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Pathology > endocrinology > Flashcards

endocrinology Flashcards

1
Q

which layer of the adrenal cortex produces androgens?

A

zona reticularis

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2
Q

what are the symptoms of Conn’s syndrome?

A

hypertension>poor vision, headaches
hypokalaemia>muscle spasms, weakness
polyuria, nocturia
asymptomatic

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3
Q

what are the functions of cortisol?

A 
decrease muscle mass
down regulates B cell immune response
decreases bone deposition
lengthens wound healing time
increases GFR
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4
Q

if a patient has Cushing’s syndrome, what is the lesion likely to be if ACTH is undetectable

A

ACTH independent so probably pituitary

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5
Q

what is Addison’s disease?

A

Adrenal insufficiency

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6
Q

in what disease will you find hyperkalaemia, hypercalcaemia, hyperuraemia and hyponatraemia

A

Addison’s because can’t retain sodium and can’t excrete potassium

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7
Q

what do you use to test for Cushing’s disease and what do you use for Addison’s?

A

Cushings>dexamethasone, see if ACTH is suppressed

Addison’s>ACTH, see if cortisol responds

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8
Q

Addison’s treatment

A

hydrocortisone

fludrocortisone

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9
Q

outline the hypothalamic, pituitary, thyroid axis

A

hypothalamus>thyrotropin releasing hormone
anterior pituitary>thyroid stimulating hormone
thyroid>thyroxine, triiodothyronine

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10
Q

what does the thyroid hormone produce?

A

thyroxine and triiodothyronine

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11
Q

hypothyroidism signs

A 
BRADYCARDIC reflexes relax slowly
Ataxia
Dry thin skin
Yawning-tired
Cold hands
Ascites
Round puffy face
Defeated
Immobile
Congestive cardiac failure
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12
Q

hypothyroidism symptoms

A 
depression
menorrhagia
hoarse voice
brittle nails
cold intolerance
coarse hair
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13
Q

what is goitre

A

inflammation of the thyroid gland due to Hashimoto’s (hypo) or Grave’s (hyper)

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14
Q

in what kind of thyroid disease do you get oligomenorrhoea?

A

hyperthyroidism, as if can’t stop to have a period, in hypo there is lots of bleeding

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15
Q

in what kind of thyroid disease do you get constipation

A

hypothyroidism cOnstipatiOn

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16
Q

causes of hyperthyroidism

A

Grave’s
toxic adenoma
ectopic production
toxic multinodular goitre

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17
Q

what will be elevated in Grave’s

A

T3 and T4

thyroid stimulating immunoglobulin

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18
Q

hyperthyroidism treatment

A

beta blocker-propanolol
carbimazole (and thyroxine)
radioiodine or thyroidectomy

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19
Q

what is a complication of carbimazole?

A

agranulocytosis, used to treat hyperthyroidism

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20
Q

what will the levels of PTH, ca and ph be in primary hyperparathyroidism?

A

high PTH which causes high Ca and low phosphate

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21
Q

what will the levels of PTH, ca and ph be in secondary hyperparathyroidism?

A

low Ca causing high PTH

Ph will be low

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22
Q

causes of secondary hyperparathyroidism

A

renal failure

vitamin D deficiency

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23
Q

how is hypoparathyroidism treated

A

calcium carbonate

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24
Q

hypoparathyroidism/hypocalcaemia symptoms

A 
Spasms
Parasthesia around mouth and lips
Anxious
Seizures
Muscle tone increased
Orientation impaired
Dermatitis
Impetgio herpeteformis
Cardiomyopathy-long QT
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25
Q

does hypo or hypercalcaemia lead to spasms?

A

hypocalcaemia

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26
Q

what are the symptoms of hypercalcaemia?

