Brainscape's Knowledge GenomeTM

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


See full index

Module 2 > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Most common type of hypothyroidism

A

Hashimoto’s

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

TSH is released from where in the hypothalamus

A

Hypophyseal portal system

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

2 medications that can cause hypothyroidism

A

Lithium and amiodarone

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

Primary hypothyroidism can be secondary to what?

A

Drugs - Lithium and amiodarone
Iodine deficiency
Post total-body irradiation
Post-partum

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

What mineral is needed to convert T4 into T3?

A

Selenium

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

Carpal tunnel syndrome may be a sign of

A

Hypothyroidism

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

Hashimoto’s blood findings

A

High TSH
Low T4
TPO (thyroid peroxidase) antibodies

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

Faster-acting management for severe hypothyroidism?

A

Liothyronine sodium

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

4 complications of untreated hypothyroidism

A
  1. CVD
  2. Pre-eclampsia
  3. Maternal anaemia
  4. Miscarriage
  5. Coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Excess T3/T4 and reduced TSH is a sign of

A

Hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Most common autoimmune hyperthyroidism

A

Graves Disease

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

Pathophysiology behind Graves Disease

A

B cells produce thyroglobulin antibodies which mimic TSH. Bind to TSH receptor on follicular cells to stimulate release of thyroid hormones.

TSH receptor autoantibodies bind throughout the body causing eye/skin issues (cross reactivity).

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

4 causes of a thyroid storm

A
  1. Stress - Childbirth, surgery
  2. Infection
  3. Stopping hyperthyroidism treatment
  4. Excess hypothyroidism treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

3 RF for Graves

A

Female, family history, smoking

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

Tachycardia secondary to hyperthyroidism is caused by an increase in

A

ANP

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

Pretibial oedema is seen in

A

Graves Disease

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

Antibodies seen in Graves?

A

Thyroglobulin autoantibodies/TSHR autoantibodies

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

Management for Graves (5 - 2 drugs; 3 other therapies)

A
  1. Beta blocker
  2. Anti-thyroid drugs: Carbimazole (weekly TFT) or carbimazole + levothyroxine
  3. Radioiodine therapy to destroy thyroid function
  4. Thyroidectomy
  5. Stop smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hypoparathyroidism causes

A

Hypocalcaemia and low vitamin D

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

5 signs of hypoparathyroidism

A
  1. Paraesthesia
  2. Chvostek’s sign
  3. Trosseau’s sign
  4. Hypocalcaemia
  5. Hyperphosphataemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Primary hyperparathyroidism is caused by what 2?

A

Parathyroid adenoma and MEN

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

Hypercalcaemia, hypophosphataemia, recurrent kidney stones and depression are signs of?

A

Hyperparathyroidism

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

Bone pain and constipation could be signs of

A

Hyperparathyroidism

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

Secondary hyperparathyroidism is caused by excess

A

PTH

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

2 causes of secondary hyperparathyroidism

A
  1. Kidney issues

2. Vitamin D deficiency

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

Hyperphosphateaemia but low calcium and vitamin D are signs of

A

Secondary hyperparathyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Diffuse goitre is often

A

Benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

5 causes of diffuse goitre

A
  1. Graves
  2. Hashimoto’s
  3. Congenital thyroiditis
  4. Pregnancy
  5. Puberty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

A solitary thyroid nodule tends to be a

A

Cyst

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

Most common type of thyroid cancer in young females

A

Papillary

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

Most common type of thyroid cancer in middle-aged older women?

A

Follicular

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

5 signs/symptoms of thyroid cancer

A
  1. Goitre
  2. Hoarseness
  3. Odynophagia
  4. Dysphagia
  5. Lymphadenopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Toxic multi nodular goitre causes

A

Hyperthyroidism

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

2 genes associated with T1DM?

A

HLA-D3 and HLA-D4

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

2 phases of T1DM

A
  1. B-cell destruction - reduced/absent insulin

2. Alpha cell dysfunction - Glucagon is secreted inappropriately leading to extreme blood sugars

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Deep, gasping breaths with a fruity smell, confusion and polyuria is a sign of

A

DKA

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

3 blood investigations in diabetes

A
  1. Fasting plasma glucose > 7
  2. Plasma glucose > 11.1 2 hours post 75 g oral glucose tolerance test
  3. Glycated HbA1C
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

3 urinalysis findings in diabetes

A
  1. Proteinuria
  2. Ketones (following DKA)
  3. Glucose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

1st line treatment (except general lifestyle changes) in T2DM?

A

Metformin - anti-hyperglycaemic drug. No risk of hypoglycaemia as does not affect insulin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

2nd line treatment in T2DM (4 drugs)?

