Endocrinology Flashcards

1
Q

Endocrine - Definition

A

Glands pour secretions directly into blood stream without ducts

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2
Q

Exocrine - Definition

A

glands pour secretions through a duct to site of action

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3
Q

Acromegaly - Definition

A

Increased GH in adults

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4
Q

Primary adrenal insufficiency

A
  1. Addison’s disease
  2. Trauma
  3. Surgical removal
  4. ACTH resistance due to drugs
  5. Invasion from tumour
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5
Q

Secondary adrenal insufficiency - Aetiology

A
  1. Iatrogenic (LT steroids)
  2. Hypothalamic-pit disease –> less ACTH
  3. Neoplasm
  4. Radiotherapy
  5. Surgery
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6
Q

Cushing’s syndrome and D - definition

A
S = chronic excessive and inappropriate elevated circulating cortisol
D = excess glucocorticoids from inappropriate ACTH from pit tumour
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7
Q

Cushing’s syndrome - Diagnostic

A
  1. Random plasma cortisol (high)
  2. Overnight dexamethasone suppression test (no suppression)
  3. Urine free cortisol over 24hrs
  4. 48hr dexamethasone suppression test
  5. Plasma ACTH (adrenal or pit)
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8
Q

Insulin secretion

A
  1. Hyperglycaemia = increased uptake into cells
  2. Increased ATP
  3. K channel closes
  4. Depolarisation
  5. Ca open –> into cell
  6. Exocytosis of insulin containing vesicles
  7. Secreted by B cells in Islets of Langerhans
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9
Q

Diabetes M 1+2 - Diagnosis

A
  1. Random plasma glucose >11.1mmol/L
  2. Fasting plasma glucose >7mmol/L
  3. HbA1c
    = amount of glycated Hb
    <6.5% (48mmol/mol)
  4. Oral glucose tolerance tests
    - Fasting >7mmol/L
    - 2hrs after glucose >11.1 mmol/L
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10
Q

Diabetes M 1+2 - Microvascular Complications

A
  1. Retinopathy
  2. Nephropathy
  3. Neuropathy
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11
Q

DM1+2 - Macrovascular complications

A
  1. Stroke
  2. Renovascular disease
  3. Limb ischaemia
  4. CVD
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12
Q

Hyperthyroidism - clinical presentation

A
  1. Weight loss
  2. Heat intolerance
  3. Diarrhoea
  4. Hyperkinesis - M spasm
  5. Goitre
  6. Palmar erythema
  7. Graves –> eye
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13
Q

Hyperthyroidism - Thyroid function tests

A
  1. Serum TSH low
    - High if 2ndary
  2. T3+T4 raised
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14
Q

Hyperthyroidism - Antibodies

A
  1. Thyroid peroxidase
  2. Thyroglobulin
  3. Graves - TSH receptor stimulating antibodies (TSHR-Ab)
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15
Q

Hyperthyroidism - Treatment

A
  1. B blocker - Propranolol
  2. Propylthiouracil (PTU)
    - Carbimazole - stop T4 to T3
  3. Radioactive Iodine (131)
  4. Thyroidectomy
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16
Q

Hashimoto’s thyroiditis

A

Autoimmune hypothyroidism

17
Q

Hypothyroidism - signs

A
BRADYCARDIA
B - Bradycardia
R - Reflexes relax slowly
A - Ataxia
D - Dry, thin hair/skin
Y- Yawn/drowsy/coma
C - Cold hands
A - Ascites
R - Round puffy face
D - Defeated demeanor
I - Immoblie +/- Ileus (temp arrest of intestinal peristalsis)
C - Congestive HF
18
Q

Hypothyroidism - Treatment

A
  1. Oral levothyroxine (T4)
19
Q

Posterior pituitary - Hormones

A
  1. Vasopressin/ADH

2. Oxytoxin (breast feeding/contraction)

20
Q

Diabetes insipidus - Clinical presentation

A
  1. Polyuria (15L in 24hrs)
  2. Compensatory polydipsia
  3. No glycosuria
  4. Hypernatraemia (water loss in excess of Na –> more conc)
  5. Dehydration
21
Q

Carcinoid tumour - Definition

A

Originate from enterochromaffin cells and are capable of producing serotonin

22
Q

Phaeochromocytoma - Definition

A

Raised plasma catecholamines

- Produced in chromaffin cells in adrenal medulla

23
Q

Pituitary tumour - Presentation

A
  1. Bitemporal hemianopia (P on optic chiasm)
  2. Hypo/hyperpituitarism
  3. Hydrocephalus
  4. CSF leak
24
Q

Hypothyroidism - Causes

A
  1. Autoimmune
  2. Hashimoto’s thyroiditis
  3. Post-partum thyroiditis
  4. Iatrogenic
  5. Drug induced
  6. Iodine deficiency
25
Q

Cushing’s D - Symptoms

A
  1. Central obesity - stretch marks
  2. Moon face
  3. Mood change
  4. Easy bruising
  5. Acne
26
Q

Addison’s disease - Symptoms

A
  1. Skin pigmentation
  2. Vitiligo (white patches + loss of body hair)
  3. Postural hypothenison
  4. Mood change
  5. Weight loss
27
Q

Hypocalcaemia - Presentation

A
  1. Trousseau’s sign (carpopedal spasm - inflate BP cuff above S P)
  2. Chvostek’s sign (tap over facial N in parotid gland –> twitch ipsilat facial M)
  3. Convulsions
  4. Paraethesia
  5. Increased excitability of M + N
28
Q

Secondary hyperparathyroidism - Levels

A
  1. High PTH
  2. Low Ca
  3. High phosphate
  4. High alkaline phosphatase
29
Q

Diabetes Insipidus - Diagnosis

A
  1. Polyuria (>3L/day)
  2. Glucose - exclude DM
  3. Water deprivation test
    - IM desmopressin
    - Urine concentrated in cranial but not nephrogenic
  4. MRI hypothalamus
30
Q

Fatiuge

A
  1. Diabetes
  2. Cancer
  3. Hypothyroid
  4. Depression
  5. Infection