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Phase 2A Med Concise > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Diabetes

A

Raised glucose/lack of insulin

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2
Q

Thyroid disorders

A

Too much/too little thyroid hormone

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3
Q

Cushing’s

A

Raised cortisol

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4
Q

Acromegaly

A

Raised growth hormone

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5
Q

Conn’s syndrome

A

Raised aldosterone

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6
Q

Diabetes insipidus

A

Lack of ADH

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7
Q

SiADH

A

Raised ADH

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8
Q

Hyperkalaemia

A

Raised K

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9
Q

Hypercalcaemia

A

Raised Ca

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10
Q

Parathyroid disorder

A

Too much/too little parathormone

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11
Q

Hyperthyroidism - Causes

A

Graves’ disease
Toxic thyroid adenoma
Iodine excess

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12
Q

Hyperthyroidism - Symptoms

A 
Diarrhoea
Weight loss
Sweats
Palpitations
Tremor
Menstrual disturbance
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13
Q

Hyperthyroidism - Signs

A

Tachycardia

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14
Q

Hyperthyroidism - Investigations

A

Thyroid function tests - TSH, T3/T4 Levels
Thyroid autoantibodies
Radioactive iodine isotope uptake scan

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15
Q

Hyperthyroidism - Treatment

A

B-blockers (acute attack symptoms)
Carbimazole (antithyroid drug)
Thyroidectomy

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16
Q

Graves’ disease - Pathophysiology

A

Autoimmune

Excess TH

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17
Q

Graves’ disease - Symptoms

A

Eye discomfort, diplopia (double vision)

Clubbing

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18
Q

Graves’ disease - Investigation

A

TRAb

Hyperthyroidism tests

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19
Q

Graves’ disease - Treatment

A

Hyperthyroidism treatments - B-blocker, carbimazole

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20
Q

Hypothyroidism - Causes

A

Thyroiditis
Iodine deficiency
Over-treatment of hyperthyroidism

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21
Q

Hypothyroidism - Symptoms

A 
Fatigue/tiredness/lethargy
Weight gain
Myalgia
Oedema
Constipation
Menorrhagia
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22
Q

Hypothyroidism - Signs

A 
Bradycardia
Ascites
Pleural/pericardial effusions
SOB
Ataxia
Dry, thin hair/skin
Feel cold
Reflexes relax slowly
Round puffy face
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23
Q

Differences between hyper/hypothyroidism

A

Hyper - Weight loss, increased appetite, prefer cool temp, tachycardia
Hypo - Weight gain, decreased appetite, prefer warm temp, bradycardia

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24
Q

Acromegaly - Pathophysiology

A

Raised growth hormone occurring in adults after fusion of the epiphyseal plates

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25
Q

Difference between acromegaly and gigantism

A

Acromegaly - Adulta

Gigantism - Children

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26
Q

Acromegaly - Causes

A

Pituitary adenoma

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27
Q

Acromegaly - Symptoms

A

Arthralgia
Sweating
Headache

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28
Q

Acromegaly - Signs

A

Massive growth of hands, feet, jaw, tongue
Darkening of skin
Deep voice

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29
Q

Acromegaly - Investigation

A

MRI pituitary fossa for adenomas

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30
Q

Acromegaly - Treatment

A

Transphenoidal surgery to remove adenoma

Pegvisomant (GH antagonist)

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31
Q

Hyperaldosteronism - Pathophysiology

A

1) Excess aldosterone, independent of RAAS
2) Aldosterone works in kidney to cause K loss, Na/H2O retention
3) Excess therefore causes hypokalaemia and Na/H2O retention

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32
Q

Hyperaldesteronism - Causes

A

Conn’s syndrome

Adenoma

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33
Q

Hyperaldosteronism - Symptoms

A

Hypertension

Hypokalaemia - Weakness, cramps, parasthesia, constipation

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34
Q

Hyperaldosteronism - Investigation

A

U&E
Increased aldosterone
CT adrenal
ECG - ST depression (hypokalemia)

