Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Primary Care > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

70% of patients with MODY (<25yrs, FHx) involve which gene mutation?

A

HNF1- alpha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diagnosis of Diabetes?

A

Symptomatic:
FBG > 7mmol/L
Random BG > 11.1mmol/L
HbA1C > 48mmol/mol

Asymptomatic:
Increased random/fasting or HbA1C on two ocassions
OR
Increase random/fasting and HbA1C at same testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pre-diabetes?
FBG 6.1-7
HbA1C 42-47

A

Risk factor for DM(4%/yr) and CVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How often should you measure HbA1C in DM?

A

2x/yr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How often should diabetics be reviewed?

A

Routine diabetic review - 6mnthly

Review of complications - annually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fingerprick cappillary glucose monitoring is recommended for?

A

Patients taking insulin

Patients on sulfonylureas/ glinides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Diabetics, if driving, must check their blood glucose 2x/day when taking which medications(2)?

A

Sulfonylureas

Glinides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Non-Pharmacological management of diabetes includes?

A

Education

  • Diet
  • Vaccinations
  • Exercise
  • Psychological
  • Smoking
  • Driving
  • Employment
  • Travel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Consider Patients with type 1 DM to be high risk for complications if; (8)

A
  • > 35yrs
  • Indian Subcontinent
  • FHx premature heart disease
  • Preexisting CVD
  • > /= 2 features of metabolic syndrome
  • Abnormal Lipids
  • Increased BP
  • Microalbuminaemia/ Proteinuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Consider T2DM patients to be high risk for complications unless all (7) apply;

A
  • not overweight
  • normotensive
  • no microalbumonaemia
  • non-smoker
  • no high risk lipid profile
  • no PMHx CVD
  • no FHx CVD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment of severe hypoglycaemia?

Glucose < 4mmol/L

A

Glucagon injection

oral glucose when conscious- effect of injection short lived

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Driving is not permitted in diabetes if?

A

> 1 hypoglycaemic episode in the pasr year

No episodes for group 2 drivers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Aspirin is given to diabetic patients in what circumstances?

A

Hx of CVD

Not primary prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Statins are given to diabetic patients who?

A

All T1 w/t increased risk of arterial disease
All T2 >75yrs
T2 any age with any high risk factors
T2 >40yrs no risk factors but CVD risk >20% over 10yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If TGs are > 4.5mmol/L despite good glycaemic control how should you proceed?

A

Prescribe a fibrate
Reduce risk of pancreatitis
Ineffective- high concentration omega 3 fish oils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In what other instance should you prescribe a fibrate to a diabetic?

A

TGs betweeen 2.3-4.5 but high CVD risk

Also decresease risk of diabetic retinopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Recurrent UTIs in DM, you should consider? and why?

A

Papillary necrosis

more common in DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Nephropathy is characterized by(3)

A
  • Proteinuria
  • Increased BP
  • Decreased Renal Function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Microalbuminuria?

A

albumin:creatinine ratio
>2.5mg/mmol Males
>3.5mg/mmol Women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If abnormal albumin:creatinine ratio how should you proceed?

A

Repeat the test 2x over the next 2-3mnths

Confirmed of >/=1 abnormal repeat result

21
Q

How do you treat DM with microalbuminemia/CKD?

A

ACE inhibitor e.g perindopril

22
Q

Referal to a Nephrologist if;

A
  • a:c ratio >70mg/mmol or p:c ratio >100mg/mmol (UTI exclude)
  • eGFR <30 or drops by >15% between tests
23
Q

The fraction of diabetics that have eye problems at presentation?

A

1/3rd

24
Q

Eye Problems seen in DM include:

A

Blurred Vision: osmotic changes- corrects with glucose control
Cataract-juvenille snowflake cataracts develop rapidly
Glaucoma-Pressure
Retinopathy

25
Q

Senile cataracts develop approximately how many years earlier in DM?

A

10

26
Q

Risk of developing Retinopathy in diabetic patients?