A
  1. Sulfonylurea - Gliclazide
  2. Thiazolidinedione = Pioglitazone
  3. Dipeptidylpeptidase-4 inhibitor (GLIPTIN)
  4. Sodium glucose co-transport 2 inhibitor/gliflozin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

3rd line treatment for T2DM

A

Metformin, Sulfonylurea, Pioglitazone

MSP

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

Metformin MOA and benefits

A

Reduce hepatic glucose output (glycogenolysis/gluconeogenesis) and increase skeletal muscle uptake.

Reduce sugar and reduce complication risks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Sulfonylurea MOA

A

Increase insulin secretion by blocking ATP-dependent K+ channels on b-cells in pancreas - raising calcium levels - promoting secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Pioglitazone MOA

A

Reduce insulin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

4th line treatment for T2DM

A

Metformin,
Sulfonylurea
Glucagon-like peptide 1 receptor agonist (-TIDES)

(MSG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

5th line treatment for T2DM

A

Insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

5 causes of non-diabetic hypoglycaemia

A
  1. Alcohol
  2. Liver failure
  3. Addison’s disease
  4. Islet’s cell tumours
  5. Hodgkin’s disease - anti-insulin receptor antibodies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

5 causes of hypercholesterolaemia

A
  1. Familial hypercholesterolaemia
  2. Hypothyroidism
  3. T2DM
  4. Glucocorticoids
  5. Alcohol abuse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Addison’s disease is caused by

A

Reduced production of adrenocortical hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

The zona glomerulosa (outer zone) produces

A

Mineralocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

The zona fasciculata (middle zone) produces

A

Glucocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

The zona reticularis and the adrenal medulla produce

A

Androgens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What 3 hormones are diminished in Addison’s?

A
  1. Cortisol
  2. Aldosterone
  3. DHEA (androgen sex steroid synthesis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

4 causes of Addison’s

A
  1. Adrenal autoantibodies
  2. Adrenal haemorrhage (anti-phospholipid syndrome, sepsis)
  3. Pituitary issues
  4. Hypothalamic issues - ACTH/CRH deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

A salty-food craving and unexplained weight loss could be a sign of

A

Addison’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Severe N&V with hypotension and fever is a sign of a

A

Adrenal crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Management in an adrenal crisi/cortisol deficiency (3)

A
  1. Glucocorticosteroid - Hydrocortisone
  2. Saline
  3. Glucose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Management for Addison’s

A
  1. Glucocorticoid - Hydrocortisone

2. Mineralocorticoid - Fludrocortisone

59
Q

Cushing’s syndrome is defined as

A

Excess cortisol from any cause

60
Q

3 causes of Cushing’s

A
  1. Long-term steroid use
  2. Pituitary adenoma
  3. Adrenal gland tumour
61
Q

Thin skin, striae, dyslipidaemia and hypertension are signs of

A

Cushing’s Syndrome

62
Q

Cushing’s Disease is defined as

A

Excess ACTH from anterior pituitary leading to excess cortisol

63
Q

Main cause of Cushing’s Disease

A

Anterior pituitary adenoma

64
Q

3 investigations for Cushing’s

A
  1. ACTH bloods
  2. Dexamethasone suppression test (stimulates cortisol)
  3. ACTH stimulation test
65
Q

Acromegaly is caused by excess?

A

Growth hormone post puberty

66
Q

Acromegaly is caused by

A

Pituitary adenomas, secreting excess GH

67
Q

Enlarging nose, separating teeth, snoring and excessive sweating are signs of

A

Acromegaly

68
Q

Diabetes insipidus is defined as

A

Inability to concentrate urine

69
Q

DI can be caused by what 2 main pathophysiology

A
  1. Reduced vasopressin - Brain injury, pituitary surgery

2. Vasopressin insensitivity in the kidney - Lithium, CKD

70
Q

What is vasopressin also known as?

A

ADH

71
Q

5 RF for DI

A
  1. Pituitary/hypothalamic disease
  2. FH
  3. Lithium
  4. CKD
  5. Hashimoto’s
72
Q

Polydipsia, polyuria and hypotonic urine are signs of

A

DI

73
Q

What electrolyte imbalance is caused by DI?

A

Hyponatraemia

74
Q

Gynaecomastia is caused by what underlying hormone

A

High oestrogen

75
Q

5 causes of gynaecomastia

A
  1. Normal physiology: Age - Newborn, puberty, old-age
  2. Anabolic steroids
  3. Impaired testosterone levels: PPIs, spironolactone
  4. Medications that increase oestrogen
  5. Prostate cancer treatment
76
Q

What drug can combat gynaecomastia?

