Brainscape's Knowledge GenomeTM

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


See full index

Clinical Medicine > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Name the 3 hormones involved in calcium and phosphate homeostasis

A
  1. Vitamin D
  2. Parathyroid hormone
  3. Calcitonin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the mechanism of action of calcitriol in the renal tubule?

A

Acts on the proximal convoluted tubule to increase calcium reabsorption

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

What are the 4 principle causes of Cushing’s syndrome?

A
  1. Exogenous steroids
  2. Cushing’s disease ( a ACTH secreted pituitary adenoma)
  3. Adrenal adenoma
  4. Paraneoplastic Cushing’s syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most common cause of paraneoplastic Cushing’s syndrome?

A

Small cell lung cancer

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

Interpret the potential results of a high dose dexamethasone suppression test based on the recorded ACTH and cortisol levels in each case.

A
  1. Pituitary adenoma - Both cortisol and ACTH is suppressed
  2. Adrenal Adenoma - Only ACTH is suppressed, normal cortisol levels
  3. Ectopic ACTH production - Neither Cortisol nor ACTH is suppressed.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

From which direction is a pituitary adenoma removed from surgically?

A

Trans-sphenoidal

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

Name the 5 hormones released by the anterior pituitary gland

A
  1. TSH
  2. ACTH
  3. FSH and LH
  4. Growth hormone
  5. Prolactin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name the 2 hormones released by the posterior pituitary gland

A
  1. Oxytocin

2. ADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the physiological action of growth hormone

A

Induces the secretion of insulin like growth actor (IGF-1) from the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Outline 3 physiological states that will induce the secretion of parathyroid hormone from the parathyroid glands

A
  1. Low serum calcium
  2. Low serum magnesium
  3. High serum phosphate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does PTH increase serum calcium concentration? (3)

A
  1. Increases the number and activity of osteoclasts in bon, thus causing reabsorption of calcium from he bones into the bloodstream.
  2. Also induces increased calcium reabsorption in the proximal convoluted tubule of the nephron
  3. Induces conversion of vitamin D3 to calcitriol. This in turn promotes calcium absorption from the small intestines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Renin is released by what cell type?

A

Juxtaglomerular cells of the kidney nephron

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

What are the 2 principle actions of angiotensin II?

A
  1. Systemic vasoconstriction

2. Induces release of aldosterone from the adrenal glands

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

Outline the 3 principle actions of aldosterone on the kidney nephron

A
  1. Increase sodium reabsorption from the distal tubule
  2. Increase potassium secretion from the distal tubule
  3. Increase hydrogen secretion from the collecting ducts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Compare the thyroid status in hyperthyroidism, primary hypothyroidism and secondary hypothyroidism respectively

A

Hyperthyroidism - Low TSH and high T3 and T4

Primary Hypothyroidism - High TSH and low T3 and T4

Secondary Hypothyroidism - Low TSH and low T3 and T4

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

Name the antibody that is most commonly implicated in autoimmune thyroid disease

A

Antithyroid peroxidase (anti TPO)

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

Name 3 thyroid disorders that can have antithyroglobulin antibodies

A
  1. Grave’s disease
  2. Hashimoto’s thyroiditis
  3. Thyroid cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name the antibody that is responsible for Grave’s disease

A

TSH receptor antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Diffuse high uptake in a radioisotope scan can be indicative of what type of thyroid disease?

A

Grave’s disease

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

Focal high uptake of a radioisotope scan can be indicative of what types of thyroid disease?

A
  1. Toxic multi nodular goitre

2. Adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Abnormally low uptake of a radioisotope scan can be indicative of what type of thyroid disease?

A

Thyroid cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Define Grave’s disease

A

An autoimmune disease in which TSH receptor antibodies cause a primary hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the most common cause of hyperthyroidism?

A

Grave’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What type of thyroid disease is sometimes refereed to as ‘Plummer’s disease’

A

Toxic multi nodular goitre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Pretibial myxoedema is specific to what type of thyroid disease?

A

Grave’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Suggest 7 universal features of hyperthyroidism

A
  1. Anxiety
  2. Sweating/ heat intolerance
  3. Tachycardia
  4. Weight loss
  5. Fatigue
  6. Frequent loose stools
  7. Sexual dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Recall 4 unique features associated with Grave’s disease

A
  1. Diffuse goitre (without nodules)
  2. Grave’s eye disease
  3. Bilateral exophthalmos
  4. Pretibial myxoedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is De Quervain’s Thyroiditis?