A

20x

27
Q

Refer Diabetic patient to ophthomalogist if;

A
  • Sudden loss of vision
  • Rubeosis iridis
  • Pre-retinal or vitreous haemorrhage
  • Retinal detatchment
  • New vessel formation
  • Maculopathy
  • Pre-proliferative retinopathy
  • Cataract affecting visual-acuity
  • Unexplained drop in visual acuity
28
Q

Laser treatment (photo-coagulation) is used to treat retinopathy?

A

Halts progression, does not retsore vision

29
Q

Symmetrical Sensory Progressive Polyneuropathy affects what percentage of patients with DM?

A

40-50%

Numbness, tingling, neuropathic pain in feet> hands

30
Q

Mononeuropathies/mononeuritis multiplex is particularly associated with which cranial nerves?

A

CN3 occulomotor: ptosis, large pupil, eye looks down and outwards
CN6 abducens:horizontal diplopia (double vision) on looking outward s

31
Q

What is amyotrophy?

A

Painful wasting of quadricep muscles

Reversible with good BG control

32
Q

Features of autonomic neuropathy?(6)

A
  • Postural Hypotension
  • Urinary Retention
  • Diabetic Diarrhoea
  • Erectile Dysfunction
  • Gastric Paresis (tx:tetracycline)
  • Gustatory Sweating (tx: propantheline bromide)
33
Q

Risk Factors for development of diabetic foot?

A 
Peripheral Neuropathy
Peripheral Vascular Disease 
Hx. Ulceration/amputation
>70yrs
Plantar Callus 
Foot Deformities
Poor Footwear
Long Duration- DM
Social Deprivation 
Poor Vision
Smoking
34
Q

Classification of foot risk?

A

Low:Normal senstation, palpable pulses
Increased:Neuropathy, absent pulses or other RF
High: Neuropathy/absent pulses + deformity/skin changes/ previous ulcer

35
Q

Charcot’s Osteoarthropathy (Charcot’s Joint)

A

Neuropathic foot damaged because of trauma secondary to loss of pain sensation

Refer immediately if suspected

36
Q

Refer a patient with a thyroid lump immediately if;

A

Signs of tracheal compression, inc. stridor

37
Q

Refer a patient with a thyroid swelling urgently if;

A
  • > /=65yrs
  • Solitary Nodule increasing in size
  • Hx of neck irradiation
  • FHx -endocrine tumour
  • Unexplained hoarseness/voice changes
  • Cervical Lymphadenopathy
  • Very young (pre-pubertal)
38
Q

Investigation of patients not requiring urgent referral?

A

TFTs
If hypo or hyperthyroid- referral to endo
If goitre alone - refer to surgeons

39
Q

With relation to screening, check TFTs in patients who;

A
  • with persistent symptoms of tiredeness/lethargy
  • On amiodarone or w/t hx of radioactive iodine therapy
  • with hypercholesterolameia, infertility, turner’s/Down’s syndrome, depresssion, dementia, obesity, DM, other AI disease
40
Q

In elderly patients, hyperthyroididm may present as?

A

Confusion
Dementia
Apathy
Depression

41
Q

Tx hyperthyroidism?

A

B Blockers: symptoms
Carbimazole:
RAI:monitor TFTs long term
Surgery:

42
Q

When should a patient be warned to stop carbimazole?

A

If they experience sore throat or other infection

43
Q

3/1000 patients on carbimazole have adverse effects, these are?

A

Agranulocytosis
Hepatitis
Aplastic Anaemia
Lupus like syndromes

44
Q

How long after RAI treatment should a women avoid pregnancy?

A

4mnths

45
Q

What percentage of women >60yrs have hypothyroidism?

A

10%

46
Q

Beginning Thyroxine therapy in a healthy patient <65yrs

A

Recheck TFTs 4-6wks
Adjust until TSH in normal range
monitor annually

47
Q

Over-replacement with thyroxine is associated with?

A

AF

Osteoporosis

48
Q

Levothyroxine can provoke what? and what should you consider adding to treatment?

A

Angina in elderly/preexisting CHD

Propranolol

Primary Care (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions