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Year 5 > MLA Endocrinology > Flashcards

MLA Endocrinology Flashcards

1
Q

What is Addison’s disease?

A

AKA primary adrenal insufficiency
- Impaired synthesis/release of glucocorticoids and mineralocorticoids

Causes: 75-90% autoimmune, or infections like TB and CMV or steroid use

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2
Q

Who is most likely to get Addison’s disease?

A

Women (90%)
Those with other autoimmune disease

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3
Q

What are some symptoms of Addison’s disease?

A

Fatigue
Muscle weakness
Anorexia
Loss of libido (hypoandrogenism)
Goitre

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4
Q

What is an Addisonian crisis?

A

An acute state of severe cortisol and aldosterone deficiency

Symptoms: severe weakness, severe abdo pain, nausea, vomiting, profound hypotension, reduced consciousness

Management: IV hydrocortisone, fluid resuscitation, and electrolyte monitoring

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5
Q

What is the function of glucocorticosteroids in the body?

A

AKA corticosteroids

Function: supress immune response, balance stress response, glucose and protein homeostasis, inti-inflammatory

Eg. cortisol

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6
Q

What is the function of mineralocorticoids in the body?

A

Regulate salt and water balance

Eg. aldosterone

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7
Q

What is Cushing’s syndrome?

A

Too much cortisol

  • Causes obesity and stunted grow in children
  • Excess hair in women
  • Irregular periods
  • Erectile dysfunction
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8
Q

What is the pathophysiology of gestational diabetes?

A

The placental hormones cause insulin resistance and the pancreas can’t produce enough hormones to overcome these effects

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9
Q

What is the management of gestational diabetes?

A

1st line: exercise and dietary changes
2nd line: meds like metformin insulin

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10
Q

What is the pathophysiology of diabetes insipidus?

A

Issues with ADH

Nephrogenic: kidneys don’t respond to ADH
- Mostly hereditary. Also caused by chronic kidney disease, pregnancy, electrolyte imbalances

Central: pituitary gland doesn’t produce enough ADH
- Mostly caused by trauma to the pituitary gland or tumours

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11
Q

What are the symptoms of diabetes insipidus?

A

Polyuria
Extreme thirst

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12
Q

How is diabetes insipidus diagnosed?

A

Fluid deprivation test

Neurogenic DI: low [urine] normalises with desmopressin.
Nephrogenic DI: low [urine] regardless of desmopressin.
Primary polydipsia: high [urine]

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13
Q

What is the pathophysiology of diabetic ketoacidosis?

A

When there is not enough glucose because of not enough insulin so the body breaks down fat for energy. If prolonged, the ketones build up and cause acidosis

Affects type 1 diabetics

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14
Q

What is the function of albumin?

A

Produced in the liver

Function: prevents fluids from leaking out of vessels and it carries hormones and enzymes

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15
Q

How is albumin linked to diabetic nephropathy?

A

Damaged vessels of the kidneys will leak proteins like albumin into the urine which can be detected to diagnose diabetic nephropathy

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16
Q

What are the causes of secondary hypertension?

A
  • Aldosteronism
  • Cushing’s syndrome
  • Sleep apnoea
  • Hyperparathyroidism
  • Endocrine disease
  • Phaeochromocytoma
17
Q

How can hyperlipidaemia occur?

A

Mainly diet, lifestyle, and genetics

Also diabetes, hypothyroidism, cushing’s syndrome, anorexia nervosa

18
Q

What is a hypermolar hyperglycaemia state?

A

AKA HHS
- Very high sugar levels in T2DM without presence of ketones causing dehydration and confusion

19
Q

What are some causes of hyperparathyroidism?

A

Primary causes
- Parathyroid hyperplasia
- carcinoma
- Ectopic secretion

Secondary causes
- Vitamin D or calcium deficiency
- Kidney failure

20
Q

What are the symptoms of hyperparathyroidism?

A

Usually asymptomatic

Can cause increased thirst, depression, nausea and vomiting, constipation, confusion, high BP, palpitations, hair loss

21
Q

What are the complications of hyperthermia?

A

Eg. heat stroke or heat exhaustion
- Precipitated by dehydration

Kidney and liver damage
Rhabdomyolysis
Confusion
Headache

22
Q

What are some complications of hypothermia?

A

Kidney failure
Pancreatitis
Arrhythmias
Frostbite
Pulmonary oedema

23
Q

What is osteomalacia?

A

‘Bone softening’ caused by prolonged vitamin D deficiency

Treatment: correct the cause, offer surgery for deformities

24
Q

What are the different thyroid disease?

A

Hashimoto’s: autoimmune hypothyroidism
- Causes fatigue, constipation, dry skin, hair loss, goitre, menstrual changes

Graves: autoimmune hyperthyroidism
- Causes bulging eyes, weight loss, anxiety, fatigue, fast metabolism

25
Q

What are the causes of SIADH?

A
  • Pituitary abnormality
  • Malignancy (small cell lung cancer)
  • Meds like antidepressants
  • Hypothyroidism
26
Q

What are the clinical findings of a pituitary tumour?

A
  • Sudden headache
  • Visual changes (loss of peripheral vision)
  • Menstrual irregularities and erectile dysfunction
27
Q

What’s a short synacthen test?

A

It measures persons ability to produce cortisol

Synacthen is injected and that stimulates the adrenal glands, followed by two blood tests to measure cortisol levels

28
Q

What’s Conns disease?

A

Primary hyperaldosteronism

Symptoms: High blood pressure, poor vision, headaches, muscular weakness, muscle spasms

29
Q

What is the difference between thyrotoxicosis and thyroid storm?

A

Thyroid storm: when there is end organ damage

Both are a complications of hyperthyroidism but thyrotoxicosis is first

Often caused by Graves disease

30
Q

What’s the most common cause of asymptomatic hypercalacaemia?

A

Almost always primary hyperparathyroidism

Sometimes malignancy but that has symptoms

31
Q

What is Trousseaus test?

A

Tie a cuff around the arm and increase the pressure for 3 mins

Positive test is flexion of the hand if there is hypocalcaemia

32
Q

How can ketones be decreased in the blood?

A

Give dextrose and insulin at the same time to stop neoproduction of ketones

33
Q

How does HSS kill?

A

It causes the blood to ‘thicken’ because of the excess glucose so the patient is at high risk of clots and occlusions

34
Q

What is a Charcot’s foot?

A

Characterised by 5 D’s:
Density change,
Destruction, Debris, Distension, Dislocation
- Progressive destruction of the joints

Often caused by gout and diabetes mellitus

35
Q

What are the characteristics oh Horner’s syndrome?

A
  1. Partial ptosis (drooping or falling of the upper eyelid)
  2. Miosis (constricted pupil)
  3. Facial anhidrosis
  4. Enopthalmos (sunken eyes appearance)
  5. Hoarse voice

Year 5 (16 decks)

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