A

A viral infection presenting with fever, neck pain and tenderness, dysphagia and features of hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the first line anti-thyroid drug?

A

Carbimazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the 2 dose regimes for carbimazole used in the treatment of patients with hyperthyroidism?

A
  1. Titration-Block

2. Block and replace

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Why is carbimazole preferred over Propylthiouracil as the first line treatment for hyperthyroidism?

A

Small risk of severe hepatic reactions and death association with Propylthiouracil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the beta blocker of choice for symptomatic control in patients with hyperthyroidism?

A

Propanolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the most common cause of hypothyroidism in the developed world?

A

Hashimoto’s thyroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Name 2 medications that can potentially lead to hypothyroidism

A
  1. Lithium

2. Amiodarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Name the 4 potential aetiologies of hypopituitarism

A
  1. Tumours
  2. Infection
  3. Vascular (e.g. Sheehan syndrome)
  4. Radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the ideal range for blood glucose concentration?

A

4.4 -6.1 mol/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Suggest 2 viral infections that can cause T1DM through damage to the pancreas

A
  1. Cocksackie B virus

2. Enterovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the 3 principle medical complications associated with an acute presentation of DKA?

A
  1. Decompensated ketoacidosis
  2. Dehydration
  3. Potassium imbalances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Outline the 3 diagnostic criteria for DKA

A
  1. Hyperglycaemia. Blood glucose > 11mmol/l
  2. Ketosis i.e. blood ketones >3 mmol/l
  3. Acidosis (pH <7.3)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Recall the components of the menuominc ‘FIG-PICK’ for the treatment of DKA

A

F - IV fluid resuscitation with normal saline
I - Insulin infusion
G - Glucose
P - Potassium
I - infection (important to treat any precipitating factors of the DKA if present)
C - Chart the patient’s fluid balance
K - Ketones (monitor serum level)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Suggest 2 medications that cane be used in the treatment of severe hypoglycaemia

A
  1. IV dextrose

2. Intramusclar glucagon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Outline 4 macrovascular complications of diabetes

A
  1. Coronary artery disease
  2. Peripheral vascular disease
  3. Stroke
  4. Hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Outline the 3 main microvascular complication associated with diabetes

A
  1. Peripheral neuropathy
  2. Retinopathy
  3. Kidney disease - particularly glomerulosclerosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Recall 4 infection related complications associated with diabetes

A
  1. UTI’s
  2. Pneumonia
  3. Skin and soft tissue infections
  4. Fungal infections (particularly oral and vaginal candidiasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Recall 3 ethnicities that have an identified increased risk of developing T2DM

A
  1. Black
  2. Chinese
  3. South Asian
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Outline the 4 main parameters used in diagnosis of diabetes

A
  1. HbA1C >48 mmol/l
  2. Random glucose > 11mmol/l
  3. Fasting glucose > 7mmol/l
  4. OGTT 2 hour result > 11mmol/l
47
Q

What is the initial first line treatment for T2DM?

A

Metformin titrated from an initial does of 500mg once daily as tolerated

48
Q

To what drug class does metformin belong to?

A

Biguanide

49
Q

What are the main side effects associated with the use of metformin?

A
  1. Diarrhoea and abdominal pain

2. Lactic acidosis

50
Q

Recall 5 side effects associated with the use of pioglitazone

A
  1. Weight gain
  2. Fluid retention
  3. Anemia
  4. Heart failure
  5. Extended use may increase the risk of bladder cancer
51
Q

Give 3 notable side effects associated with the use of sulphonyureas drugs

A
  1. Weight gain
  2. Hypoglycaemia
  3. Increased risk of CV disease and MI when used as a mono therapy
52
Q

Name the most commonly used sulphonylureas drug

A

Gliclazide

53
Q

What are the 3 main functions of the incretin hormones?