A

moans (depression, asomnia, anxiety), bones (pain), groans (ado pain), stones (biliary or renal), thrones (polyuria), weakness

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27
Q

causes of hypocalcaemia

A

vitamin D deficiency (AEDs/ lack of sunlight)
insufficient intake
alkalosis

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28
Q

what is spasmodic

A 
hypoparathyroidism and hypocalcaemia symptoms and signs
Spasms
Parasthesia around mouth and lips
Anxious
Seizures
Muscle tone increased
Orientation impaired
Dermatitis
Impetigo herpeteformis
Cardiomyopathy-long QT
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29
Q

risk factors for type 2 diabetes?

A 
SE Asia
Male
acromegaly
CF
SSRIs
pregnant
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30
Q

3 symptoms of T1DM, acute presentation

A

polydipsia (drinking)
polyuria
weight loss
possibly DKA

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31
Q

what GU complication may result from type 1 diabetes?

A

genital thrush-candida

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32
Q

symptoms of T2DM

A

gradual onset polydipsia, polyuria, lethargy, recurrent or prolonged infection

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33
Q

what is the next drug used after metformin for T2DM patients?

A

sulfonyurea

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34
Q

complications of T2DM

A 
HUNRIV
Hyperosmolar hyperglycaemic state
Ulcers, foot ulcers
Nerves, diabetic neuropathy
Retinopathy, diabetic
Infection, recurrent, injection sites
Vascular disease-MI, angina, Virchow's triad
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35
Q

features of hypoglycaemic shock

A 
tachycardic
irratable, confused
loss of consciousness
n&v
blurred vision
sweating
palpitations
shaking
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36
Q

what does ketoacidosis use?

A

free fatty acids, there is hyperglycaemia but cells can’t use it

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37
Q

symptoms of DKA?

A 
lethargy
pear drop breath
Kussmaul hyperventilation
Abdominal pain
confusion
polyuria
thirsty
dehydration
38
Q

what should your priority be in DKA?

A

dehydration, give fluids

39
Q

features of Conn’s syndrome

A

hypokalaemia

hypertension

40
Q

symptoms of acromegaly

A 
prominent prognathism, interdental separation
macroglossia
deep voice
thick greasy skin
tiredness
weight gain
sweating
41
Q

symptoms of SIADH

A 
anorexia
malaise
nausea
then irritability, weakness and seizures
NOT oedema
42
Q

causes of diabetes insipidus

A

cranial: congenital, trauma, idiopathic
nephrogenic: Li, metabolic, CKD

43
Q

what will prolactinoma cause?

A

amenorrhoea

lactation

44
Q

prolactinoma treatment

A

dopamine agonists

45
Q

sodium levels in diabetes insipidus?

A

hypernatraemia

46
Q

SIADH treatment

A

loop diuretic

47
Q

diabetes insipidus treatment

A

central-desmopressin

nephrogenic-thiazide

48
Q

what might polydipsia and polyuria indicate

A

hypercalcaemia

diabetes

49
Q

tetany
constipation
muscle weakness
decreased tone and reflexes

A

hypokalaemia

50
Q

long QT

A

hypokalaemia

hypocalcaemia

51
Q

ECG changes with hyperkalaemia

A

tall tented T waves
LONG QRS
VF
small p waves

52
Q

how do you protect the heart in hyperkalaemia?

A

iv calcium gluconate (and insulin)

53
Q

how do you prevent potassium absorption?

A

polystyrene sulfonate resins

54
Q

where do carcinoid tumours metastasise from?

A

GI tract and liver

55
Q

symptoms of carcinoid crisis

A

life threatening hypotension, tachycardia and bronchoconstriction

56
Q

what will happen to sodium, potassium and calcium in Addison’s disease

A

low sodium and high potassium because no aldosterone and raised calcium
eosinophilia

57
Q

first line treatment for hyperthyroidism

A

propranolol

58
Q

what state is type 1 diabetes similar to?

