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Specialities > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

What is acromegaly?

A

A condition caused by excessive growth hormone resulting in a coarse facial appearance, larger tongue and excessive sweating and oily skin.

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2
Q

What are the causes of acromegaly?

A
  • Pituitary adenoma (>95% of cases)

- Ectopic GHRH or GH production by tumours e.g. pancreatic (rare)

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3
Q

What are the features of acromegaly?

A
  • Coarse facial appearance, spade-like hands, increase in shoe size
  • Large tongue, prognathism, interdental spaces
  • Excessive sweating and oily skin: caused by sweat gland hypertrophy
  • Features of pituitary tumour: hypopituitarism, headaches, bitemporal hemianopia
  • Raised prolactin in 1/3 of cases → galactorrhoea
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4
Q

In what condition do 6% of patients have MEN-1?

A

Acromegaly

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5
Q

What is the first-line treatment for acromegaly?

A

Trans-sphenoidal surgery

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6
Q

If surgery to remove a pituitary tumour causing acromegaly cannot be done (unresectable) then what is the treatment?

A

1st line: somatostatin analogue (adjuncts dopamine agonist and debulking surgery)

2nd line: growth hormone-receptor antagonist (GHRA)

3rd line: radiotherapy

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7
Q

What is the method of action of a somatostatin analogue?

A

It directly inhibits the release of growth hormone

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8
Q

In what proportion of patients with acromegaly are somatostatin analogues effective?

A

50-70%

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9
Q

In what proportion of patients with acromegaly are GH receptor antagonists effective?

A

90%

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10
Q

What is an example of a somatostatin analogue?

A

Octreotide

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11
Q

What is an example of a GH receptor antagonist?

A

Pegvisomant

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12
Q

What is an example of a dopamine agonist?

A

Bromocriptine

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13
Q

What is Graves’ disease?

A

An autoimmune condition associated with hyperthyroidism

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14
Q

What are the key diagnostic factors for Graves’ disease?

A
  • Heat intolerance
  • Sweating
  • Weight loss
  • Palpitations
  • Tremor
  • Diffuse goitre
  • Orbitopathy
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15
Q

What is the treatment for Graves’ disease?

A

Antithyroid drug therapy such as carbimazole or thiamazole

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16
Q

What is Hashimoto’s thyroiditis?

A

Autoimmune-mediated lymphocytic inflammation of the thyroid gland resulting in a destructive thyroiditis with release of thyroid hormone and transient thyrotoxicosis (hyperthyroidism)

17
Q

What is Hashimoto’s thyroiditis also known as?

A

Lymphocytic thyroiditis

18
Q

What are the key diagnostic factors of Hashimoto’s thyroiditis?

A
  • Heat intolerance
  • Nervousness
  • Small non-tender goitre
  • Tremulousness
19
Q

What is the treatment for a moderate/severe thyrotoxic phase of Hashimoto’s thyroiditis?

A

Beta-blocker/calcium-channel blocker plus corticosteroid e.g. atenolol/verapamil and prednisolone

20
Q

What can low levels of parathyroid hormone indicate?

A
  • Hypoparathyroidism
  • Cancer that has spread to the bones
  • Excess calcium
  • Sarcoidosis
  • Low magnesium
  • Vitamin D toxicity
21
Q

What drug belongs to the class biguanides?

A

Metformin

22
Q

How do biguanides work?

A
  • Increasing insulin sensitivity
  • Increasing glucose uptake by cells therefore reducing plasma glucose concentrations
  • Decreasing liver gluconeogenesis
23
Q

What are alpha-glucosidase inhibitors and how do they work?

A

A class of diabetes medication that stop blood glucose levels rising too fast after eating

24
Q

What is an example of an alpha-glucosidase inhibitor?

A

Acarbose

25
Q

What are gliptins?

A

DPP-4 inhibitors used to treat type 2 diabetes

26
Q

How do gliptins work?

A

1) Blocks DPP-4
2) Increases activity of incretins
3) Incretins stimulate insulin release and inhibit glucagon release
4) Blood glucose is lowered

27
Q

What are sulfonylureas and how do they work?

A

A class of drug used to treat type 2 diabetes. They work by increasing the amount of insulin produced by the pancreas

28
Q

What are two examples of sulfonylureas?

A
  • Gliclazide

- Glimepiride

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