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Endocrine > Physiology > Flashcards

Physiology Flashcards

1
Q

Drugs that can cause SiADH?

A

SSRI’s
Carbamazepine
Cyclophosphamide

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2
Q

Drugs that can cause nephorgenic DI

A

Lithium
Demeclocycline

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3
Q

Causes of nephrohenic DI

A

Hereditary
Hypercalcaemia
Hypokalaemia
Drugs (lithium, demeclocyline)

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4
Q

Treatment for central Diabetes insipidis

A

Desmopressin

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5
Q

What is Sheehans syndrome

A

Ischaemic infarct of pituitary following severe post partum haemorrhage (increased pituitary growth in pregnancy = more vulnerable to hypoperfusion)

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6
Q

What is pituitary apopexy

A

Sudden haemorrhage of the pituitary usually in the presence of an existing pituitary adenoma

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7
Q

Diagnosing acromegaly

A

Increased serum IGF- 1
Failure to suppress GH following glucose tolerance test
Pituitary MRI

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8
Q

What is subacute granulomatous thuroiditis

A

DeQuervain thyroiditis
Transient Hyperthyroid - euthyroid - hypothyroid - euthyroid
Often after viral infection
Painful jaw and tender thyroid
Granulomatous inflammation

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9
Q

Features of reidel thyroiditis

A

Slowly enlarging, hard (rock-like), fixed nontender thyroid

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10
Q

What is Reidel thyroiditis

A

Also called invasive fibrous thyroiditis
May occur as part of IgG4 related diseases
Hypothyroidism in 1/3
Fibrosis may extend to surrounding structures

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11
Q

Features of congenital hypo thyroidism

A

6 P’s
Pot bellied
Protruding tongue
Protruding umbillicus
Poor brain development
Pale
Puffy face

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12
Q

Histology found in graves disease

A

Tall, crowded follicular epithelial cells, scalloped colloid

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13
Q

Antibodies associated with graves disease

A

HLA-DR3, HLA-B8

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14
Q

Histology of pappilary thyroid cancer

A

“Pap and mama adopted orphan annie”
Psammoma bodies
Empty nuclei with central clearing (orphan annie’s)
Grooved nuclei

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15
Q

What is medullary thyroid cancer arised from?

A

Parafollicular C cells

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16
Q

Histology staining of medullary thyroid Ca

A

Congo red

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17
Q

Electrolyte disturbance associated with medullary thyroid Ca

A

Hypocalcium - due to increased calcitonin produced from parafollicular c cells

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18
Q

Mutation associated with anaplastic thyroid cancer

A

TP53

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19
Q

Lab values hypoparathyroidism vs pseudohypoparathyroidism

A

Hypopara - low Ca, increased PO, low PTH
Pseudohypopara - low Ca, increased PO, high PTH

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20
Q

What condition is hashimotos thyroiditis associated with?

A

MALT lymphoma

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21
Q

What is the mechanism by which ADH causes hyponattaemia

A

Insertion of aquaporin 2 channels

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22
Q

How can insulin decrease K levels

A

Increases Na / K pump

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23
Q

What diabetic medication is associated with UTI’s and why

A

Dabagliflozin
Sodium glucose co-transporter 2 inhibitors: increase urinary excretion of glucose which provides an environment for bacterial growth

24
Q

What diabetic medication is associated with pancreatitis?

A

Enexatide
(GLP-1 analogues)

25
Q

What diabetic medication is associated with fractures

A

thiazolidinediones i.e. pioglitazone

26
Q

What is waterhouse-frideeichsen syndrome

A

Bilateral adrenal haemorrhage in the setting of infection causing acute adrenal insufficiency

27
Q

Causes of primary secondary and teritary adrenal insufficiency

A

Primary - addisons (autoimmune adrenal atrophy)
Secondary - pituitary
Tertiary - exogenous removal of steroids (tertiary from treatment)

28
Q

What does a phaeochromocytoma arises from?

