Random stuff Flashcards
What are the lab values for calcium, phosphate, ALP, and PTH in osteoporosis?
Calcium: Normal
Phosphate: Normal
ALP: Normal
PTH: Normal
What are the lab findings in primary hyperparathyroidism (leading to osteitis fibrosa cystica)?
Calcium: Increased
Phosphate: Decreased
ALP: Increased
PTH: Increased
How do calcium, phosphate, ALP, and PTH levels change in osteomalacia?
Calcium: Decreased
Phosphate: Decreased
ALP: Increased
PTH: Increased
How does chronic kidney disease (leading to secondary hyperparathyroidism) affect calcium, phosphate, ALP, and PTH levels?
Calcium: Decreased
Phosphate: Increased
ALP: Increased
PTH: Increased
What are the lab values in Paget’s disease of bone?
Calcium: Normal
Phosphate: Normal
ALP: Increased
PTH: Normal
What are the expected lab values for osteopetrosis?
Calcium: Normal
Phosphate: Normal
ALP: Normal
PTH: Normal
What are the thyroid function test results in primary hypothyroidism?
TSH: High
T3: Low
T4: Low
What are the thyroid function test results in secondary hypothyroidism?
TSH: Low
T3: Low
T4: Low
What are the thyroid function test results in sub-clinical hypothyroidism?
TSH: High
T3: Normal
T4: Normal
What are the thyroid function test results in primary hyperthyroidism?
TSH: Low
T3: High
T4: High
What are the thyroid function test results in secondary hyperthyroidism?
TSH: High
T3: High
T4: High
What are the thyroid function test results in sub-clinical hyperthyroidism?
TSH: Low
T3: Normal
T4: Normal
What is another name for sick euthyroid syndrome?
Non-thyroidal illness
What happens to TSH, T4, and T3 levels in sick euthyroid syndrome?
TSH: Usually inappropriately normal (but can be low)
T4 (Thyroxine): Low.
T3 (Triiodothyronine): Low
Why is TSH considered “inappropriately normal” in sick euthyroid syndrome?
Because TSH should be high when T4 and T3 are low, but in this condition, it remains normal or low
What causes sick euthyroid syndrome?
Severe systemic illness, such as sepsis, trauma, or chronic disease
How do thyroid function tests change after the illness resolves and what is the treatment?
They return to normal once the patient recovers and no treatment is needed
What are the three zones of the adrenal cortex
Zona Glomerulosa
Zona Fasciculata
Zona Reticularis
What does the zona glomerulosa of the adrenal cortex produce?
Mineralocorticoids, mainly aldosterone
What does the zona fasciculata of the adrenal cortex produce?
Glucocorticoids, mainly cortisol
What does the zona reticularis of the adrenal cortex produce?
Sex steroids (androgens) and some glucocorticoids
Where are the adrenal glands located?
Superior and medial to the upper pole of the kidneys
What is the weight of each adrenal gland?
Around 4-5 grams per gland
What are the two main parts of the adrenal gland?
Outer cortex and central medulla
A 39-year-old man presents with headaches and excessive sweating. He also reports some visual loss. Visual fields testing reveal loss of temporal vision bilaterally
What is this describing?
Acromegaly
High insulin, High C-peptide means what?
Endogenous insulin production
= Insulinoma or sulfonylurea use/abuse
In hypercalcaemia secondary to malignancy what would blood results look like?
PTH is low, although PTHrP may be raised
What is used in the management of prostate cancer may result in gynecomastia?
GnRH agonists (e.g. goserelin)
A 56-year-old female is admitted to ITU with a severe pneumonia. Thyroid function tests are most likely to show
- TSH normal/low
- Thyroxine low
- T3 low
No action neccarsily
John, 84, has been previously diagnosed with metastatic prostate cancer. He is brought to the emergency department by his family due to confusion which began approximately one day ago. John had previously been complaining of increased drowsiness, nausea, decreased appetite and aching pains in his legs before the onset of confusion.
John’s medications include MST, Oramorph and co-danthramer. His last set of blood results were taken by his GP 2 months ago and showed a slight hypernatraemia. Which of the following electrolyte imbalances is the most likely cause of his current symptoms?
The mnemonic for remembering the symptoms of hypercalcaemia is stones, bones, groans, thrones and psychiatric overtones. Breaking this down we get:
- Stones (renal)
- Bones (bone pain)
- Groans (abdominal pain, nausea and vomiting)
- Thrones (polyuria)
- Psychiatric overtones (confusion and cognitive dysfunction, depression, anxiety, insomnia, coma)
hypercalcaemia
What can give a falsely low HbA1c?
premature red blood cell death
= HBA1C is a form of haemoglobin
sickle-cell anaemia, GP6D deficiency and hereditary spherocytosis
Thyrotoxicosis with tender goitre treatment
Conservative management with ibuprofen
IF YOU KNOW ITS TO DO WITH MALIGNANCY WHAT THE FUCK DO YOU PRESS
ANY FORM OF FUCKING CANER, MYELOMA, LYMPHOMA ANYTHING
BENCE JONCE PROTEINS RELATED TO MYELOMA
ANYTHING RELATED TO A CANCER
Where does anti-diuretic hormone (ADH) promote water reabsorption in the kidneys, and how does it do so?
ADH, also known as vasopressin, is released by the posterior pituitary and promotes water reabsorption in the collecting ducts of the kidneys by stimulating the insertion of aquaporin-2 channels
An F1 who has just started has been asked to draw up 10 units of insulin using an insulin syringe. However, he makes the serious error of using a normal syringe to draw the insulin up and draws up 10ml of a standard insulin preparation. The nurse on the ward spots his doing this and immediately stops him before a serious error, and explains to him the vital importance of using an insulin syringe.
How many units of insulin did the F1 draw up?
1 ml of insulin = 100 units
10 ml of insulin = 100 units/ml × 10 ml = 1000 units of insulin.
What does Trousseau’s sign indicate, and how is it tested?
Indicates hypocalcaemia
= It is tested by inflating a blood pressure cuff above the patient’s systolic pressure for about 2 minutes, causing carpopedal spasm (a tightening of the hand and fingers)
What is Chvostek’s sign, and what does a positive result indicate?
test for hypocalcaemia
= It is elicited by tapping over the parotid gland (near the facial nerve, CN VII), causing a twitch or spasm of the facial muscles if the sign is positive