A
  1. Increase insulin secretion
  2. Inhibit glucagon production
  3. Slow absorption by the GI tract
54
Q

Name the most commonly used DPP-4 inhibitor

A

Sitagliptin

55
Q

Give 3 notable side effects associated with Sitagliptin

A
  1. GI tract upset
  2. Symptoms of upper respiratory tract infection
  3. Pancreatitis
56
Q

Classify the drug exenatide

A

GLP-1 mimetic

57
Q

Name 3 rapid acting insulins

A
  1. Novarapid
  2. Humalog
  3. Apidra
58
Q

Name 3 short acting insulins

A
  1. Actrapid
  2. Humulin S
  3. Insuman rapid
59
Q

Name 3 Intermediate acting insulins

A
  1. Insulatard
  2. Humulin I
  3. Insuman Basal
60
Q

Name 3 long acting insulins

A
  1. Lantus
  2. Levemir
  3. Degludec
61
Q

What is the adverse effect commonly associated with sulphonylureas?

A

Hypoglycaemia

62
Q

Briefly outline the methodology of a glucose tolerance test

A

Fasting blood glucose is taken, then the patient is given a 75g glucose load. A second blood glucose reading is then taken after 2 hours.

63
Q

What are the 3 main side effects associated with the use of insulin?

A
  1. Hypoglycaemia
  2. Weight gain
  3. Lipodystrophy
64
Q

Outline the mechanism of action of metformin

A
  1. Increases insulin sensitivity

2. Decreases hepatic gluconeogenesis

65
Q

What are the principle side effects associated with the use of metformin?

A
  1. GI upset

2. Lactic acidosis

66
Q

Outline a patient subgroup for which the use of metformin is contra-indicated

A

Those with an eGFR <30 ml/min

67
Q

Name 2 examples of sulphonylureas

A
  1. Gliclazide

2. Glimepiride

68
Q

Give an example of a thiazolidinedione

A

Pioglitazone

69
Q

Recall 2 side effects associated with pioglitazone

A
  1. Weight gain

2. Fluid retention

70
Q

Outline the mechanism of action of the thiazolidinediones

A

Activate PPAR-gamma receptors in adipocytes to promote angiogenesis and fatty acid uptake

71
Q

Outline the mechanism of action of DPP-4 inhibitors

A

Increase incretin release thereby inhibiting glucagon secretion from the pancreatic alpha cells

72
Q

Outline the mechanism of action of SGLT-2 inhibitors

A

Inhibit the reabsorption of glucose in the kidney

73
Q

Outline the mechanism of action of GLP-1 agonists

A

Incretin mimetic that will inhibit glucagon secretion

74
Q

Which class of diabetes medication has been linked with an increased incidence of pancreatitis?

A

GLP-1 agonists

75
Q

Which is the most common electrolyte abnormality associated with small cell lung cancer?

A

Hypercalcaemia

76
Q

What is the most appropriate clinical investigation for acromegaly?

A

Serum IGF-1

77
Q

Though not always present, suggest 2 clinical signs which may be seen in patients with familial hypercholesterolaemia

A
  1. Premature arcus senilis

2. Tendon Xanthomata

78
Q

Name the criteria used to diagnose familial hypercholesterolaemia

A

Simon Broome Criteria

79
Q

What is the mode of action of Statin medications?

A

Competitively inhibit HMG-CoA reductase

80
Q

Recall 3 significant (but rare) side effects associated with the use of statins

A
  1. Myalgia and in severe cases rhabdomyolysis
  2. Hepatotoxicity
  3. Statin induced diabetes
81
Q

Give 4 contra-indications for the use of fibrates

A
  1. Hypoalbuminaemia
  2. Gallbladder disease
  3. Nephrotic syndrome
  4. Photosensitivity to fibrates
82
Q

Name a drug type that may inhibit iodide transport

A

Thiocyanates

83
Q

Outline the 4 main clinical features of subacute thyroiditis

A
  1. Hyperthyroidism
  2. Painful goitre
  3. Raised ESR
  4. Globally reduced uptake on iodine-131 scan
84
Q

When prescribing levothyroxine for hypothyroidism, name two patient groups that should be started on a lower than normal dose

A
  1. Elderly

2. Patients with ischaemic heart disease

85
Q

Name 4 side effects associated with thyroxine therapy

A
  1. Hyperthyroidism as a result of overreplacement
  2. Reduced bobe mineral density
  3. Worsening of angina
  4. Atrial Fibrillation
86
Q

Name the clinical test used to diagnose acromegaly

A

Oral glucose tolerance test

87
Q

Diabetes insipidus leads to what type of sodium imbalance?