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35
Q

Hyperaldosteronism - Treatment

A

Laparoscopic adrenalectomy

Spironolactone (aldosterone antagonist)

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36
Q

Hyperparathyroidism - Causes

A

Adenoma
Parathyroid hyperplasia
Hypocalcaemia

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37
Q

Hyperparathyroidism - Symptoms

A

Hypercalcaemia - Weak, tired, thirsty, renal stones
Bone resorption causes pain, fracture, osteoporosis
Hypertension

38
Q

Hyperparathyroidism - Investigation

A

Bloods - Increased PTH, Ca

DEXA bone scan (osteoporosis)

39
Q

Hyperparathyroidism - Treatment

A

Fluids
Surgery
Bisphosphonates

40
Q

Hypoparathyroidism - Pathophysiology

A

Autoimmune destruction of parathyroid glands

41
Q

Hypoparathyroidism - Causes

A

Congenital

Surgical removal

42
Q

Hypoparathyroidism - Signs and symptoms

A

Hypocalcaemia signs and symptoms

43
Q

Hypoparathyroidism - Treatment

A

Ca supplement
Calcitriol
Synthetic PTH

44
Q

Pseudohypoparathyroidism - Pathophysiology

A

Decreased response to PTH

Bloods show low Ca, high PTH

45
Q

Hypokalemia - Causes

A

1) Low K in serum (ECF) causes a water gradient out of the cell (ICF)
2) Increased leakage from ICF causing hyperpolarisation of myocyte membrane decreasing myocyte excitability

46
Q

Hypokalemia - Investigations

A

ECG - T wave absent/inversion

47
Q

Hypokalemia - Treatment

A 
Oral K (mild)
IV K (severe)
48
Q

Hyperkalemia - Investigations

A

ECG - T waves tall

49
Q

Hyperkalemia - Treatment

A 
Calcium gluconate (decreases VF risk)
Insulin (drives K into cells)
50
Q

Hyper/hypokalemia - Causes

A

Hyper - Low aldosterone

Hypo - High aldosterone

51
Q

Hyper/hypokalemia - Symptoms

A

Hyper (everything speeds up) - Cramping, weakness, paralysis, cardiac arrythmias/arrest - all due to over contraction of muscles and so drained of energy
Hypo (everything slows) - Constipation, weakness, cramping, cardiac palpitations/arrythmias

52
Q

Calcium homeostasis is controlled by 2 factors

A

PTH (Parathyroid)

Calcitonin (Thyroid)

53
Q

Calcium in bone is stored as

A

Calcium phosphate

54
Q

Hypocalcaemia - Causes (HAVOC)

A 
Hypoparathyroidism 
Acute pancreatitis 
VitD deficiency 
Osteomalacia
CKD
55
Q

Hypocalcaemia - Signs and symptoms

A 
Spasms
Peripheral parasthesia
Seizures
Increased muscle tone
Arrhythmias
56
Q

Hypocalcaemia - Investigations

A

ECG - Long QT interval

57
Q

Hypocalcaemia - Treatment

A 
Adcal (mild)
Calcium gluconate (severe)
58
Q

Hypercalcemia - Causes

A

Hyperparathyroidism

Cancer

59
Q

Hypercalcemia - Symptoms

A

Painful bones
Renal stones
GI - N&V, constipation, indigestion

60
Q

Hypercalcemia - Investigations

A

FBC - PTH, Ca levels
U&E - Renal damage
XR

61
Q

Hypercalcemia -Treatment

A

Bisphosphonates

Saline

62
Q

Difference between cushing’s syndrome and cushing’s disease

A

Cushing’s syndrome - Excess cortisol

Cushing’s disease - Cushing’s syndrome due to pituitary adenoma

63
Q

Cushing’s - Causes

A

Pituitary adenomas

Adrenal adenomas

64
Q

Cushing’s syndrome - Symptoms

A 
Cataracts
Ulcers
Striated skin
Acne
Hypertension 
Increased infections
Obesity/weight gain
65
Q