A

the fasting state, it is catabolic

59
Q

features of type 1 diabetes

A

continued lipolysis, gluconeogenesis, glycogenolysis, skeletal muscle breakdown and decreased uptake

60
Q

symptoms of hypoglycaemic shock

A 
tremor
anxiety
sweating
hunger
palpitations
dizziness
61
Q

DKA symptoms

A 
lethargy
confusion
abdominal pain
Kussmaul's hyperventilation
anorexia and vomiting
62
Q

DKA complications

A

falling blood volume>circulatory collapse
cerebral oedema
hypokalaemia

63
Q

DKA management

A

ABCDE-saline
insulin
K+

64
Q

how should hyper plastic hyperaldosteronism be treated?

A

spironolactone

65
Q

what decreases levels of calcium?

A

calcetonin

66
Q

what are the facial changes associated with acromegaly

A

frontal bossing
prominent prognathism
interdental separation

67
Q

what test can be used to diganose acromegaly

A

glucose tolerance test, there will be no decrease in growth hormone in response to glucose

68
Q

give an example of a dopamine agonist

A

cabergoline

69
Q

what can dopamine agonists be used for?

A

acromegaly (not very effective)

prolactinoma

70
Q

what are more effective than dopamine agonists for acromegaly

A

somatostatin analogues and surgery is first line

71
Q

what is used for hyperthyroidism and what for prolactinoma

A

hyperthyroidism-CARBIMAZOLE

prolactinoma-CABERGOLINE (because milk is mainly fat, not CARBS)

72
Q

what stimulates the release of FH and LSH

A

gonadotrophin releasing hormone

73
Q

what stimulates the release of adenocorticotrophic releasing hormone?

A

corticotropin releasing hormone

74
Q

causes of hypopituitism?

A

Sheehan’s (apoplexy)

tumour

75
Q

symptoms of hypopituitism?

A

growth hormone>stunted growth, tiredness
ADH>lots of dilute urine
cortisol>tiredness, weakness

76
Q

what is bradycardic?

A 
hypothryoidism
bradycardia
reflexes relax slowly
ataxia
dry, thin hair
yawning-tired
cold hands
ascites
round puffy face
defeated demeanour
immobile
congestive cardiac failure
77
Q

in which endocrine disease might you get dermatitis and impetigo herpetiformis?

A

spasmodic-hypocalcaemia

78
Q

what are absent in spontaneous bacterial peritonitis?

A

pain and pyrexia

79
Q

what electrolyte imbalances will CKD lead to?

A

hyponatraemia-high fluid
hypocalcaemia
hyperkalaemia
acidosis

80
Q

what leads to cardiac excitability and how?

A

hyperkalaemia inactivates sodium channels

81
Q

ECG findings in hyperkalaemia

A

small p waves
wide QRS complex
tall tented t waves
ventricular fibrillation

82
Q

what endocrine diseases lead to hypokalemia

A

anything that leads to sodium retention: Conn’s and Cushing’s from mineralocorticoids, diuretics lead to it because it isn’t reabsorbed

83
Q

loop diuretic

A

furosomide-inhibits Na/K/2Cl=4, 4 syllables

84
Q

thiazide diuretic

A

bendroflumethiazide-Na/Cl-flumeee so distal convoluted tubule

85
Q

what are potassium sparing diuretics?

A

aldosterone antagonists so collecting duct

86
Q

where does aldosterone work?

A

collecting duct

87
Q

carcinoid tumour symptoms

A

frequent bowel movements
facial flushing
abdominal pain

88
Q

better than ultrasound for carcinoid tumours?

A

endoscopic ultrasound

89
Q

somatostatin anologues are used for carcinoid tumours and acromegaly-give some examples?

A

ocretide

lanreotide

90
Q

after which cancers is insulin resistance likely

A

ALL

brain tumours

91
Q

what is impetigo

A

thin walled vesicles on face with rupture easily giving regions of yellow crusted exudate

92
Q

how is rosacea treated

A

topical metronidazole

Pathology (21 decks)

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