A

Tamoxifen

77
Q

Galactorrhoea is defined as

A

Spontaneous milk flow associated with childbirth/nursing

78
Q

3 causes of galactorrhea

A
  1. Hyperprolactinaemia
  2. Hyperthyroidism
  3. Medication: SSRIs, antipsychotics, methyl-dopa, opioids
79
Q

Pheochromocytoma is a tumour in what cell type located where?

A

Chromaffin cells in adrenal medulla

80
Q

Brand name for metformin

A

Glucophage

81
Q

Metformin advice for patients (4 points)

A
  1. Continue with lifestyle changes
  2. Take whole with or after food with water to minimise GI side effects
  3. Notify doctors of metformin prior to CT/operations
  4. Limit alcohol - lactic acidosis (weakness, muscle pain, diarrhoea)
82
Q

Issue with weight gain in T2DM

A

More weight = more insulin resistance = worsened T2DM

83
Q

3 metformin contraindications

A
  1. eGFR < 30
  2. AKI
  3. IV contrast
84
Q

3 metformin cautions

A
  1. Alcoholism - hypoglycaemia risk
  2. Hepatic impairment
  3. CKD < 45 but > 30
85
Q

3 side effects of metformin

A
  1. Nausea
  2. Vomiting
  3. Taste disturbance
86
Q

Dual therapy Hba1c aim

A

< 53 mmol/mol

87
Q

Metformin and sulfonylureas only work when there is

A

Residual b-cell pancreatic function

88
Q

2 benefits of metformin over other anti-diabetic drugs

A
  1. No weight gain

2. No hypos

89
Q

Sulfonylureas advice

A
  1. Take with breakfast (30 mg -> 120 mg)
  2. Lifestyle measures are still important
  3. Be cautious of hypoglycaemia (sugar then starch)
  4. Caution if poorly - side effects more likely
90
Q

Contraindication of sulfonylureas

A

Pregnancy and breastfeeding = hypoglycaemia

91
Q

3 side effects of sulfonylureas

A
  1. GI upset
  2. Hypoglycaemia
  3. Weight gain
92
Q

3 adverse effects of sulfonylureas

A
  1. Hepatic toxicity
  2. Drug hypersensitivity syndromes
  3. Agranulocytosis
93
Q

2 Abx to avoid with sulfonylureas due to increased exposure

A
  1. Clarithromycin

2. Chloramphenicol

94
Q

Dipeptidylpeptidase-4 inhibitors are also known as

A

Gliptins

95
Q

Role of DPP-4 and MOA of DPP-4 inhibitors (gliptins)

A

DPP-4 hydrolyses incretins needed for stimulating insulin secretion/preventing glucagon release in the intestine

Inhibiting DPP-4 prevents hydrolysis of incretins, thus promoting insulin release and reducing glucose

96
Q

Perk of using a gliptin over a sulfonylurea (glicazide)

A

Gliptins are less likely to cause hypoglycaemia as they work in the presence of incretins aka sugar/food

97
Q

2 adverse side effects of gliptins

A

Pancreatitis and anaphylaxis

98
Q

Gliptins are taken in a fixed combination tablet with

A

Metformin

99
Q

What class of drug is pioglitazone?

A

Thiazdolidine

100
Q

3 risks of pioglitazone, particularly in those who are elderly or with risk factors?

A
  1. Bladder cancer
  2. Heart failure
  3. Increased risk of fractures
101
Q

Pioglitazone works by

A

Reducing peripheral insulin resistance to decrease blood sugar

102
Q

3 common side effects of pioglitazone

A
  1. Visual disturbance
  2. Weight gain
  3. Numbness
103
Q

Dose of pioglitazone and max daily dose

A

15-30 mg, max 45 mg

104
Q

SGLT-2 inhibitors are also known as

A

Gliflozins

105
Q

Anti-diabetic drug with the best vascular outcome

A

SGLT-2 inhibitors (gliflozin - canagliflozin)

106
Q

MOA of SLGT-2 inhibitors/gliflozins

A

Inhibit reabsorption of glucose from renal tubule into the blood, promoting urinary glucose loss and reduced blood glucose

107
Q

Anti-diabetic drug that promotes urinary glucose loss

A

SLGT-2 inhibitors

108
Q

3 adverse side effects of SLGT-2 inhibitors

A
  1. DKA
  2. Foot disease - ulceration/osteomyelitis/gangrene
  3. Fournier’s gangrene (genitals/perineum gangrene)
109
Q

