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9
Q

example of a Dpp-4 inhibitor?

A

act on incretin system
DPP-4 usually breaks down GLP-1

Sitagliptin is an example

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10
Q

pioglitazone MOA and example
negative s/e

A

thiazolidinedione

improves insulin sensitivity

weight gain
worsen HF

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11
Q

Sulfonyureas

A

cause release of insulin from beta pancreatic cells

Glipizide

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12
Q

SGLT2 inhibitors?

A

dapagliflozin

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13
Q

most common cause of malignancy thyroid?

A

papillary carcinoma

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14
Q

First line in thryoid nodules?

A

ultrasonograohy

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15
Q

High-dose dexamethasone suppression test with a pituitary adenoma
affects on cortisol?
on acth?

A

cortisol not suppressed
ACTH suppressed

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16
Q

an HBA1c of what is considered diagnostic if patient also has symptoms?

A

HBa1c of 48mmol >

6.5%

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17
Q

Random glucose test diagnostic of T2DM?

A

11.1

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18
Q

fasting glucose?

A

7.0 mmol/l

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19
Q

what is pre diabetes?

A

42-47
6.0-6.4%

20
Q

OGTT impaired fasting glucose?

A

OGTT 2-hour value greater than or equal to 7.8 mmol/l but less than 11.1 mmol/l

21
Q

Diffusely reduced uptake of radioactive iodine-131

is shown in what?

A

subacute de quervein thyroiditis

22
Q

High-dose dexamethasone suppression test with an ectopic source of ACTH

A

not suppressed
not suppressed

23
Q

tender goitre and hyperthyroid signs

A

subacute (De Quervain’s) thyroiditis

Graves is not tendeer

24
Q

is the single most important blood test to assess a patient’s response to treatment with levothyroxine for Hashimoto’s thyroiditis.

25
what is klinefelters?
47 XXY primary hypogonadism testicular failure
26
neoplastic lesions in the pituitary gland parathyroid gland pancreas
multiple endocrine neoplasia type 1 all p's
27
multiple endocrine neoplasia 2? 2a
2p's parathyroid phaeochromocytoma
28
men type 2b?
medullary thyroid cancer 1P phaechromocytome marfanoid
29
prednisolone / glucocorticoids can cause?
neutrophilia
30
what is the difference between impaired fasting glucose impaired glucose tolerance
impaired fasting is on a fasting plasma 6.1- 6.9 Impaired glucose tolerance is on an OGTT 7.8-11
31
congenital androgen insensitivity syndrome
phenotype is female - female genitalia genotype is male
32
diabetic neuropathy GI
Gastroparesis GORD chronic diarrhoea
33
what is the pathophysiology of gastroparesis?
sensory loss from diabetes autonomic neuropathy
34
what is the trademarks of gastroparesis?
delayed gastric emptying (due to autonomic dysfunction = erratic BM) bloating nausea early satiety vomiting
35
why does cushing cause hypokalaemia metabolic alkalosis?
excess of cortisol production = sodium and water retention =htn and hypokalaemia
36
hypoglycaemia mx?
oral glucose 10-20 quick-acting carbohydrate intravenous 20% glucose solution
37
modifiable risk factor for development of thyroid eye disease?
smoking
38
thyroid eye disease presenting with change
Any change in vision with thyroid eye disease requires urgent review by a specialist
39
Mx DKA
1st line isotonic saline - fluid !!! fixed rate insulin when glucose <14 add 10% dextrose check and manage potassium 1u/kg/day
40
which class of antidiabetics are good for weight loss>?
Dpp-4 inhibitors GLP1 mimetics (obvi)
41
Primary hyperaldosteronism management?
spironolactone
42
thiazides cause which electrolyte abnormality?
hypercalcaemia
43
T1DM how often should you monitor as a minimum?
4 times before bed and every meal
44
Blood glucose targets T1DM on waking
5-7 mmol
45
Blood glucose targets T1DM after meals?
4-7 mmol/l
46
regime of choice for t1dm?
twice-daily insulin detemir Once-daily insulin glargine or insulin detemir
47