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MHU > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

What is the most common cause of mortality in diabetic patients?

A

Cardiovascular disease (macrovascular complications)

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2
Q

What is the difference between Cushing’s Syndrome and Cushing’s Disease?

A

Cushing’s Syndrome = hypercortisolism due to any cause

Cushing’s Disease = hypercortisolism due to ACTH-secreting pituitary adenoma

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3
Q

Which hormones are secreted by the anterior pituitary?

A

ACTH, Prolactin, GH, FSH, LH, TSH

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4
Q

Which hormones are secreted by the posterior pituitary?

A

Oxytocin, ADH (vasopressin)

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5
Q

What are the complications of Cushing’s Syndrome?

A

Osteoporosis
Diabetes
Hypertension

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6
Q

How is hypercortisolism investigated?

A 
1. Serum cortisol
(+/- midnight plasma + salivary cortisol)
2. 24 hour free urinary cortisol
3. 1mg Dexamethasone suppression test
4. 8mg Dexamethasone suppression test
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7
Q

What conditions comprise MEN I syndrome?

A

Pituitary Tumours
Primary Hyperparathyroidism
Enteropancreatic Tumours

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8
Q

What conditions comprise MEN II syndrome?

A

Medullary Thyroid Cancer
Phaeochromocytoma
Parathyroid Hyperplasia

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9
Q

What is Zollinger-Ellison Syndrome?

A

Gastrin-secreting tumour (gastrinoma) formation in pancreas and/or duodenum that causes increased HCl secretion and PUD.

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10
Q

What is Conn’s syndrome?

A

Aldosterone-secreting adrenal cortex tumour

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11
Q

What are the clinical features of hyperaldosteronism?

A

Hypertension
Hypokalaemia
Fatigue, weakness, headache, paraesthesia, intermittent paralysis

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12
Q

What is an Addisonian crisis?

A

Acute adrenal insufficiency (unable to make enough cortisol)

Usually due to abrupt cessation of exogenous steroids

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13
Q

What are the causes of adrenal insufficiency?

A

Primary: autoimmune destruction of cortex (Addison’s disease)
Secondary: decreased ACTH production or lack of CRH

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14
Q

Which thyroid autoantibodies are associated with Hashimoto’s Thyroiditis and Graves’ Disease?

A

Hashimoto’s: anti-TPO

Graves’: thyroid stimulating Ig (TSI)

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15
Q

What medical emergencies may develop in thyroid disease?

A 
Thyrotoxic Crisis (hyperthyroidism)
Myxoedema Coma (hypothyroidism)
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16
Q

Give 3 differentials for a midline neck lump and how they can be distinguished on physical examination.

A 
Thyroid goitre (moves up on swallowing)
Thyroglossal cyst (moves up on poking tongue out)
Dermoid cyst (in SC layer, can move skin over the top of it)
17
Q

Why is it necessary to correct for serum calcium levels?

A

40% calcium bound to albumin

therefore albumin levels may affect serum total calcium

18
Q

What clinical signs are used to detect hypocalcaemia?

A

Trosseau’s sign: carpal spasm

Chovstek’s sign: CN VII

19
Q

What is the most common cause of secondary hyperparathyroidism?

A

Renal Failure

decreased excretion of phosphate > suppress serum calcium

20
Q

What are the features of polycystic ovarian syndrome?

A

Menstrual dysfunction + infertility
Hyperandrogenism (acne, hirsutism)
Metabolic syndrome
Polycystic ovaries

21
Q

What is the function of aldosterone?

A

e.g. Angiotensin II > Aldosterone release > principal cells of DCT > increased activity of Na+/K+ ATPase > increased sodium resorption and potassium excretion

22
Q

After serum calcium and PTH levels, what is the most useful investigation for hyperparathyroidism?

A

Sestamibi scan

23
Q

What is the equivalent average BGL for a patient with a HbA1c of:

(a) 6% (42mmol/L)
(b) 7% (53mmol/L)

A

(a) 7.0mmol/L

(b) 8.5mmol/L

24
Q

How is Diabetes diagnosed?

A

OGTT >11.1mmol/L OR
Random BGL >11.1mmol/L OR
Fasting BGL >7.0mmol/L
Patient must have 2 positive laboratory tests if they are asymptomatic

25
Q

What are the components of metabolic syndrome?

A

Dyslipidaemia (elevated triglycerides and reduced HDL)
Hypertension
Elevated Fasting Plasma Glucose

26
Q

How does insulin cause hypercholestrolinaemia?

A

Induces HGM-CoA Reductase to increase cholesterol synthesis

27
Q

In which type of diabetes is acanthosis nigricans seen?

A

Type 2 Diabetes (insulin resistance)

28
Q

Which two laboratory tests are used to diagnose acromegaly?

A

OGTT (high BGL should suppress GH release)

IGF-1 (GH stimulates production of IGF-1)

29
Q

Why is serum GH not used to diagnose acromegaly?

A

It varies too much during the day

30
Q

What stimulates the production of IGF-1?

A

GH

31
Q

Give 4 endocrine disorders causing obesity.

A

Hypothyroidism
Cushing’s Syndrome
PCOS
Hyperprolactinaemia

MHU (14 decks)

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