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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
Q

Blood test result in diabetes insipidus

A

hypernatraemia

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26
Q

How is diabetes insipidus diagnosed

A

water deprivation test

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27
Q

treatment for central diabetes insipidus

A

desmopressin

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28
Q

Most common cause of SIADH

A

small cell lung cancer

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29
Q

Plasma concentration of salt is ____ in SIADH

A

Low

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30
Q

What causes secondary hyperparathyroidism

A

prolonged hypocalcaemia e.g. CKD, vitamin D deficiency

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31
Q

Symptoms of hyperparathyroidism

A

stones - calcium stones in kidney
bones - bone pain, osteopaenia, weak bones
groans - abdo pain
psychiatric overtones - depression, anxiety

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32
Q

Calcium is _____ in hyperparathyroidism?

A

Elevated

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33
Q

Symptoms of hypoparathyroidism?

A

Paraesthesia, tetany, hyperphosphataemia

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34
Q

2 signs that are positive in hypocalcaemia

A

Chvostek’s sign and trousseau’s sign

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35
Q

What is affected in secondary hypothyroidism?

A

Pituitary gland

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36
Q

Most common cause of hypothyroidism in UK?

A

Hashimoto’s thyroiditis

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37
Q

What is addison’s disease?

A

Not enough cortisol or aldosterone

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38
Q

Investigation for addison’s disease?

A

Adrenicocorticotrophic Hormone (ACTH) stimulation test

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39
Q

Antibodies present in Hashimotos thyroiditis (autoimmune hypothyroidism)

A

anti-thyroid peroxidase (TPO)

Anti-Tg antibodies

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40
Q

What antibodies are present in 90-100% of people with grave’s disease?

A

TSH receptor antibodies

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41
Q

What causes addison’s disease

A

Autoimmune destruction of the adrenal glands

42
Q

Hyperpigmentation of the palmar creases indicates

A

Primary Addison’s disease

43
Q

Most common causes of HYPERcalcaemia

A

malignancy

hyperparathyroidism

44
Q

Management of thyrotoxicosis

A

carbimazole 6 weeks

45
Q

Most common causes of DKA

A

infection
MI
missed insulin

46
Q

what is Kussmaul respiration?

A

Deep hyperventilation seen in DKA

47
Q

Blood test results in addisons

A

high potassium and calcium, low sodium, low glucose

48
Q

Painful goitre, hypothyroidism and raised ESR poijnts to

A

subacute thyroiditis, de Quervain’s

49
Q

Diagnosis of acromegaly?

A

Serum IGF-1 measurements

50
Q

Karyotype in kleinfelter’s syndrome

A

47, XXY

51
Q

what is 5-alpha reductase syndrome?

A

inability to convert testosterone into dihydrotestosterone

52
Q

Characteristic features of Kallmann’s syndrome

A

lack of smell in a boy with delayed puberty

53
Q

What would you see on thyroid scintigraphy in De Quervain’s? thyroiditis

A

globally reduced uptake of iodine-131

54
Q

What is De Quervian’s?

A

Subacte thyroiditis - hyperthyroidism`

55
Q

2nd most common cause of cushing’s after steroids?

A

Pituitary adenoma

56
Q

Subclinical hypothyroidism on blood test…

A

elevated TSH with normal T4 indicates

57
Q

What to give if calcium >3

A

IV bisphosphonates

58
Q

Orphan Annie eyes on microscopy are seen in

A

Papillary thyroid cancer

59
Q

Calcitonin is a tumour marker for

A

medullary thyroid cancer

60
Q

thyroglobulin is a tumour marker for

A

papillary and follicular thryoid cancer

61
Q

Raised serum parathryoid would also give…

A

raised serum calcium and low phosphate

62
Q

Hashimoto’s thyroiditis = which antibody

A

anti TPO

63
Q

What is the target HbA1c in type 2 diabetes?

A

48 mmol

64
Q

What medication changes should be made in a sick patient with addison’s disease?

A

double the dose of glucocorticoids e.g. hydrocortisone

65
Q

treatment f addisons

A

glucocorticoid and mineralocorticoid replacement therapy

hydrocortisone + fludrocortisone

66
Q

What does radioactive iodine treat

A

toxic multinodular goitre

67
Q

What IS addison’s disease

A

Autoimmunde destruction of the adrenal glands

68
Q

How is addison’s disease diagnosed

A

Short synacthen test (it should stimulate cortisol production)

69
Q

Blood test results in addisons

A

hyponatraemia

hyperkalaemia

70
Q

Diagnosis of phaeochromocytoma?

A

24 hour urinary collection of mentanephrines

71
Q

What may be needed in childhood for turner’s syndrome treatment

A

growth hormone

72
Q

Name a drug that most commonly causes gynaecomastia

A

spironolactone

73
Q

Most common cause of secondary hypothyroidism

A

pituitary insufficiency

74
Q

TSH and T4 in SECONDARY hypothyroidism

A

low tsh, low t4

75
Q

Treatment of diabetic ketoacidosis in adults

A

0.1units/kg/hour insulin IV

76
Q

initial treatment of DKA

A

fluids THEN insulin

77
Q

When should you add a 2nd drug (after metformin) in a patient not controlling their T2DM?

A

HbA1c > 58

78
Q

How is Conn’s syndrome diagnosed?

A

Renin:Aldosterone ratio

79
Q

Hypertension + hypokalaemia =

A

primary hyperaldosteronism/Conn’s syndrome

80
Q

most common cause of hyperparathyroidism?

A

solitary parathyroid adenoma

81
Q

What characterises an addisonian crisis?

A

hyperkalaemic metabolic acidosis

82
Q

How should regular insulin be managed in acute DKA treatment?q

A

fixed rate insulin
continue regular long acting insulin
stop short acting insulin

83
Q

treatment of addisonian crisis

A

hydrocortisone 100mcg im or iv

84
Q

most important blood test in hashmotos

A

TSH

85
Q

most common cause of hyperaldosteronism

A

bilateral adrenocortical hyperplasia

86
Q

treatment of hyperalsostetonism

A

spironolactone

87
Q

what blood test do you need to do when starting carbimazole and why

A

FBC - rule out agranulocytosis

88
Q

lack of what electrolyte may cause hypocalcaemia?

A

magnesium

89
Q

Klinefelter’s syndrome causes hormonally…

A

high LH, low testosterone

90
Q

Management of hypercalcaemia

A

IV saline, THEN bisphosphinates

91
Q

hyponatraemia and hyperkalaemia points to…

A

Addison’s disease

92
Q

Pepper pot skull indicates…

A

hyperparathyroidism

93
Q

Which medication controls BP in phaechromocytoma?

A

labetoloL

94
Q

side effects of sulfonylureas

A

weight gain (hypos)

95
Q

complication of fluid resuscitaiton in DKA

A

cerebral oedema

96
Q

blood results in cushing’s

A

hypokalaemic metabolic alkalosis

97
Q

treatment of Addisonian crisis

A

IV hydrocortison

98
Q

Blood Features of an addisonian crisis

A

hyperkalaemia, hyponatramia, hypoglycaemia

99
Q

1st line management of prolactinoma?

A

bromocriptine

100
Q

how many readings do you need before you can diagnose diabetes in asymptomatic patients?

A

2

101
Q

what fasting and random glucose test suggest diabetes?

A

fasting >7mmol/l

random >11.1mmol/l

Phase 3b/finals (19 decks)

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