A

Hypernatraemia

88
Q

Give 3 complications associated with acromegaly

A
  1. Hypertension
  2. Diabetes
  3. Cardiomyopathy
89
Q

Suggest a medical treatment for acromegaly

A

Somatostatin analogue e.g. octreotide

90
Q

What electrolyte imbalance is most commonly associated with Cushing’s syndrome?

A

Hypokalaemic metabolic alkalosis

91
Q

How can you distinguish clinically between pituitary and ectopic ACTH secretion?

A

Petrosal sinus sampling

92
Q

List the 3 causes of concurrent hypokalaemia and hypertension

A
  1. Cushing’s syndrome
  2. Conn’s syndrome
  3. Liddle’s syndrome
93
Q

Name 2 ‘drugs’ that can potentially cause hypokalaemia associated with hypertension

A
  1. Carbenoxolone

2. Liquorice excess

94
Q

What is the medical treatment for Liddle’s syndrome?

A

Either amiloride or triamterene

95
Q

What are the 5 potential causes of hypokalaemia without hypertension?

A
  1. Diuretics
  2. GI losses
  3. Renal tubular acidosis
  4. Bartter’s syndrome
  5. Gitelman’s syndrome
96
Q

Outline the 4 electrolyte abnormalities associated with Addison’s disease

A
  1. Hyperkalaemia
  2. Hyponatraemia
  3. Hypoglycaemia
  4. Normal anion gap metabolic acidosis
97
Q

What is the most common extra-adrenal location for a pheochromocytoma?

A

Organ of Zuckerkandl (adjacent to the bifurcation of the aorta)

98
Q

Which virus is associated with a higher incidence of Burkitt’s lymphoma?

A

EBV

99
Q

Recall Whipple’s triad of symptoms associated with an insulinoma

A
  1. Hypoglycaemia with fasting or exercise
  2. Reversal of symptoms with glucose
  3. Recorded low BMs at the time of symptoms
100
Q

Name a common complication of a PCP infection

A

Pneumothorax

101
Q

What is the first line treatment for a PCP infection?

A

Co-trimoxazole

102
Q

Recall the 3 types of frontotemporal lobar degeneration

A
  1. Frontotemporal dementia (Pick’s disease)
  2. Progressive non fluent aphasia (Chronic progressive aphasia (CPA)
  3. Semantic dementia
103
Q

What are the ‘4Ds’ of causes of postural hypertension with a compensatory tachycardia?

A
  1. Deconditioning
  2. Dysfunctional heart: aortic stenosis
  3. Dehydration: Disease (acute illness, adrenal insufficiency), dialysis and drugs (diuretics or narcotics)
  4. Drugs: Levodopa, antidepressants, antipsychotics, tamsulosin
104
Q

What is the triad of symptoms associated with Parkinson’s disease?

A
  1. Bradykinesia
  2. Tremor
  3. Rigidity
105
Q

Outline the 5 main causes of adrenal failure

A
  1. Autoimmune
  2. Adrenal haemorrhage
  3. Adrenal metastatic disease
  4. Sepsis
  5. TB
106
Q

Bilateral adrenalectomy will lead to which clinical syndrome?

A

Nelson’s syndrome

107
Q

Name the 5 adrenal tumour types of functional significance

A
  1. Conns syndrome
  2. Cushing’s syndrome
  3. Virilizing tumours (testosterone releasing)
  4. Pheochromocytoma
  5. Metastatic disease
108
Q

Suppression during a high dose dexamethasone suppression test is indicative of what kind of adrenal disease?

A

Pituitary adenoma - Cushing’s disease

109
Q

What are the 2 main clinical ‘risks’ associated with Conn’s syndrome?

A
  1. Severe hypertension

2. Flash pulmonary oedema

110
Q

Define Glucocorticoid remediable aldosteronism

A

Autosomal dominant disorder characterised by increased sensitivity of the zona glomerulosa to ACTH thereby leading to hypersecretion of aldosterone.

111
Q

What is the name of an extra-adrenal pheochromocytoma?

A

Paraganglioma

112
Q

Suggest 6 potential causes of endocrine hypertension

A
  1. Pheochromocytoma
  2. Conn’s syndrome
  3. Cushing’s disease
  4. Renal artery stenosis
  5. Acromegaly
  6. Diabetes Mellitus
113
Q

What is an important expected affect of metformin?

A

Reduction in patient’s insulin resistance i.e. smaller doses will likely be required

Clinical Medicine (8 decks)

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