3 side effects of SLGT-2 inhibitors

A
  1. UTI
  2. Constipation
  3. Thirst/hypotension/syncope
110
Q

GLP-1 receptor agonists include

A

Semaglutatide

111
Q

MOA of semaglutatide

A

SC injected drug that activates glucagon-like peptide 1 receptor to increase insulin secretion, suppress glucagon secretion and slow gastric emptying

112
Q

Anti-diabetic drug that can cause AV block or pancreatitis

A

GLP-1 receptor agonists

113
Q

Addison’s disease is what type of adrenalism

A

Hypoadrenalism

114
Q

3 causes of primary Addison’s

A
  1. Autoimmune (anti-21-hydroxylase)
  2. Adrenal haemorrhage - Waterhouse-Friderichsen (meningococcal septicaemia)
  3. Infection (TB, HIV)
115
Q

Hallmark symptom only seen in primary Addison’s

A

Hyperpigmentation, particularly of palmar creases or mucosal/sun-exposed areas

116
Q

Gold-standard test for Addison’s and how is it performed

A

ACTH stimulation test - short Synacthen test

  1. Measure plasma cortisol
  2. Administer Synacthen 250 ug IM
  3. Measure plasma cortisol 30 minutes later
117
Q

Investigation for Addison’s if ACTH test isn’t available

A

9am morning cortisol

118
Q

Patient education for Addison’s (4)

A
  1. Do not miss steroid doses
  2. Medi bracelet/steroid card
  3. Double dose if become unwell
  4. Hydrocortisone injection in unwell
119
Q

If morning cortisol comes back as < 500 nmol/l, what investigation should be done next?

A

ACTH stimulation

120
Q

2 causes of ACTH dependent Cushing’s (Disease or Ectopic)

A
  1. Pituitary tumours

2. SLCC

121
Q

3 causes of ACTH-independent causes of Cushing’s Syndrome

A
  1. Steroids
  2. Adrenal adenoma
  3. Adrenal carcinoma
122
Q

What 2 conditions mimic Cushing’s (pseudo)?

A
  1. Alcoholism

2. Severe depression

123
Q

Gold standard test for Cushing’s

A

Overnight dexamethasone suppression test

+ve when there is a morning cortisol spike (not suppressed)

124
Q

High TSH levels, low T4 levels and TPO antibodies are a sign of

A

Hashimoto’s

125
Q

Painful goitre with a raised ESR is

A

Subacute thyroiditis/de Quervain’s

126
Q

Fibrotic goitre is a sign of

A

Riedel’s thyroiditis

127
Q

Secondary hypothyroidism is suggestive of what pathology

A

Pituitary

128
Q

Untreated congenital hypothyroidism can cause

A

CI

129
Q

Dysgenesis of the thyroid refers to

A

Underdevelopment of the thyroid gland

130
Q

Prolonged neonatal jaundice, puffy face, macroglossia and hypotonia are signs of

A

Congenital hypothyroidism

131
Q

Reidel’s thyroiditis is linked to what other fibrosis?

A

Retroperitoneal

132
Q

Blood findings in subclinical hypothyroidism

A

Raised TSH, normal T4, sometimes antibodies

133
Q

TSH > 10 in subclinical hypothyroidism in a < 70 year old warrants

A

Levothyroxine

134
Q

2 underlying causes of pregnancy hyperthyroidism?

A
  1. HCG rise in 1st trimester activates TSH receptors

2. Rise in thyroxine binding globulin, increasing total T4

135
Q

5 issues linked to thyroid eye disease

A
  1. Exophthalmos
  2. Conjunctival oedema
  3. Optic disc swelling
  4. Ophthalmoplegia
  5. Inability to close eyelids
136
Q

2 skin complaints in Graves

A
  1. Pretibial oedema

2. Erythematous oedematous lesions over lateral malleolus

137
Q

3 points in thyroid acropathy

A
  1. Clubbing
  2. Soft tissue swelling of hands/feet
  3. Periosteal new bone formation
138
Q

Anti-thyroid drug given in pregnancy and biggest adverse effect

A

Propylthiouracil - hepatic injury

139
Q

Complication of autoimmune hypothyroid conditions in the acute phase?

A

Thyroid storm

140
Q

Nuclear scintigraphy finding in toxic MN goitre

A

Patchy uptake

141
Q

Difference between MN goitre and toxic MN goitre

A

MN goitre - Euthyroid

TMN goitre - Hyperthyroid

142
Q

Hashimoto’s is associated with what lymphoma

A

MALT

143
Q

Raised calcitonin may be a sign of

A

Medullary thyroid cancer

Module 2 (7 decks)

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