A

Chromaffin cells (arise from neural crest)

29
Q

Extra adrenal locations of phaeochromocytoma

A

Bladder wall
Organ of zuckerkandI

30
Q

Treatment for pheochromocytoma

A

Alpha antagonist (phenoxybenazmine) before beta antagonist to prevent hypertensive crisis

31
Q

What is found in the urine due to a phaeochromocytoma

A

Catecholamines and metanephrines
(E.g. homovanilic acid, vanillylamndelic acid)

32
Q

Where does a neuroblastona arise from

A

Adrenal medulla

33
Q

Histology finding in neuroblastoma and medulloblastoma

A

Homer-wright rosettes (neuroblasts surrounding a central area of neurophil)
Bombedin and NSE positive

34
Q

MEN 1 features

A

MEN1 gene (codes for menin found oj chromosome 11)
3 P’s
Pancrease, pituitary and parathyroid

35
Q

MEN 2A gene and features

A

RET (protooncogene, codes for tyrosine kinase receptor, chromosome 10)
2 P’s and 1 M
Parathyroid, medullary thyroid cancer and phaeochromocytoma

36
Q

MEN 2B gene and features

A

Mutations in RET gene, may have marfans habitus
1 P and 2 M’s
Phaeochromocytoma
Medullary thyroid cancer
Mucosal neuromas

37
Q

Features of glucaganoma

A

6 D’s
Dermatitis
Diarrhoea
Depression
Declining weight
Diabetes
DVT

38
Q

Features of somatostatinoma

A

Diabetes / impaired glucose tolerence
Steattorhoea
Gallstones
Achlorhydria

39
Q

Where do carcinoid tumours origionate from

A

Neuroendocrine cells, most commonly intestines or lung

40
Q

What substance does carcinoid tumours secrete?

A

5-HT

41
Q

Histology of carcinoid tumours

A

Carcinoids Really Can Sting
Rosettes
Chromogranin A positive
Synaptophysin

42
Q

Urinary feature of carcinoid tumours

A

Invreased urinary 5-HIAA

43
Q

How does carcinoid tumours cause carcinoid syndrome

A

They produce 5-HT which undergoes heparic first pass metabolism and enzymatic breakdown by MAO in the lung. If 5-HT reaches the systemic circulation (i.e. liver mets) causes carcinoid syndrome

44
Q

Features of carcinoid syndrome

A

Flushing
Wheezing
Diarrhoea
Right sided valvular failure
Niacin deficiency

45
Q

Mechanism of heat intokerence snd weight loss on hyperthyroidism

A

Increased Na/K/ATPase = increase metabolic rate = calorigenesis

46
Q

Mechanism of myxedema in hypothyroidism

A

Increase GAG’s in interstitial space = increased osmotic pressure = water retension

47
Q

Mechanism of secondary hyperparathyroidism

A

Low Ca or high PO causes parathyroid hyperplasia = increase PTH and ALP

48
Q

How does siADH cause hyponatraemia

A

Decreases aldosterone which increases Na urinary excretion

49
Q

Pathophysiology of hashimotos

A

lymphocytic infiltratation of the thyroid gland and formation of germinal centers

50
Q

CKD can cause hyperparathyoirdism, what lab values would you expect to find

A

low ca
high PO4
high PTH
high alk phosphatase

51
Q

medullary thyroid cancer is associated with what gene

A

RET gene
sometimes associated with MEN2A and MEN2B

52
Q

radiation to the neck is a major risk factor for what type of thyroid cancer

A

papillary

53
Q

FNA of thyroid nodule shows amyloid deposits

A

medullary thyroid cancer

54
Q

how is ACE inhibitors renoprotective in diabetes

A

normalises albuminuria

55
Q

acarbose drug action

A

alpha glucosidase inhibitor
used in diabetes to decrease cho absorption from GI tract

56
Q

side effects of acarbose (alpha-glucosidase inhibitor)

A

flatulence
GI symtpoms

Endocrine (3 decks)

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