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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
does hypo or hypercalcaemia lead to spasms?
hypocalcaemia
26
what are the symptoms of hypercalcaemia?
moans (depression, asomnia, anxiety), bones (pain), groans (ado pain), stones (biliary or renal), thrones (polyuria), weakness
27
causes of hypocalcaemia
vitamin D deficiency (AEDs/ lack of sunlight) insufficient intake alkalosis
28
what is spasmodic
``` 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 ```
29
risk factors for type 2 diabetes?
``` SE Asia Male acromegaly CF SSRIs pregnant ```
30
3 symptoms of T1DM, acute presentation
polydipsia (drinking) polyuria weight loss possibly DKA
31
what GU complication may result from type 1 diabetes?
genital thrush-candida
32
symptoms of T2DM
gradual onset polydipsia, polyuria, lethargy, recurrent or prolonged infection
33
what is the next drug used after metformin for T2DM patients?
sulfonyurea
34
complications of T2DM
``` HUNRIV Hyperosmolar hyperglycaemic state Ulcers, foot ulcers Nerves, diabetic neuropathy Retinopathy, diabetic Infection, recurrent, injection sites Vascular disease-MI, angina, Virchow's triad ```
35
features of hypoglycaemic shock
``` tachycardic irratable, confused loss of consciousness n&v blurred vision sweating palpitations shaking ```
36
what does ketoacidosis use?
free fatty acids, there is hyperglycaemia but cells can't use it
37
symptoms of DKA?
``` lethargy pear drop breath Kussmaul hyperventilation Abdominal pain confusion polyuria thirsty dehydration ```
38
what should your priority be in DKA?
dehydration, give fluids
39
features of Conn's syndrome
hypokalaemia | hypertension
40
symptoms of acromegaly
``` prominent prognathism, interdental separation macroglossia deep voice thick greasy skin tiredness weight gain sweating ```
41
symptoms of SIADH
``` anorexia malaise nausea then irritability, weakness and seizures NOT oedema ```
42
causes of diabetes insipidus
cranial: congenital, trauma, idiopathic nephrogenic: Li, metabolic, CKD
43
what will prolactinoma cause?
amenorrhoea | lactation
44
prolactinoma treatment
dopamine agonists
45
sodium levels in diabetes insipidus?
hypernatraemia
46
SIADH treatment
loop diuretic
47
diabetes insipidus treatment
central-desmopressin | nephrogenic-thiazide
48
what might polydipsia and polyuria indicate
hypercalcaemia | diabetes
49
tetany constipation muscle weakness decreased tone and reflexes
hypokalaemia
50
long QT
hypokalaemia | hypocalcaemia
51
ECG changes with hyperkalaemia
tall tented T waves LONG QRS VF small p waves
52
how do you protect the heart in hyperkalaemia?
iv calcium gluconate (and insulin)
53
how do you prevent potassium absorption?
polystyrene sulfonate resins
54
where do carcinoid tumours metastasise from?
GI tract and liver
55
symptoms of carcinoid crisis
life threatening hypotension, tachycardia and bronchoconstriction
56
what will happen to sodium, potassium and calcium in Addison's disease
low sodium and high potassium because no aldosterone and raised calcium eosinophilia
57
first line treatment for hyperthyroidism
propranolol
58
what state is type 1 diabetes similar to?
the fasting state, it is catabolic
59
features of type 1 diabetes
continued lipolysis, gluconeogenesis, glycogenolysis, skeletal muscle breakdown and decreased uptake
60
symptoms of hypoglycaemic shock
``` tremor anxiety sweating hunger palpitations dizziness ```
61
DKA symptoms
``` lethargy confusion abdominal pain Kussmaul's hyperventilation anorexia and vomiting ```
62
DKA complications
falling blood volume>circulatory collapse cerebral oedema hypokalaemia
63
DKA management
ABCDE-saline insulin K+
64
how should hyper plastic hyperaldosteronism be treated?
spironolactone
65
what decreases levels of calcium?
calcetonin
66
what are the facial changes associated with acromegaly
frontal bossing prominent prognathism interdental separation
67
what test can be used to diganose acromegaly
glucose tolerance test, there will be no decrease in growth hormone in response to glucose
68
give an example of a dopamine agonist
cabergoline
69
what can dopamine agonists be used for?
acromegaly (not very effective) | prolactinoma
70
what are more effective than dopamine agonists for acromegaly
somatostatin analogues and surgery is first line
71
what is used for hyperthyroidism and what for prolactinoma
hyperthyroidism-CARBIMAZOLE | prolactinoma-CABERGOLINE (because milk is mainly fat, not CARBS)
72
what stimulates the release of FH and LSH
gonadotrophin releasing hormone
73
what stimulates the release of adenocorticotrophic releasing hormone?
corticotropin releasing hormone
74
causes of hypopituitism?
Sheehan's (apoplexy) | tumour
75
symptoms of hypopituitism?
growth hormone>stunted growth, tiredness ADH>lots of dilute urine cortisol>tiredness, weakness
76
what is bradycardic?
``` hypothryoidism bradycardia reflexes relax slowly ataxia dry, thin hair yawning-tired cold hands ascites round puffy face defeated demeanour immobile congestive cardiac failure ```
77
in which endocrine disease might you get dermatitis and impetigo herpetiformis?
spasmodic-hypocalcaemia
78
what are absent in spontaneous bacterial peritonitis?
pain and pyrexia
79
what electrolyte imbalances will CKD lead to?
hyponatraemia-high fluid hypocalcaemia hyperkalaemia acidosis
80
what leads to cardiac excitability and how?
hyperkalaemia inactivates sodium channels
81
ECG findings in hyperkalaemia
small p waves wide QRS complex tall tented t waves ventricular fibrillation
82
what endocrine diseases lead to hypokalemia
anything that leads to sodium retention: Conn's and Cushing's from mineralocorticoids, diuretics lead to it because it isn't reabsorbed
83
loop diuretic
furosomide-inhibits Na/K/2Cl=4, 4 syllables
84
thiazide diuretic
bendroflumethiazide-Na/Cl-flumeee so distal convoluted tubule
85
what are potassium sparing diuretics?
aldosterone antagonists so collecting duct
86
where does aldosterone work?
collecting duct
87
carcinoid tumour symptoms
frequent bowel movements facial flushing abdominal pain
88
better than ultrasound for carcinoid tumours?
endoscopic ultrasound
89
somatostatin anologues are used for carcinoid tumours and acromegaly-give some examples?
ocretide | lanreotide
90
after which cancers is insulin resistance likely
ALL | brain tumours
91
what is impetigo
thin walled vesicles on face with rupture easily giving regions of yellow crusted exudate
92
how is rosacea treated
topical metronidazole

Pathology (21 decks)

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