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Phase3 Specialties - Imperial College London MBBS > MLA Endocrinology > Flashcards

MLA Endocrinology Flashcards

1
Q

OGTT threshold for diabetes diagnosis?

A

> 11.1

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2
Q

Which investigation as an alternative to HbA1c is recommended in patients with existing haemoglobinopathy?

A

Fructosamine test

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3
Q

What is the diagnostic threshold for type 2 diabetes mellitus on fasting blood glucose?

A

> 7.0

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4
Q

What is the HbA1c range associated with impaired glucose tolerance?

A

42-47

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5
Q

Which auto-antibody (3) is associated with type 1 diabetes mellitus?

A

Islet cell
Anti-GAD
ZnT8

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6
Q

Which blood test should be performed in patients with suspected type 1 diabetes?

A

C-peptide (low) indicates insulin deficiency (marker of beta-cell function)

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7
Q

Which type of T1DM presents in adulthood?

A

Latent autoimmune diabetes in adults (LADA)

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8
Q

What is the cause of type 3c diabetes mellitus?

A

Pancreatogenic e.g., chronic pancreatitis, pancreatic cancer, CF, haemochromatosis

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9
Q

What are the side effects associated with metformin?

A

Diarrhoea

Lactic acidosis

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10
Q

What are the common adverse effects associated with SGLT-2 inhibitors?

A

UTIs
Thrush
Fournier’s gangrene
Euglycaemic ketoacidosis

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11
Q

What should be done to sustained release metformin in patients presenting with diarrhoea?

A

Switch to a modified release

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12
Q

Which anti-hyperglycaemic drug is associated with weight gain?

A

Sulfonylureas / glitazones

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13
Q

Which cancer risk is increased in patients on glitazones?

A

Bladder cancer

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14
Q

What is the initial insulin regimen for diabetes?

A

Basal bolus regimen

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15
Q

What severe features are associated with non-proliferative diabetic retinopathy?

A

Cotton wool spots

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16
Q

On biopsy, what is the characteristic finding observed in patients with diabetic nephropathy?

A

Kimmelstein-Wilson nodules

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17
Q

Which neuropathic medication is indicated in the management of diabetic neuropathy?

A

Duloextine
Amitriptyline
Gabapentin
Pregablin

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18
Q

Which nerve in the thigh is affected in amyotrophy (diabetes)?

A

Femoral nerve

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19
Q

What rheumatological manifestations are associated with T2DM?

A

Charcot neuroarthropathy
Adhesive capsulitis

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20
Q

What is the glucose threshold for hypoglycaemia in patients with diabetes?

A

<4.0 mmol/L

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21
Q

Which drug class can cause impaired hypoglycaemia awareness?

A

Beta-blockers

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22
Q

What is the first-line management option in patients with hypoglycaemia (conscious)?

A

Oral glucogel
Sugary drink

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23
Q

Unconscious - hypoglycaemia management (1st line)

A

IM glucagon or IV glucose (10-20%)

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24
Q

pH diagnostic threshold for DKA?

A

<7.3

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25
Q

Bicarbonate threshold for DKA?

A

<15

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26
Q

1st line management for DKA?

A

1L stat 0.9% sodium chloride then 1 hour then 2 hours.

27
Q

Following fluid resuscitation, what is the next most appropriate management for DKA?

A

Fixed-rate insulin 0.1 Units /kg

28
Q

What is the glucose threshold to begin administering glucose?

A

CBG <14

29
Q

What is the complication of rapid correction of glucose?

A

Central pontine myleinolysis

30
Q

What is the fasting plasma glucose level for gestational diabetes?

A

5.6

31
Q

What is the 2-hour OGTT threshold for gestational diabetes?

A

7.8

32
Q

What are the foetal complications associated with gestational diabetes?

A

Macrosomia

Shoulder dystocia

Polyhydramnios

Hypoglycaemia (neonatal)

Stillbirth

33
Q

When is a 75 g 2 hour OGTT test performed during pregnancy?

A

At 24-28 weeks

34
Q

If the FPG is >7.0 during pregnancy, what medication is recommended?

A

Insulin

35
Q

1st line management for gestational diabetes if fasting blood glucose is 6.0 - 6.9?

A

Metformin

36
Q

When are diabetic drugs discontinued during gestational diabetes?

A

Immediately postpartum

37
Q

Which criteria is used to diagnose FH?

A

Simon–Broome Criteria

38
Q

What is the inheritance pattern for familial hypercholesterolaemia?

A

Autosomal dominant

39
Q

What is the total cholesterol threshold for FH?

A

> 7.5 mmol/L

40
Q

What is the first line management of cranial diabetes insipidus?

A

Desmopressin

41
Q

What is a common cause of pseudohyponatraemia?

A

High glucose, lipids or paraproteins

42
Q

What sodium level is associated with severe hyponatraemia?

A

<120 mmol/L (normal range 135-145)

43
Q

What is the management of hyponatraemia in patients with SIADH?

A

Fluid restriction and vaptans

44
Q

What is the most common cause of hypercalcaemia?

A

Primary hyperparathyroidism (parathyroid adenoma)

45
Q

What ECG findings are consistent with hypercalcaemia?

A

Short QT interval
J waves

46
Q

What is the most important blood test to perform in a patient with hypercalcaemia?

A

Serum parathyroid hormone

47
Q

What is the first line management of hypercalcaemia?

A

Intravenous fluids 4-6 L in 24 hours

48
Q

What is the second step in the management of hypercalcaemia?

A

IV bisphosphonates

49
Q

What is the main cause of secondary hyperparathyroidism?

A

Vitamin D deficiency, Chronic kidney disease

50
Q

What is the mechanism of action of Denusomab?

A

RANK-L inhibitor

51
Q

What is a common complication of thyroidectomy?

A

Hypocalcaemia

52
Q

What is the first line management of severe symptomatic hypocalcaemia?

A

IV calcium gluconate

53
Q

What ECG findings are associated with hypokalaemia?

A

ST depression
T-wave flattening
PR prolongation
U waves

54
Q

What is the standard rate of potassium replacement in hypokalaemia?

A

10 mmol/hour

55
Q

What drug is indicated to stabilise the cardiac membrane in patients with hyperkalaemia and ECG changes?

A

Calcium gluconate

56
Q

Where is aldosterone produced in the adrenal cortex?

A

Zona glomerulosa

57
Q

Where are glucocorticoids produced in the adrenal cortex?

A

Zona fasciculata

58
Q

Which drugs can induce adrenal insufficiency?

A

Long-term steroids
Ketoconazole

59
Q

What is the first line test for diagnosing Addison’s disease?

A

9 am cortisol + ACTH (Synacthen test)

60
Q

What is the first line management for an Addisonian crisis?

A

IV hydrocortisone

61
Q

Sick day rules for Addison’s disease?

A

Double hydrocortisone dose and keep the fludrocortisone dose the same

62
Q

What is the acid-base status for Addison’s?

A

Hyperkalaemic metabolic acidosis

63
Q
A

Phase3 Specialties - Imperial College London MBBS (12 decks)

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