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RACP > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

What are the causes of a false positive ARR

A

Beta Blockers
NSAIDs
Alpha agonists (central) - clonidine

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2
Q

What are the causes of a false negative ARR

A

Spironolactone
ACE and ARBs
Other Diuretics
SSRI

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3
Q

Which form of insulin is bound to albumin?

A

Detemir

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4
Q

Which cells do bisphophonates act?

A

Osteoclasts

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5
Q

How does prednisone cause osteoporosis

A

Suppression of osteoblast proliferation.

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6
Q

What response would expect to see with Desmopressin after water deprivation in central DI?

A

Dramatic response to DDAVP With osmolality of >600

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7
Q

What response would expect to see with Desmopressin after water deprivation in nephrogenic DI

A

Poor response (<50% increase) in urine osmolality.

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8
Q

What response would expect to see with Desmopressin after water deprivation in psychogenic polydipsia

A

No response (<10% increase in urine osmolality)

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9
Q

What is the treatment of lithium induced nephrogenic DI?

A

Low sodium diet
Amiloride
Indomethacin
Desmopressin (if not able to have indomethacin)

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10
Q

What is the treatment of central DI?

A

Low solute diet
Desmopressin
Thiazide diuretics

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11
Q

What is the treatment of nephrogenic DI?

A

Low sodium low protein diet

Thiazide diuretics

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12
Q

Characteristic findings in MEN1?

A

Pituitary Adenomas
Parathyroid hyperplasia
Pancreatic neuroendocrine tumours

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13
Q

What is commonly found on gastroscope in patients with Zollinger Ellison syndrome?

A

Single sub centimetre duodenal ulcer (75%)

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14
Q

How do you diagnose MEN1?

A

Clinical - 2 or more primary MEN1 tumour types

Genetic - Germline mutation in someone without clinical diagnosis

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15
Q

How do you investigate a high IGF-1?

A

Oral glucose tolerance test with growth hormone levels.

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16
Q

What is the single best test for acromegaly?

A

Serum IGF-1

17
Q

How do you interpret an oral glucose tolerance test when diagnosing acromegaly?

A

Levels of growth hormone 2 hours post administration.

GH >1ng/ml is diagnostic of acromegaly.

18
Q

What is the treatment of acromegaly?

A
  1. Trans-sphenoidal surgery
  2. Long acting somatostatin analogue (if not for surgery or not controlled)
  3. Addition of pegvisomant if not controlled
19
Q

Mechanism of pegvisomant?

A

Growth hormone receptor antagonist.

20
Q

Mechanism of cabergoline?

A

Dopamine receptor agonist

21
Q

What is the most common genetic cause of MODY3?

A

HNF1a

22
Q

What is the mechanism of pasireotide?

A

Somatostatin receptor 5 agonist used in acromegaly.

23
Q

Osteogenesis imperfecta is a disorder of what?

A

Type 1 collagen

24
Q

What mutation would you most often find in a patient with an autonomous thyroid module?

A

Activating TSH receptor mutation

25
Q

What is the pathophys of Graves’ disease?

A

Thyroid stimulating immunoglobulin production

Thyrotropin receptor antibodies

26
Q

Mechanism of carbimazole?

A

Inhibition of iodine oxidation

27
Q

What do you measure to monitor for recurrent medullary thyroid cancer?

A

Calcitonin

28
Q

What is the treatment of a macroprolactinoma?

A
  1. Dopamine agonist therapy

2. Surgery if does not respond

29
Q

What is the management of acromegaly in a patient who is a candidate for surgery?

A
  1. Surgery
  2. Long acting somatostatin analogue (octreotide)
  3. Add on dopamine agonist
  4. Replace DA with pegvisomant
  5. Radiation or repeat surgery
30
Q

What is the most common autoimmune disease associated with type 1 DM?

A

Autoimmune thyroiditis

31
Q

What are the major antibodies associated with Hashimoto’s thyroiditis ?

A

Thyroid peroxidase

Thyroglobulin

32
Q

What is the treatment of painless thyroiditis?

A

Hyperthyroid phase - beta blockade

Hypothyroid phase - thyroxine

33
Q

What is the cell that PTH primarily acts on in bone?

A

Osteoblast

34
Q

What effect does amiodarone have on T4 and T3?

A

Inhibits peripheral conversion of T4 to T3

35
Q

What are the most likely diagnoses with a low TSH, a high T3 and a normal T4?

A

Graves’ disease

Thyroid adenoma

36
Q

What are the most likely diagnoses with a low TSH, a high T4 and a normal T3?

A

Amiodarone induced
Thyroxine ingestion
Non thyroidal illness

37
Q

What are the sonographic features for a thyroid nodule which necessitate FNA?

A

Subcapsular location
Extra thyroidal extension
Large lymph nodes
Solid and >1cm

RACP (16 decks)

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