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Lottie's Question Books > Endo > Flashcards

Endo Flashcards

1
Q

Tingling fingers and toes. Carpopedal spasm. Dx?

A

Hypocalcaemia

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2
Q

What is Trousseau’s sign?

A

Muscle spasming of the hand and forearm due to occlusion of brachial artery

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3
Q

List signs of hypocalcaemia

A

Chvostek’s sign
Prolonged QT interval
Hyperreflexia
Stridor

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4
Q

Young pt with heart problems, cleft palate and low Ca. Dx?

A

DiGeorge’s syndrome

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5
Q

Depression, constipation and renal stones. Dx?

A

Hypercalcaemia

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6
Q

What is the main cause of hyper Ca?

A

PTH tumours

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7
Q

What causes primary hyperparathyroidism?

A

Parathyroid adenomas producing XS PTH

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8
Q

What causes secondary hyperparathyroidism?

A

Compensatory increase in PTH in CKD or Vit D def

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9
Q

What causes tertiary hyperparathyroidism?

A

Long secondary hyperPTH eg CKD

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10
Q

What is Conn’s syndrome?

A

Hyperaldosteronism due to adrenal tumour

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11
Q

What is the first Ix for someone with suspected Conn’s?

A

24hr ambulatory BP - to rule out essential HTN

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12
Q

What are further Ix for Conns?

A

Aldosterone-renin ratio
CT scan
Abdo USS

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13
Q

What causes phaeochromocytomas?

A

Adrenal medulla tumours

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14
Q

What is principle of initial Tx against a phaeo?

A

Complete alpha and beta blockade

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15
Q

What drugs are used in initial Tx of phaeo?

A

Phenoxybenzamine (alpha blocker)

Propanolol (beta blocker)

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16
Q

What drug is used in the later stages of phaeo Tx and how?

A

Sodium nitroprusside - to vasodilate ( esp during surgery to remove tumour )

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17
Q

47 y/o with weight loss, hyperglycaemia and ketones in the urine. Dx?

A

Latent autoimmune diabetes of adults (LADA)

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18
Q

What is predictive of LADA disease progression?

A

Islet cell ABs

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19
Q

What is the 1st line Tx for T2DM?

A

Lifestyle changes eg diet and exercise

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20
Q

What is best Tx for overweight/obese T2DM pts, after lifestyle changes?

A

Metformin

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21
Q

What is best Tx for NON-overweight/obese T2DM pts, after lifestyle changes?

A

Sulphonylureas

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22
Q

Firm lump on abdo of someone with long standing T1DM. Dx?

A

Lipohypertrophy due to xs injections in one site

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23
Q

Precocious puberty, cushing features, acromegaly, brown spots on back. Dx?

A

McCune-Alrbright Syndrome

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24
Q

What are the brown spots on the back of someone with McCune-Albright syndrome?

A

Cafe-au-lait spots

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25
Q

What causes Sx in McCune-Alrbright Syndrome?

A

Uncontrolled secretion of a number of endocrine glands

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26
Q

What is a genetic lack of GnRH called?

A

Kallman Syndrome

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27
Q

List Sx of Kallman’s syndrome in men

A

Hypogonadism - lack of pubic hair, undescended testes, low plasma testosterone, infertility

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28
Q

What distinguishes Kallmans from idiopathic hypogonadotrophic hypogonadism?

A

Ansomia (loss of smell) in Kallmans

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29
Q

What is the karyotype of Kleinfelters?

A

47 XXY (extra X chromosome)

30
Q

Tiredness, cold intolerant, weight gain. Best Ix?

A

TSH

31
Q

Painful neck, fever, HTN, tachycardia. Then 2 weeks later is cold intolerant. Dx?

A

De Quervain’s thyroiditis

32
Q

6 y/o with abdo pain, N&V, tachypnoea, cap refil, dry tongue. What would her breath smell like?

A

Fruity

33
Q

6 y/o with abdo pain, N&V, tachypnoea, cap refil, dry tongue. Dx?

A

Diabetic ketoacidosis

34
Q

Man with Cushing’s disease who had a bilateral adrenalectomy. 1 year later has constant dull headache, visual disturbances and pigmented skin creases. Dx?

A

Nelson syndrome

35
Q

What is a Nelson syndrome?

A

Loss of negative feedback due to bilateral adrenalectomies causes formation of macroadenoma in pituitary. Secretes ACTH.

