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Phase 3b/finals > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

What hormones are released by the posterior pituitary?

A

Oxytocin + ADH

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2
Q

What are the 3 layers of the adrenal cortex and what do they produce?

A

zona glomerulosa, fasciculata and reticularis

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3
Q

What does the glomerulosa produce?

A

Mineralocorticoids e.g. aldosterone

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4
Q

What does the zona fasciculata produce?

A

GLucocorticoids e.g. cortisol

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5
Q

WHat does the zona reticularis produce?

A

Androgens

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6
Q

Where are Norepinephrine and epinephrine produced?

A

renal medulla

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7
Q

What does TRH act on

A

the anterior pituitary causing it to release TSH

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8
Q

What does TSH act on?

A

the thyroid, causing it to release T3 and T4 (thyroxine)

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9
Q

What does T4 inhibit?

A

THe hypothalamas and anterior pituitary

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10
Q

What does LH act on?

A

Leydig cells to produce testosterone

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11
Q

What does FSH act on?

A

Sertoli cells to produce androgen binding globulin and inhibin

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12
Q

What hormons is under negative control from the hypothalamus?

A

Prolactin

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13
Q

Name a treatment for prolactinoma?

A

Cabergoline

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14
Q

How is cushing’s syndrome investigated?

A

Overnight dexamethasone suppression test

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15
Q

How is acromegaly diagnosed?

A

Glucose tolerance test

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16
Q

Treatment of acromegaly

A

Surgical removal of pituitary tumour

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17
Q

2 main features of Conn’s syndrome

A

Hypertension and hypokalaemia

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18
Q

Increased aldosterone production is known as

A

Conn’s syndrome

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19
Q

What does aldosterone do

A

absorb sodium and water, excrete potassium in the distal convoluted tubule

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20
Q

Blood test result in conn’s

A

raised aldosterone to renin ratio

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21
Q

Diagnosis of Conn’s

A

aldosterone does not decrease with an IV 0.9% saline solution in Conn’s

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22
Q

Name an aldosterone agonist

A

spironolactone

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23
Q

Central vs nephrogenic diabetes insipidus

A

Central = pituitary does not release ADH

Nephrogenic - kidney not responding to ADH

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24
Q

What does ADH do?

