Formative Quiz Flashcards
insulin receptor type?
tyrosine kinase
growth hormone receptor?
cytokine
calcium receptor type?
GPCR
how does insulin affect hepatic glycogen synthesis?
increases it
anabolic hormone (not catabolic)
increases DNA synthesis
what is the cavernous sinus?
part of the brains dural venous sinus
either side of the sella turcica (where pituitary sits)
what cranial nerves are found around the cavernous sinus and intermediate vicinity?
3, 4, 5(1), 5(2), 6
which structure is at risk of damage in total thyroidectomy?
recurrent laryngeal nerve
which diabetics need to check blood glucose every time they drive?
everyone on insulin
what is the target of action for the drug dapagliflozin?
sodium glucose cotransporter-2 (SGLT2)
what is the most appropriate first line action for an ulcer in a type 2 diabetic with fever, nausea and sweats?
IV antibiotics
don’t need to swab first - commence best guess antibiotics
graves disease vs toxic multi-nodular goitre vs thyroiditis on thyroid uptake scan?
graves disease = even uptake - whole gland would be dark
nodular = patchy uptake - patches of dark
thyroiditis = whole gland would be grey or white as no uptake
side effects of carbimazole?
granulocytosis
- can present as severe sore throat and fever
- should stop carbimazole and do urgent FBC
solitary thyroid nodule with normal thyroid function, no inflammatory infiltrate or visible nodule?
papillary thyroid cancer
first line treatment for prolactinoma?
cabergoline (dopamine agonist)
- can give for 3-5 years (usually normalises within a few months, shrinks tumour within 3-5 years)
surgery = last resort
what visual field is affected by an enlarged pituitary?
bi-temporal hemianopia
first line for addisons disease?
..
how is an adrenal tumour managed (causing sweating, panic attacks with hypertension and raised urinary catecholamines)?
alpha then beta blockers
beta blocker first can cause hypotensive crisis due to unopposed alpha action?
what initial test is done for primary hyperaldosteronism(conns syndrome)?
paired renin and aldosterone measurement
saline suppression test can be used before surgery
hypercalcaemia associated with a raised parathyroid hormone level and high urinary calcium, thyroid uptake scan showed a dark right inferior parathyroid gland?
right inferior parathyroid adenoma
best initial test for Cushing’s?
low dose dexamethasone suppression test
best initial test for acromegaly?
glucose tolerance test
- should suppress growth hormone if normal
most appropriate initial action in Addisonian crisis?
urgent IV normal saline and hydrocortisone
goal for all diabetics is HbA1c <53, true or false?
false
all diabetics needs to check blood glucose at least once per day?
no
only if on insulin, SURs or relevant job
is metformin always first line in type 2?
no - majority but not all
hypoglycaemia management?
20% dextrose
presentation of non-functional pituitary tumour?
headache
no hormonal effects
bloods can show some low hormone levels and some higher hormone levels
treatment of non-functional pituitary adenoma if anterior pituitary dysfunction (abnormal synacthen, high prolactin, low testosterone, low LH, low T3/T4 with normal TSH)
hydrocortisone
always steroids first (straight into thyroxine can cause crisis)
raised calcium in child
father has primary hyperparathyroidism, recurrent peptic ulcer and raised prolactin
what is the genetic condition?
MEN1
3 Ps - parathyroid, pancreas, pituitary
