Endocrinology Flashcards
Secondary Adrenal Insufficiency.
Sheehan Syndrome.
-Will not cause Hyperkalemia.
-Aldosterone production is intact.
Propylthiouracil
In Early pregnancy.
Chances of Maternal Hepatotoxicity more in later stages hence switched to Carbimazole.
Carbimazole
Third Trimester.
Minimum dose is used.
Block-replace regimen during Pregnancy
Block-replace regimen for Graves’ is contraindicated in pregnancy. This is because anti-thyroid drugs cross the placenta, but thyroxine does not.
This means that a high-dose block-replace regimen is likely to drive significant fetal hypothyroidism.
Anti-thyroid drugs in monotherapy, used at the minimum dose to control thyrotoxicosis, are the recommended option.
Underlying cause of Thyroid Eye Disease?
Glycosaminoglycan (GAG) deposition due to hyperstimulation of Fibroblasts.
GAG is hydrophilic, draws water, oedema causes pressure on Optic nerve leading to visual changes, affects colour visions.
Corticosteroids Initially given. MMF is also effective.
Thyroid Lymphoma
-Not treated by surgical excision.
-R-CHOP (rituximab plus standard chemotherapeutic agents), and
External beam radiotherapy.
Presence of Maternal Thyroid Autoantibody
Higher risk of Spontaneous Abortions.
MODY -2
Mutation in Glucokinase.
The mutations
in glucokinase essentially increase the body’s ‘normal’ baseline for blood glucose, meaning that fasting blood
glucose is higher than normal, but the rise in blood glucose seen in the oral glucose tolerance test is much less
than patients with conventional diabetes.
MODY -5
Defects in Hepatocyte nuclear factor-1-beta.
Associated with development of Renal cysts and diabetes.
Homocystinuria (Type -1)
Defect in Cystathionine synthase.
-Mild-to-moderate learning disability
-Marfan-like syndrome
-Thrombotic episodes.
Homocystinuria (Type -2)
Defect in Methylenetetrahydrofolate reductase.
Alkaptonuria.
-Homogentisic acid oxidase
-Black urine,
Discolored sclera and cartilage
Maple syrup urine
disease
Branched-chain ketoacid dehydrogenase
First sign of Puberty in Girls
Breast bud development.
Craniopharyngioma
Inferior Quadrantanopia
Hypokalaemic Periodic Paralysis
Muscle calcium-channel mutation
(CACLN1A3)
There are two types based on the causative gene, CACNA1 (calcium channel) and SCN4A (αsubunit of the sodium channel).
Glucagonoma
Necrolytic Migratory Erythema
Tamoxifen
Mixed Estrogen receptor Antagonist and Partial Agonist.
Direct precursor of Estradiol.
Testosterone.
Testosterone is derived from cholesterol and is converted to oestradiol by aromatase. Alcohol excess and obesity are known to increase aromatase activity, and may therefore account for feminisation in obese patients or those with alcoholism.
High TSH, T3,T4
Pituitary Tumor
Diabetic Ketoacidosis
Precipitating factors:
Infection (30–40%)
Non-compliance with treatment (25%)
Alterations to insulin dose (13%)
Newly diagnosed diabetes (10–20%)
Myocardial infarction (< 1%)
Stages of severity:
Mild: blood pH mildly reduced to between 7.25 and 7.30 (NR 7.35–7.45); serum bicarbonate reduced to
15–18 mmol/l (NR > 20); the person is alert
Moderate: pH 7.00–7.25; bicarbonate 10–15; mild drowsiness may be present
Severe: pH below 7.00; bicarbonate below 10; stupor or coma may occur.
Porphyria Cutanea Tarda
Antinuclear antibodies positive.
Estrogens can precipitate development of the condition.
Urinary porphyrins raised
Metoclopramide
Binds to D2-receptors on pituitary lactotropes.
Stimulates the release of prolactin by the anterior pituitary, resulting in galactorrhoea.
Progesterone
Shedding of Endometrium during menstruation.
