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MSRA > Endocrinology/metabolic > Flashcards

Endocrinology/metabolic Flashcards

1
Q

What biochemical abnormality does vitamin D deficiency lead to?

A

Low calcium
Low phosphate
Secondary hyperparathyroidism
Raised ALP

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2
Q

Give an example of a long acting insulin

A

Glargine (Lantus)

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3
Q

What is the treatment for acute symptomatic hyponatraemia?

A

Hypertonic saline

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4
Q

What are the causes of a low TSH and normal T4?

A

Sublcinical hyperthyroidism
Thyroxine ingestion

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5
Q

What is the normal anion gap range?

A

12-17 mmol/l

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6
Q

What is pseudohypoparathyroidism caused by?

A

Resistance to PTH
Results in low calcium, high PTH and high phosphate
Skeletal abnormalities including short stature, rounded face, shortened fourth metacarapals

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7
Q

Describe the thyroid morphology in Hashimoto’s thyroiditis

A

Large, firm and lobulated due to lymphocytic infiltration and fibrosis

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8
Q

Describe the thyroid morphology in Riedel’s thyroiditis

A

Replacement of the normal thyroid parenchyma by dense fibrosis extending beyond the capsule

Most patients are euthyroid but 1/3rd become hypothyroid

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9
Q

What is the most common type of thyroid cancer?

A

Papillary - affecting 20-55 year olds

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10
Q

How does ACTH work?

A

Activates the 20,22 desmolase enzyme which catalyses the rate limiting step in adrenal steroidogenesis

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11
Q

How do you diagnose diabetes mellitus?

A

HbA1c > 48mmol/mol
Fasting glucose >7 mmol/l
Random glucose >11.1 mmol/l

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12
Q

What is POEMs syndrome?

A

Polyneuropathy, organomegaly, endocrinopathy and m-protein band from a plasmacytoma & skin pigmentation/tethering

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13
Q

What is milk-alkali syndrome?

A

Triad of hypercalcaemia, renal failure and metabolic alkalosis secondary to ingestion of large amounts of calcium and absorbable alkali

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14
Q

What is the most common cause of subclinical hypothyroidism?

A

Chronic autoimmune thyroiditis

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15
Q

How should you further investigate subclinical hypothyroidism?

A

Repeat measurement after 3 months

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16
Q

In which groups should HbA1C not be used to diagnose DM?

A

<18y
Pregnant women or women who are <2m postpartum
Symptoms of diabetes <2m
Acutely ill
Medication that may cause hyperglycaemia
Acute pancreatic damage
HIV infection
ESRD

17
Q

How do you calculate plasma osmolarity?

A

2xNa + Ur + glucose

18
Q

What is the normal range for plasma osmolarity?

A

285-295 mmol/l

19
Q

Name some clinical features of Grave’s disease

A

Exophthalmos
Ophthalmoplegia
Thyroid acropatchy
Pretibial myxoedema

20
Q

What is the genetic defect in MEN1?

A

Mutations in the tumour suppressor gene MEN1

21
Q

What is the genetic defect in MEN2?

A

Mutations in the RET proto-oncogene

22
Q

Name some causes of hypoglycaemia

A

Exogenous
Pituitary insufficiency
Liver failure
Addison’s disease
Islet cell tumours
Non-pancreatic neoplasms

23
Q

How do you biochemically diagnose acromegaly?

A

IGF-1 is better than GH due to more consistent serum levels

24
Q

What is a ‘medical’ III nerve palsy?

A

III palsy with pupillary sparing as fibres for sphincter pupillae run on the outside

25
Q

What is the HbA1C target if taking a drug associated with hypoglycaemia?

A

52mmol/mol

26
Q

Name some secondary causes of DM

A

Drugs: steroids, thiazides
Pancreatic disease: pancreatitis, Ca, haemoschromatosis, CF
Endocrine: Cushing’s, thyrotoxicosis, phaeo, acromegaly
Others: glycogen storage diseases, insulin receptor antibodies

27
Q

What are the clinical features of toxic multinodular goitre?

A

Also known as Plummer’s disease
Most patients are over 50
Consists of a thyroid gland with autonomously functioning thyroid nodules

28
Q

Which genetic mutations are implicated in hereditary haemochromatosis?

A

C282Y & H63D HFE mutations commonly tested

29
Q

In which conditions may you find lanugo?

A

Premature newborns
Anorexia nervosa

30
Q

How does Danazol work?

A

It inhibits pituitary gonadotrophins

31
Q

Name some clinical features of medullary thyroid carcinoma

A

Diarrhoea and facial flushing due to excessive calcitonin
Malignancy of parafollicular C-cells

32
Q

Name some clinical features of papillary thyroid carcinoma

A

Occurs more frequently in women
Presents in 30-40yr age group

MSRA (13 decks)

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