Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 3 - MedEd Lectures > Endo 1 > Flashcards

Endo 1 Flashcards

1
Q

What is Diabetes Insipidus?

A

Inadequate secretion or insensitivity to ADH, leading to ‘Hypotonic Polyuria’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the two types of Diabetes Insipidus?

A

Cranial/Central: Failure of the posterior pituitary to secrete ADH

Nephrogenic: Collecting ducts become insensitive to ADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What causes Cranial/Central Diabetes Insipidus?

A

Pituitary Tumour

Infection (Meningitis)

Sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can cause Nephrogenic DIabetes Insipidus

A

Hypercalcaemia

Hypokalaemia

Lithium

Inherited Genes (AVPV2)

Idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How would a patient with Diabetes Insipidus typicall present?

A

Polyuria (incl. nocturia)

Polydipsia

Symptoms of Hypernatraemia (Lethargy, Irritability, Confusion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How would you investigate a potential case of Diabetes Insipidus?

A

U&Es, Glucose

Water Deprivation Test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is a water deprivation test used to diagnose Diabetes Insipidus?

A

Water restricted for 8 hours, with plasma and urine osmolality measured every hour.

Give Desmopressin after 8 hours and measure urine osmolality.

In cranial DI - Increase of >50% post-desmopressin

In nephrogenic DI - Increase of <45% post-desmopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you manage a patient with Diabetes Insipidus?

A

Treat the underlying cause

Intranasal Desmopressin (Cranial)

Thiazide Diuretics/NSAIDS (Nephrogenic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do T1DM and T2DM differ in terms of presentations?

A

Both present with Polyuria + Polydipsia

T1 presents with Tiredness, weight loss, DKA,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does a patient experiencing a DKA present?

A

Nausea and Vomiting

Abdominal Pain

Kussmaul Breathing

Sweet Breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the risk factors for T1 and T2 DM?

A

T1 - HLA DR3/4, Other autoimmune conditions

T2 - Obesity, FHx, ethnicity, endocrine disease, drug use.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is Diabetes Mellitus diagnosed?

A

Fasting Glucose >7 mmol/L

Random Glucose >11.1 mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is T1DM managed?

A

Insulin

Education

Fluids for DKA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is T2DM managed?

A

Diet and Lifestyle advice

Metformin +/- sulphonylurea +/- Insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the main causes of Hyponatraemia?

A

Hypovolaemic - Diarrhea, Vomiting, Diuretics

Euvolaemic - Hypothyroidism, Hypoadrenalism, SIADH

Hypervolaemia - HF, Cirrhosis, Nephrotic Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How would you investigate a euvolaemic patient with Hyponatraemia?

A

TFTs

Short synACTHen test

Drug Review

Breast Exam

CXR/Brain MRI (For tumour - SIADH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How would you determine the volaemic status of a patient with hyponatraemia?

A

Hypo - Reduced turgor, postural hypotension, dry mucous membranes

Hyper - Oedematous, High JVP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does Hypernatraemia present?

A

Lethargy, irritability, thirst, dehydration, confusion, coma, fits.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What may cause Hypernatraemia?

A

Rare

Vomiting

Diarrhoea

DI

Primary Aldosteronism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is SIADH?

A

Syndrome of Innappropriate ADH secretion.

Not a diagnosis

Need to find an underlying cause.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What can cause SIADH?

A

CNS Pathology

Lung Pathology

Drugs: SSRI, TCA, Opiates, PPIs, Carbamazepine

Tumours (don’t forget breast)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What can cause Hyperprolactinaemia?

A

Pituitary Prolactinoma

Hypothyoridism

Drugs (Metoclopramide, antipsychotics)

Physiological causes, such as pregnancy

23
Q

How does hyperprolactinaemia present?

A

Women - Galactorrhoea, amenorrhoea, infertility

Men - Loss of libido, infertility, galactorrhoea

Tumour Symptoms - Headache, Bitemporal Hemianopia

24
Q

How would you investigate the cause of Hyperprolactinaemia?

A

Prolactin levels

TFTs

Pituitary MRI

25
Q

How would you manage a patient with Hyperprolactinaemia?

A

1) DA Agonist - Bromocriptine (Amir Sam says Cabergoline - both are used)
2) Surgery

26
Q

How does Hyperthyroidism present?

A

Heat Intolerance, Sweating

Palpitations

irritable

Weight Loss (Good appetite)

Diarrhoea

Menstrual Irregularities/Impotence

Tremor

27
Q

How does Hypothyroidism present?

A

Cold Intolerance

Bradycardia

Lethargy

Weight Gain

Constipation

Menstrual Disturbance

Dry skin

28
Q

What are the main causes of Hyperthyroidism?