36
Q

What is the cause of Addison’s?

A

Autoimmune destruction of adrenals

37
Q

What is the best way to measure diabetes adherence?

A

HbA1c

38
Q

What does HbA1c actually show?

A

Glycated Hb over the past 3 months

39
Q

Unconscious diabetic with very good insulin injection regime who has recently been stressed. Likely Dx?

A

Hypoglycaemic coma due to missed meals but regular insulin

40
Q

What is first line medical treatment for diabetes in a healthy weight man with very high HbA1c?

A

Sulphonylureas

41
Q

What is first line medical Tx for diabetic who is overweight and slightly elevated HbA1c?

A

Metformin

42
Q

Man with protruding jaw who needs his wedding ring cut off. Ix?

A

Glucose tolerance test

43
Q

Why is GH level not measured for acromegaly Ix?

A

GH is so fluctuant and may be raised during stress

44
Q

List complications of acromegaly

A

HTN and heart failure

Colon cancer

45
Q

What is initial Mx for acromegaly?

A

Trans-sphenoidal surgery

46
Q

Pt with polyuria, polydipsia, weight loss. What is likely fasting plasma glucose?

A

> 7mmol/L

47
Q

What are Sx of Carcinoid syndrome?

A

Diarrhoea, dementia, dermatitis

48
Q

What is Carcinoid syndrome?

A

Metastases of carcinoid tumours, usually starting in appendix or ileum

49
Q

Anorexia, lethargy, polydipsia, polyuria, dehydration, abdominal pain, vomiting and coma. Dx?

A

DKA coma

50
Q

What is the most common ECG finding of PE?

A

Sinus tachycardia

51
Q

In which type of DM is DKA most common?

A

1

52
Q

Long Hx of dehydration in T2DM patient. BCG is >35mmol/L. Dx?

A

Hyperosmolar hyperglycemic state (HHS)

53
Q

What are the criteria for diagnosis of DKA?

A

raised blood glucose(>11.1 mmol/L), or known diabetes
ketonuria ++ or more
serum bicarbonate <15 mmol/L
pH<7.3 (if measured)

54
Q

What is the equation for anion gap?

A

(Na+ and K+) – (Cl- and HCO3-) ≈ 10 to 18mmol/L

55
Q

What is best 1st Mx of DKA?

A

Obtain good intravenous access and run in 1 litre of 0.9% sodium chloride - to correct fluid depletion

56
Q

Should HbA1c be part of the DKA Mx?

A

NO - shows BGC over last 3 months, so not immediately relevant

57
Q

What is involved in a septic screen?

A

MSU, chest X-ray and blood cultures

58
Q

What is 2nd Mx for DKA? Why?

A

Give 0.9% sodium chloride with 40mmol potassium
- Patients with DKA are potassium depleted and plasma potassium levels fall as it is driven into cells by the action of insulin

59
Q

Why should DKA patients have a urinary catheter placed?

A

Oligo-anuria is a sign of inadequate intravascular fluid replacement and may precede impending renal failure requiring haemofiltration
Also allows regular dipstick for ketones

60
Q

Why should insulin be continued in DKA patients even after BGC is normal?

A

To clear ketones

61
Q

How do glistens help with DM control?

A

Gliptins (DPP-4 inhibitors) reduce the peripheral breakdown of incretins such as GLP-1

62
Q

What type of drug is gliclazide?

A

Sulphonylurea

63
Q

What is the mechanism of action of sulphonylureas?

A

stimulating the sulphonylurea-1 receptors on the pancreatic cells to stimulate insulin production

64
Q

What is the mechanism of DKA?

A

Uncontrolled lipolysiswhich results in an excess of free fatty acids that are ultimately converted to ketone bodies

65
Q

How do you calculate the anion gap?

A

(Na+K) - (HCO3+Cl)

66
Q

What is the normal range for an anion gap?

A

10-18mmol/L

67
Q

Sudden headache, vomitting, visual disturbance.

O/E bitemporal superior quadrantopia. Hyperdense area in pituitary gland. Dx?

A

Pituitary apoplexy

68
Q

List causes of pituitary apoplexy

A

Sudden growth of pituitary adenoma / infarction

69
Q

Which CN are affected in pituitary apoplexy?

A

CN III, IV, VI

70
Q

What is Kallman’s syndrome?

A

Gonadotrophin deficiency and anosmia

Lottie's Question Books (15 decks)

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