A

Water reabsorption in the colelcting ducts

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25
Blood test result in diabetes insipidus
hypernatraemia
26
How is diabetes insipidus diagnosed
water deprivation test
27
treatment for central diabetes insipidus
desmopressin
28
Most common cause of SIADH
small cell lung cancer
29
Plasma concentration of salt is ____ in SIADH
Low
30
What causes secondary hyperparathyroidism
prolonged hypocalcaemia e.g. CKD, vitamin D deficiency
31
Symptoms of hyperparathyroidism
stones - calcium stones in kidney bones - bone pain, osteopaenia, weak bones groans - abdo pain psychiatric overtones - depression, anxiety
32
Calcium is _____ in hyperparathyroidism?
Elevated
33
Symptoms of hypoparathyroidism?
Paraesthesia, tetany, hyperphosphataemia
34
2 signs that are positive in hypocalcaemia
Chvostek's sign and trousseau's sign
35
What is affected in secondary hypothyroidism?
Pituitary gland
36
Most common cause of hypothyroidism in UK?
Hashimoto's thyroiditis
37
What is addison's disease?
Not enough cortisol or aldosterone
38
Investigation for addison's disease?
Adrenicocorticotrophic Hormone (ACTH) stimulation test
39
Antibodies present in Hashimotos thyroiditis (autoimmune hypothyroidism)
anti-thyroid peroxidase (TPO) | Anti-Tg antibodies
40
What antibodies are present in 90-100% of people with grave's disease?
TSH receptor antibodies
41
What causes addison's disease
Autoimmune destruction of the adrenal glands
42
Hyperpigmentation of the palmar creases indicates
Primary Addison's disease
43
Most common causes of HYPERcalcaemia
malignancy | hyperparathyroidism
44
Management of thyrotoxicosis
carbimazole 6 weeks
45
Most common causes of DKA
infection MI missed insulin
46
what is Kussmaul respiration?
Deep hyperventilation seen in DKA
47
Blood test results in addisons
high potassium and calcium, low sodium, low glucose
48
Painful goitre, hypothyroidism and raised ESR poijnts to
subacute thyroiditis, de Quervain's
49
Diagnosis of acromegaly?
Serum IGF-1 measurements
50
Karyotype in kleinfelter's syndrome
47, XXY
51
what is 5-alpha reductase syndrome?
inability to convert testosterone into dihydrotestosterone
52
Characteristic features of Kallmann's syndrome
lack of smell in a boy with delayed puberty
53
What would you see on thyroid scintigraphy in De Quervain's? thyroiditis
globally reduced uptake of iodine-131
54
What is De Quervian's?
Subacte thyroiditis - hyperthyroidism`
55
2nd most common cause of cushing's after steroids?
Pituitary adenoma
56
Subclinical hypothyroidism on blood test...
elevated TSH with normal T4 indicates
57
What to give if calcium >3
IV bisphosphonates
58
Orphan Annie eyes on microscopy are seen in
Papillary thyroid cancer
59
Calcitonin is a tumour marker for
medullary thyroid cancer
60
thyroglobulin is a tumour marker for
papillary and follicular thryoid cancer
61
Raised serum parathryoid would also give...
raised serum calcium and low phosphate
62
Hashimoto's thyroiditis = which antibody
anti TPO
63
What is the target HbA1c in type 2 diabetes?
48 mmol
64
What medication changes should be made in a sick patient with addison's disease?
double the dose of glucocorticoids e.g. hydrocortisone
65
treatment f addisons
glucocorticoid and mineralocorticoid replacement therapy hydrocortisone + fludrocortisone
66
What does radioactive iodine treat
toxic multinodular goitre
67
What IS addison's disease
Autoimmunde destruction of the adrenal glands
68
How is addison's disease diagnosed
Short synacthen test (it should stimulate cortisol production)
69
Blood test results in addisons
hyponatraemia | hyperkalaemia
70
Diagnosis of phaeochromocytoma?
24 hour urinary collection of mentanephrines
71
What may be needed in childhood for turner's syndrome treatment
growth hormone
72
Name a drug that most commonly causes gynaecomastia
spironolactone
73
Most common cause of secondary hypothyroidism
pituitary insufficiency
74
TSH and T4 in SECONDARY hypothyroidism
low tsh, low t4
75
Treatment of diabetic ketoacidosis in adults
0.1units/kg/hour insulin IV
76
initial treatment of DKA
fluids THEN insulin
77
When should you add a 2nd drug (after metformin) in a patient not controlling their T2DM?
HbA1c > 58
78
How is Conn's syndrome diagnosed?
Renin:Aldosterone ratio
79
Hypertension + hypokalaemia =
primary hyperaldosteronism/Conn's syndrome
80
most common cause of hyperparathyroidism?
solitary parathyroid adenoma
81
What characterises an addisonian crisis?
hyperkalaemic metabolic acidosis
82
How should regular insulin be managed in acute DKA treatment?q
fixed rate insulin continue regular long acting insulin stop short acting insulin
83
treatment of addisonian crisis
hydrocortisone 100mcg im or iv
84
most important blood test in hashmotos
TSH
85
most common cause of hyperaldosteronism
bilateral adrenocortical hyperplasia
86
treatment of hyperalsostetonism
spironolactone
87
what blood test do you need to do when starting carbimazole and why
FBC - rule out agranulocytosis
88
lack of what electrolyte may cause hypocalcaemia?
magnesium
89
Klinefelter's syndrome causes hormonally...
high LH, low testosterone
90
Management of hypercalcaemia
IV saline, THEN bisphosphinates
91
hyponatraemia and hyperkalaemia points to...
Addison's disease
92
Pepper pot skull indicates...
hyperparathyroidism
93
Which medication controls BP in phaechromocytoma?
labetoloL
94
side effects of sulfonylureas
weight gain (hypos)
95
complication of fluid resuscitaiton in DKA
cerebral oedema
96
blood results in cushing's
hypokalaemic metabolic alkalosis
97
treatment of Addisonian crisis
IV hydrocortison
98
Blood Features of an addisonian crisis
hyperkalaemia, hyponatramia, hypoglycaemia
99
1st line management of prolactinoma?
bromocriptine
100
how many readings do you need before you can diagnose diabetes in asymptomatic patients?
2
101
what fasting and random glucose test suggest diabetes?
fasting >7mmol/l | random >11.1mmol/l

Phase 3b/finals (19 decks)

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