Endocrinology Flashcards
What is the management for subacute thyroiditis?
Supportive care, anti-thyroid medications are ineffective, NSAIDs
What does Nelson’s syndrome cause?
Cushing’s syndrome after bilateral adrenalectomy
Causes increased CRH, which leads to anterior pituitary adenoma
Causes headache, visual field defects, hormonal issues (skin pigmentation)
What is the treatment for Cushing’s syndrome?
Metyrapone (blocks steroid synthesis pathway)
What are the symptoms of carcinoid syndrome? What is the test and management?
Flushing, diarrhoea, hypotension, wheezing, right atrial enlargement
Test - urinary 5-HIAA
Management - Octreotide
What is the treatment of Grave’s disease?
Carbimazole - inhibits thyroid peroxidase enzyme, side effect = rash, pruritus
What are the symptoms of primary hyperaldosteronism?
Weakness, cramps, parasthesia, thirst, hypokalaemia, increased aldosterone:renin ratio
What are the causes of primary hyperaldosteronism?
Bilateral adrenal hyperplasia, Conn’s, familial hyperaldosteronism, adrenal carcinoma
What is the treatment for primary hyperaldosteronism?
K+-sparing diuretics (Amiloride, Spironolactone, Eplerenone)
What HTN medication is contraindicated in pregnancy?
ACEi and ARB
What is the first treatment for hypopituitarism?
Cortisol
Which medication is preferred for pregnancy females with hypothyroidism?
Propylthiouracil > carbimazole
Propanolol - symptomatic relief
What is the test for an insulinoma?
24 hr fast
What does a raised PTH, decreased calcium and no kidney disease indicate?
Pseudohypoparathyroidism
What is the treatment for hypoglycaemia unawareness?
Decrease insulin, more than normal blood glucose target
If severe = 10% IV dextrose and glucagon
What is the triad for phaechromocytoma?
Headache, sweating, tachycardia
What is seen in the investigations of bilateral adrenal hyperplasia?
normal sodium, decreased potassium, primary hyperaldosteronism, secondary HTN
Why does sulphonylureas cause hypoglycaemia?
Increased K+ channel closing, more insulin release, more risk of hypoglycaemia
What are the signs of secondary hyperparathyroidism and what can cause it?
Low Ca2+, high phosphate, high PTH, high ALP
CKD, decreased phosphate excretion
Vit D deficiency has low phosphate
What is the first line investigation for Cushing’s?
Overnight dexamethasone suppression - plasma cortisol levels are measured 8am the next day
What are the signs of prolactinoma in men and women?
Women -> amenorrhoea, galactorrhea, infertiltiy
Men -> gynaecomastia, erectile dysfunction, decrease sex drive, less body hair
Headache, N&V, sweating
