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Helena's finals > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Hypoglycaemia cut off

A

Less than 4 mmol/L

Make 4 the floor

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2
Q

Drug most likely to cause hypoglycaemia

A

Sulphonylureas

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3
Q

Alcohol withdrawal

A

Lorazepam/diazepam
Pabrinex
Glucos
Supportive care

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4
Q

Hyperthyroidism medication in pregnancy

A

1st trimester stop carbimazole and start propylthiouracil
- carbimazole risk of congenital abnormalities

2nd trimester switch back to carbimazole
- propylthiouracil high risk of severe hepatic injury

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5
Q

Is levothyroxine safe in pregnancy and breastfeeding?

A

Yes

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6
Q

How does thyroxine requirement change in pregnancy

A

Increases

So hypothyroid patients need to increase by 50%

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7
Q

SGLT-2 inhibitors example, MOA and side effects

A

Empaglifozin, ertugliflozin

Reversible inhibit sodium glucose co transporter 2 in renal PCT to reduce glucose reabsorp and more glucose peed out

Benefit is also lose weight

Risk is glucosuria results in UTI, thrush
Also, normoglycaemic ketoacidosis

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8
Q

insulinoma triad of symptoms

A

whipple’s triad

  1. hypoglycaemia with fasting/ exercise
  2. recorded low BMs at time of symptoms
  3. reversal of symptoms with glucose (food)
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9
Q

which MEN disease is associated with insulinomas?

A

MEN 1

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10
Q

symptoms of hypoglycaemia

A

weakness, diplopia, dizziness

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11
Q

corticosteroid side effects

A

endocrine - impaired glucose regulation, increased appetite, weight gain, hyperlipidemia, hirsutism, cushing’s syndrome

Musk - osteoporosis, avascular necrosis of femoral head, proximal myopathy

immunosuppressive (+ paradoxical raised neutrophils)

psychiatric - insomnia, depression, psychosis

GI: peptic ulceration, pancreatitis

opthalmic: cataracts
derm: acne

grow suppression in children

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12
Q

mineralocorticoid side effects

A

fluid retension

hypertension

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13
Q

useful antibody for type 1 diabetes

A

anti-GAD
glutamic acid decarboxylase
present in 80% of patients

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14
Q

bony mets vs multiple myeloma as a cause of hypercalcaemia

A

very hard to distinguish

multiple myeloma: CRAB

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15
Q

primary vs secondary adrenal insufficiency

A

skin pigmentation
primary - high ACTH but adrenal gland not responding. ACTH is a large pre-cursor that includes melanocyte-stimulating hormone so more pigmented

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16
Q

Klinefelters vs Kallman’s syndrom

A

Klinefelter’s syndrome 47 XXY - low testosterone, high Lh/FHS

Kallman’s X linked - hypogonadotrophic hypogonadism - low/normal LH, FSH, low testosterone

17
Q

lady on long term steroids for rheumatoid arthritis, has surgery for something and then shortly after becomes hypotensive and delirious

A

adrenal insufficiency!
long term steroidshas resulted in adrenal insufficiency
surgery has increased her coritsol requirements
she is having an addisonian crisis so needs IV hydrocortisone

18
Q

1st line treatment for brain mets

A

high dose dexamethasone to reduce cerebral oedema

19
Q

diabetes drug contraindicated in heart failure

A

Thiazolidinediones eg. Pioglitazone

20
Q

what diabetes drug is contraindicated in breast feeding and pregnancy?

A

sulfonylureas eg. gliclazide

21
Q

Ectopic ACTH secretion from?

A

small cell lung cancer

22
Q

cardiac symptoms of thyrotoxicosis

A

AF, high output cardiac failure

23
Q

consequence of overtreatment with levothyroxine

A

osteoporosis

24
Q

reasons why HbA1c might not be accurate

A

increased RBC turnover rate (shorter lifespan) - haemolysis, sickle cell, G6PD deficiency

decreased HbA1c turnover rate (longer lifespan) - B12/ folate/ iron deficiency, splenectomy

25
Q

effect of thyrotoxicosis on heart

A

AF

high output heart failure

26
Q

Less important antibodies t1dm

A

Auto islet cell antibodies

Auto insulin antibodies

27
Q

T2dm starting on statin?

A

QRISK Score CVD risk in 10 years
Over 10
Start on statin

28
Q

Reason to avoid metformin

A

eGFR < 30

29
Q

T3 vs T4

A

T3 is 4 times more active than the more abundant T4. The half-life of T4 is 5-7 days; the half-life of T3 is only 1 day.

30
Q

which diabetes drug has increased risk of urinary/genital infections?

A

SGLT-2 inhibitors (empagliflozin, dapaglifoflozin)
they reversible inhibit the SGLT-2 in the renal PCT

there is glycosuria which increases urine/genitala infections

Helena's finals (22 decks)

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