Cushing’s - Investigations

A

Dexamethasone test - failure to suppress cortisol levels over 24hr period is diagnostic of cushing’s

66
Q

Cushing’s - Treatment

A

Stop steroids
Transphenoidal removal of pituitary adenoma
Adrenalectomy/radio

67
Q

T2DM - Risk factors

A

Male
Asian
Obese
Alcohol

68
Q

T2DM - Investgations

A

Urine - polyuria/polydipsia (hyperglycaemic signs)

Random, fasting, 2hr post-meal glucose levels

69
Q

T2DM - Prediabetic Treatment

A

No meds!

Lifestyle - diet, exercise, annual review

70
Q

T2DM - Diabetic Treatment

A 
Lifestyle
1st line - Metformin (monotherapy)
1st line - Metformin+DPP4i (gliptin)
2nd line - Metformin+glitazone
3rd line - Metformin+sulphonylurea
4th line - Metformin+glifazon
If dual therapy fails, then proceed to triple therapy with sulphonylurea each line 
Finally move to insulin based therapy as last resort
71
Q

Side effects of T2DM drugs

A

Hypoglycaemia

72
Q

Weight changes with T2DM drugs

A

Metformin - Weight loss
Sulfonylurea - Weight gain
DPP4i/gliptin - No change
Glitazone - Weight gain

73
Q

T1DM - Risk factors

A

Young

Adolescent onset

74
Q

T1DM - Signs and symptoms

A

Polyuria
Polydipsia (excessive thirst)
Weight loss

75
Q

T1DM - Investigation

A

Signs of hyperglycaemia plus one/or more of: rapid weight loss, young, family history/personal autoimmune disease, ketosis

76
Q

T1DM - Treatment

A

Only insulin!

77
Q

Addison’s disease - Pathophysiology

A

Autoimmune impairment of adrenal gland (low cortisol and aldosterone)
Opposite of cushing’s syndrome

78
Q

Addison’s disease - Signs and symptoms

A 
Lean/toned
Tanned
Depression
N&V
Abdo pain
Tired
79
Q

Addison’s disease - Investigation

A

Bloods - Low Na, high K (due to low aldosterone)

Short ACTH stimulation test - Cortisol levels remain low = positive result

80
Q

Addison’s disease - Treatment

A

Hydrocortisone (replace cortisol)

Fludrocortisone (replace aldosterone)

81
Q

Diabetes insipidus - Pathophysiology

A

Lack of ADH from posterior pituitary or kidney not responding to ADH

82
Q

Diabetes insipidus - Causes

A

Head trauma
Pituitary tumour
Drugs (lithium)

83
Q

Diabetes insipidus - Signs and symptoms

A

Dehydration
Polyuria
Polydipsia

84
Q

Diabetes insipidus - Investigation

A

Water deprivation test

85
Q

Diabetes insipidus - Treatment

A

Desmopressin (cranial)

Bendroflumethiazide (nephron)

86
Q

SIADH (Syndrome of Inappropriate ADH secretion) - Pathophysiology

A

Excess ADH (Opposite to DI)

87
Q

SIADH (Syndrome of Inappropriate ADH secretion) - Causes

A

Malignancy
Drugs
CNS disorder

88
Q

SIADH (Syndrome of Inappropriate ADH secretion) - Signs and symptoms

A

Confusion
Anorexia
Nausea
Conc urine

89
Q

SIADH (Syndrome of Inappropriate ADH secretion) - Investigation

A

Measure urine and plasma osmolarity

90
Q

SIADH (Syndrome of Inappropriate ADH secretion) - Treatment

A

Restrict fluids

Vasopressin receptor antagonist

Phase 2A Med Concise (18 decks)

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