endocrinology Flashcards
what accounts for 60-80% of hyperthyroidism cases?
Graves disease (thyroid receptor antibodies)
graves disease can cause what to the eyes?
Exopthalmous
hyperthyroid drug treatment?
Symptoms - Propranolol (non selective)
1st line = Carbimazole (agranulocytosis)
TFT of secondary hypothyroidism?
Low free hormones and TSH
peak flow worse in mornings is…
diurnal variability (>20% difference)
samter’s triad
asthma, nasal polyps, aspirin sensitivity
asthma diagnosis?
> 15% improvement in PEFR after reliever or inhaled steroids
which pathogen cause desaturation on exertion?
Pneumocystis jiroveci
what should yu be careful with when taking rifmapicin?
oral contraception and warfarin
P450 inducer!!
anti-TPO antibody =
hashimoto’s thyroiditis
first line test for acromegaly?
serum IGF-1
treatment of thyroid storm?
propylthiourcil, hydrocortisone, beta blockers
features of SIADH?
euvolaemic hyponatraemia with low serum osmolality
high urine osmolality
high urine sodium
first line treatment for SIADH?
fluid restriction
most common cause of cortisol excess?
exogenous steroid use (NOT ACTH secreting tumour)
posterior pituitary hormones?
Oxytocin
ADH
what is osmolality?
concentration of solution expressed as total number of solute particles per kilogram
test for diabetes insipidus?
water deprivation test - measure osmolality (urine will maintain low osmolality while plasma osmolality will increase)
then given ADH and urine will concentrate, or not, if kidney problem
features of SIADH?
low plasma sodium
low plasma osmolality
high urine sodium
high urine osmolality
treat underlying cause + fluid restriction
describe Addisons?
adrenal insufficiency
hyperpigmentation
postural hypotension
depression
investigation for addison’s?
Synacthen test
treatment for Addison’s?
Hydrocortisone
+
Fludrocortisone (if primary cause)
describe Addisonian Crisis
hypotension + Coma
Bloods = low sodium and high potassium
causes = acute stress e.g. infection, trauma
