Endocrinology 4 Flashcards
Types of Ectopic hormone secretion
- SCLC of lung produces?
- Squamous lung produces?
- HCC produces?
- choriocarcinoma/hydatidform mole/testes
- Breast cancer
- SCLC of lung = SIADH ( low Na)
SCLC of lung = ACTH ( low K) - Squamous cancer of lung = PTH ( hypercalcemia)
- HCC = EPA ( Polycythemia)
HCC = Insulin growth factor ( low BGL) - Choriocarcinoma/hydatidform mole/testes = TSH
- Breast cancer = GNRH ( gynecomastia/galatorrhoea)
Schmidt syndrome - what is it?
T1DM a/w adrenal insufficiency/autoimmune Thyroid!
White adipocytes - what is it?
Brown adipocytes - what is it?
White =Normal adipose tissue
Brown Uncoupling protein (UCP1) + Iron mitochondria -convert fat into heat
-found in paravetebral/supraclavicular region
MEN4 - what gene mutation and features?
CDNK1B
-Anterior pituitary + Parathyroid tumours
Pagets’ mutation - SQSTM1 causes what?
Prevents p62 to bind to ubiquitin
SO RANKL have freedom! and activates osteoclast
Diabetic gastroparesis
- what causes autonomic neuropathy?
- what causes enteric neuropathy?
- what causes iatrogenic neuropathy?
Autonomic neuropathy - vagal nerve problem
Enteric neuropathy - Loss Interstitial cells of Cajal!= delay gastric emptying
iatrogenic neuropathy - GLP1-agonist drug = blocks vagal nerve
How does high glucose causes diabetic gastroparesis?
Pyloric muscle contractions but antral hypomotility due to acute hyperglycemic state
When do you start thiazides for Diabetes insipidus?
Once urine volume > 4L/day
Work up for Pheochromocytoma?
there are 4 lines of work-up
1st line = Plasma metanephrine
2nd line = 24 hours urine fractionated catecholamines/metanephrines
3rd line = MRI - hyperintense tumor
4th line = MIBG scan ( metadobenzylguanidine) - resembles norepinephrine taken up by pheochromocytoma
*Use 4th line esp. if CT/MRI can’t detect or multiple tumors
Highest specificity test for pheo?
Lowest accuracy test for pheo?
Urinary EPInephrine
Plasma catecholamines
what side effect strongly a/w Dapagliflozin?
UTI!!
Majority of thyroid carcinoma - driver mutation comes from what pathway?
MAPK pathway
Commonest - BRAF V600E mutations! RAS 2nd
Transgender people
aim hormone estradiol and testosterone at what level?
When is GnRH analogues used?
Estradiol - 300 - 600
Testosterone < 0.2
GnRH analogues only in adolescents as puberty blocker
Bariatric surgery
-What mineral deficiency likely with Roux-en-Y bypass and Biliopancreatic diversion?
RYGB and BPD = Zinc deficiency
Types of bariatric surgery
Restrictive?
Malabsorption?
Mixed
Restrictive = Gastric sleeve/banding
Malabsoprtion = BPD - biliopancreaticodiversion
Mixed - Roux-En-Y bypass