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Phase 3 > Endocrinology (Week 9) > Flashcards

Endocrinology (Week 9) Flashcards

1
Q

What fasting glucose level is indicative of diabetes?

A

> /=7 mmol/L

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2
Q

What random plasma glucose level is indicative of diabetes?

A

> /= 11mmol/L

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3
Q

What is the significance of testing C-peptide in diabetes diagnosis?

A

Secreted in equimolar concentration to insulin (shows level secreted in blood/urine)

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4
Q

What is the significance of HbA1c in diabetes diagnosis?

A

Shows blood sugar levels over the last 6-8 weeks

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5
Q

Name three causes of pancreatic diabetes

A
  1. Pancreatectomy
  2. Pancreatitis
  3. Cystic Fibrosis
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6
Q

Why do patients with pancreatic diabetes have a greater risk of hypoglycaemia than T1DM?

A

Due to loss of alpha cells and hence glucagon

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7
Q

What does LADA stand for?

A

Latent autoimmune diabetes of the adult

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8
Q

What is the average HbA1c target for diabetics?

A

HbA1c <53mmol/L

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9
Q

What is the mechanism of action of Metformin?

A

Reduced hepatic glucose production and increased muscle uptake and peripheral sensitivity

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10
Q

What is the mechanism of action of Sulfonylureas?

A

Close K+ channels in beta cells to release insulin

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11
Q

What is the mechanism of action of DDP-4 inhibitors?

A

Enhance effect of endogenous incretin to increase insulin release and decrease glucagon secretion

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12
Q

What is the mechanism of action of Flozins?

A

Inhibit SGLT-2 transported in PCT to decrease renal glucose absorption

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13
Q

What is the mechanism of action of Glitazones?

A

Increase fat, muscle and liver sensitivity to endo and exo insulin

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14
Q

What is the major side effect of Metformin?

A

Diarrhoea

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15
Q

During pituitary pathology, which cells are lost first and which cells tend to preserved until late disease?

A

1st to be lost: somatotrophs (hence growth hormone)

Last to be lost: Thyrotrophs

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16
Q

Bruit and thyroid eye disease are indicative of which condition?

A

Grave’s disease

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17
Q

Name 2 treatments for hyperthyroidism

A
  1. Beta blockers for symptom relief e.g. sweating

2. Carbimazole to block thyroid hormone production

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18
Q

Name a drug which actively causes hyper- and hypothyroidism

A

Amiodarone

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19
Q

In thyroid eye disease, what is lid lag?

A

If the sclera is seen above the iris

20
Q

What is exophthalmos?

A

If the sclera is seen below the iris, indicates changes in pupil

21
Q

What does proptosis indicate?

A

Changes behind the pupil

22
Q

Which layer of the adrenal cortex produces aldosterone?

A

Zona glomerulosa

23
Q

Which layer of the adrenal cortex produces cortisol?

A

Zona fasciculata

24
Q

Which layer of the adrenal cortex produces androgens?

A

Zona reticularis

25
Q

What cells produce catecholamines and where are they found?

A

Chromograffin cells in the adrenal medulla

26
Q

Name three tests used to diagnose Cushing’s syndrome

A
  1. 24hr free urinary cortisol
  2. Urine cortisol:creatinine ratio
  3. Dexamethasone suppression test
27
Q

What is Addison’s disease?

A

Primary adrenal insufficiency

28
Q

What test is commonly used in Addison’s disease diagnosis?

A

Short synacthen test

29
Q

What is congenital adrenal hyperplasia?

A

AR disorder with deficiency of 21 alpha-hydroxylase so cortisol cannot be produced

30
Q

How is late onset CAH diagnosed?

A

Short synacthen test with 17-OH progesterone (cortisol precursor)

31
Q

What is the best screening tool in primary aldosteronism?

A

Aldosterone-renin-ratio

32
Q

What is a paraganglioma?

A

Catecholamine producing tumour outside the adrenal glands in neural crest cells anywhere in the sympathetic chain

33
Q

Name the three components of Whipple’s triad

A
  1. Hypoglycaemia symptoms
  2. Low plasma glucose
  3. Symptoms resolve after plasma glucose raised
34
Q

In multiple endocrine neoplasia type 1, what three areas are predisposed to tumours?

A

Pancreas
Pituitary (anterior)
Parathyroids

35
Q

Name 4 symptoms of carcinoid syndrome

A
  1. Flushing
  2. Diarrhoea
  3. Asthma
  4. Right heart valvular lesions
36
Q

What is hirsutism?

A

Male pattern hair growth due to increased androgens and increased skin sensitivity to them

37
Q

Name the three chemicals implicated in PCOS

A
  1. Gonadotrophins
  2. Androgens
  3. Insulin
38
Q

In hypogonadotrophic hypogonadism, where is the problem?

A

Hypothalamus or anterior pituitary

39
Q

In primary gonadal failure, where is the problem?

A

Testes

40
Q

Give three signs of hypogonadism in children

A

Slow growth
Small testes
Lack of 2nd sexual characteristics

41
Q

Give three signs of hypogonadism in adults

A

Low libido
Depression
ED

42
Q

On an orchidometer, what testes volume indicates late puberty?

A

12-15ml

43
Q

What syndrome is described as isolated gonadotrophin deficiency when GnRH cells don’t migrate to the hypothalamus?

A

Kallmann’s syndrome

44
Q

In Kallmann’s syndrome, which sense is often absent?

A

Smell

45
Q

What sex chromosome karyotype is seen in Klinefelter’s syndrome?

A

XXY

46
Q

How does androgen binding protein assist in sperm development?

A

It ‘locks’ testosterone in the testes to encourage sperm maturation

47
Q

What is bimanual synkinesia?

A

R and L hands execute same movements despite only one being intentionally moved

Phase 3 (15 decks)

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