A

Grave’s Disease

De Quervain (Viral) thyroiditis

Toxic Multinodular Goitre

Adenoma

29
Q

What is Grave’s Disease?

A

Autoantibodies to TSH receptor

Associated with other Autoimmune Diseases

Triad = Exopthalmos, Pretibial Myxoedema, Thyroid Acropachy (Nail changes)

30
Q

How does De Quervain’s Thyroiditis typically present?

A

Post-Viral

Presents with Fever, high ESR, Painful Goitre

Self-Limiting (NSAID treatment)

31
Q

How does Toxic Multinodular Goitre typically present?

A

In the elderly, and in areas where iodine diet deficincies are more likely.

32
Q

What is a Thyroid Adenoma?

A

Single nodule producing T3/4

33
Q

What would you see on Radioisotope Uptake scans for the main common causes of Hyperthyroidism?

A

Grave’s - Diffuse increased uptake

De Quervain’s Thyroiditis - No Uptake

TMG - Multiple areas of increased uptake

Adenoma - Single area of increased uptake

34
Q

What are the main causes of Hypothyroidism?

A

Autoimmune Hashimoto’s Thyroiditis (Common in the West)

Iodine Deficiency (Common Worldwide)

Iatrogenic - Post-Surgery, radioiodine, amiodarone

De Quervain’s Thyroiditis - Hypo once supplies are exhausted

Congenital

35
Q

How would you manage a patient with Hypothyroidism?

A

Levothyroxine

36
Q

What are the main types of Thyroid Cancer?

A

Papillary

Follicular

Medullary

Lymphoma

Anaplastic

37
Q

What is Papillary Thyroid Cancer?

A

Most Common, affecting younger patients

Risk factor- Radiation Exposure

SBA Buzzwords - ‘Psammoma Bodies’, ‘Orphan Anne Nuclei’

38
Q

What is Follicular Thyroid Cancer?

A

Type affecting middle aged women predominantly

SBA Buzzwords - Hurthle Cells

39
Q

What is Medullary Thyroid Cancer associated with?

A

MEN2, FHx important

40
Q

What is a Thyroid Lymphoma?

A

Cancer more common in females, general occurs after ore-existing Hashimoto’s thyroiditis

41
Q

What is Anaplastic Thyroid Cancer?

A

The most aggressive Thyroid Cancer

Affects mainly Elderly Females

SBA Buzzwords - Giant Cells, Pleomorphic Hyperchromatic Nuclei

42
Q

What is Acromegaly?

A

Hypersecretion of GH in Adults.

43
Q

What most commonly causes Acromegaly?

A

GH secreting Adenoma in the Pituitary

44
Q

How does Acromegaly typically present?

A

Rings and shoes become tight

Sweaty, oily skin

Weight Gain

Headaches/Vision changes

Carpal Tunnel Syndrome

HTN

Insulin Resistance

45
Q

How would you investigate a possible case of Acromegaly?

A

Serum IGF-1 as screening

OGTT - Failure to suppress GH after being given glucose orally - this is diagnostic.

MRI brain to assess tumour

46
Q

How do you manage Acromegaly?

A

1) Transphenoidal Hypophysectomy
2) Somatostatin Analogue (Octeotride)

47
Q

What is Multiple Endocrine Neoplasia?

A

Autosomal dominant condition causing the formation of multiple hormone-producing tumours in mutliple organs.

48
Q

What is MEN1?

A

The formation of Endocrine tumours in the Parathyroid Gland, Pancreas and Pituitary Gland

49
Q

What can a MEN1 tumour in the Pituitary cause?

A

Hyperprolactinaemia

Acromegaly

Hyperadrenalism

Carcinoid Syndrome

50
Q

Which tumours does MEN2 typically present with?

A

Thyroid (Medullary)

Adrenal (Phaeochromocytoma)

Parathyroid Hyperplasia

51
Q

What is Carcinoid Syndrome?

A

Syndrome caused by systemic release of humoural factors from Carcinoid Tumours

Leads to increased production of secretory products, such as Serotonin, Histamine, Tachykinins and prostaglandins.

Commonly occur in the Appendix and Rectum

52
Q

How does Carcinoid Syndrome typically present?

A

Paroxysmal Flushing

Diarrhoea

Crampy Abdo pain

Wheeze

Sweating

Palpitations

53
Q

How would you investigate a possible case of Carcinoid Syndrome?

A

24Hr Urinary 5-HIAA Levels

Serotonin metabolite, increased in Carcinoid Syndrome

CT/MRI to localise tumours

Year 3 - MedEd Lectures (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions