Endocrinology Flashcards
Recall some symptoms of acromegaly
Hyperhidrosis Hyperprolactinoma Hypopituitary Headaches Carpal Tunnel
Describe the skin of an acromegaly patient
Thick and greasy
In which endocrinological condition is bitemporal hemianopia a symptom?
Acromegaly
Which specific blood test should be orderd for suspected acromegaly?
IGF-1
Recall the medical and surgical options for acromegaly treatment
medical: bromocriptine, octreotide
surgical: transphenoidal hypophysectomy
Differentiate primary and secondary adrenal insufficiency
Primary = AI: Addisson's Secondary = hypothalamopituitary disease
What is the main endocrinological consequence of cessation of long-term steroid therapy?
Adrenal failure
What are the presenting features of acute adrenal insufficiency?
Addissonian crisis = sudden haemodynamic collapse: hypotensive shock, tachycardia, pale, cold, oligouria
What are the chronic features of adrenal insufficiency?
Dizziness, nausea, anorexia, depression, abdominal pain
Recall 3 signs of adrenal insufficiency
Hair loss
Hyperpigmentation
Postural hypotension
Which test is done to confirm a diagnosis of adrenal insufficiency?
Short synacthen
Which test is done to determine pathological mechanism of adrenal insufficiency?
Long synacthen
What is the main electrolyte imbalance resulting from adrenal failure?
Hyperkalaemia
Define the carcinoid syndrome
Constellation of symptoms caused by systemic release of humoral factors from carcinoid tumours
Recall 2 types of tumours that are commonly implicated in the carcinoid syndrome
- Slow-growing neuroendocrine tumours
2. Small bowel - enterochromaffin cell tumours that secrete 5-HT
What are the main symptoms of the carcinoid syndrome?
Paroxysmal flushing, wheeze, tachycardia, abdominal pain (if enterochromaffin cell tumour)
What is themain hormone implicated in the carcinoid syndrome?
5- HT
What electrolyte imbalance is produced by Cushing’s syndrome?
Hypokalaemia
What is the use of the LDDST and the HDDST?
LDDST = diagnosis of Cushing's HDDST = determine cause of Cushing's
Recall 2 drugs that can be used to manage Cushing’s
Meyrapone
Ketoconazole
Recall 2 options for the surgical management of Cushing’s syndrome?
Transsphenoidal hypophysectomy
Bilateral adrenalectomy
Which part of the kidney does ADH act on?
Collecting duct
Recall the medical management of central and nephrogenic diabetes insipidus
Central = desmopressin Nephrogenic = thiazide diuretics
What is the main electrolyte imbalance that results from diabetes insipidus?
Hypernatraemia
Recall 2 auto-antigens related to T1DM
GAD
anti-insulin
Recall the fasting and random blood glucose values indicative of DM
Fasting >7
Random > 11.1
What abnormality is seen on an FBC of someone with a DKA?
High WCC
What do U&Es show in DKA?
Dehydration
Recall the 3 components of an initial management plan for a T1DM patient
- Short-acting insulin eg. lispro TDS
- Long-acting insulin OD
- HbA1c every 3-6months
How is DKA managed?
- Soluble insulin in normal saline
- –> Subcut insulin for 1-2 days
- Insulin will drive K+ into cells so replace potassium
What happens to HGO in T2DM?
Increases
Recall 2 monogenic causes of T2DM
MODY
Mitochondrial diabetes
Recall the diagnostic criteria for T2DM
1 or more of the following present:
- Symptoms + random plasma BM of >11.1
- Fasting BM >7
- 2-hour BM after 75g OGTT >11.1
What may happen to urine protein as a result of T2DM?
Microalbuminuria
Recall 3 medications for diabetes (and write another Q on this)
Metformin
Citagliptin
Sulphonylureas
What is the T2DM equivalent of DKA?
Hyperosmolar hyperglycaeimc state
How does the HHS differ from DKA?
No acidosis
What are the ranges for “impaired” fasting and random glucose?
Fasting: 5.6-6.9
Random: 7.8-11.0
What is the most common cause of hyperthyroidism?
Grave’s disease
Recall 3 signs of Grave’s disease seen in the hands
Palmar erythema
Sweaty and warm
Tremor
Describe 2 signs of hyperthyroidism in the limbs
Proximal myopathy
Hyperreflexia
Which endocrinological condition can cause lid lag?
Hyperthyroidism
Differentiate the possible causes of hyperparathyroidism depending on if it is primary or secondary
Primary = parathyroid adenoma/ hyperplasia Secondary = chronic renal failure, vit D deficiency
Describe the serum calcium in each type of hyperparathyroidism
Primary: hypercalcaemia
Secondary: hypocalcaemia
Tertiary: hypercalcaemia
Describe the serum Vit D in each type of hyperparathyroidism
Primary: high
Secondary: low
Tertiary: low