BMJ Flashcards
(15 cards)
What drugs can exacerbate statin related myopathy
Calcium channell blockers, macrolides, fibrates, amiodarone and grapefruit juice
A condition which may improve with insulin therapy
Diabetic amyotrophy - characterised by proximal muscle wasting
A dermatological marker of insulin resistance
Acanthosis nigricans
Difference between Cushings syndrome and Disease
Syndrome - due to corticosteroid immune suppression
Disease - due to pituitary adenoma
Causes of hypercalcaemia
- Malignancy.
- Hyperparathyroid
3.
Other
endocrine (Addison’s, phaeochromocytoma, hyperthyroidism)
dehydration
respiratory (Sarcoidosis, TB)
drugs (lithium, thiazides, Vitamin D)
How does diabetic amyotrophy present?
Painful asymmetrical proximal motor neuropathy of the lower limbs (initially pain in the thigh which progress to muscle wasing, loss of knee reflexes and tender proximal muscles)
Cuased by occlusion of the vasa nervorum of the proximal lumbar plexus and/or femoral nerve
Equivalent glucocorticoid action of prednisolone to hydrocortisone
4:1
So if on 20 of hydrocort in a day
you need to divide by 4 to get pred dose
5mg
Risk factors for cataracts
Female sex
steroid use
DM
uveitis
Smoking
ETOH
What percentage of patients with resistant hypertension have primary aldosteronism?
30%
What percentage of patients with primary aldosteronism have associated hypokalaemia?
30%
Causes of a false-positive ARR
beta-blockers, central agonists (clonidine, α-methyldopa), nonsteroidal anti-inflammatory drugs, liquorice, renal impairment and oral oestrogens.
How long should an infant not be breast fed after a radionuclide scan?
Tc-99m pertechnetate is concentrated in breast milk; therefore, infants should not be breastfed for 26 hours after their mother has undergone scintigraphy.
Approximately what percentage of cases of secondary amenorrhoea in women of reproductive age are caused by hyperprolactinaemia?
Hyperprolactinaemia is discovered in approximately 15% of cases of secondary amenorrhea in women of reproductive age, and the measurement of serum prolactin should be undertaken in all women presenting with menstrual disturbance or infertility.
In a patient taking OCP or carbemazepine in whom you suspect Cushings Syndrome - what would you order?
For most patients in the primary care setting, the 1 mg overnight DST is best. Instances in which the 1 mg DST is not suitable include when a patient is taking CYP3A4 enzyme–inducing medications such as carbamazepine (increased metabolism of dexamethasone, leading to non-suppression of cortisol) or they are taking oral oestrogens, including the oral contraceptive pill (increased serum cortisol from oestrogen stimulation of corticosteroid-binding globulin).
Then do 24 hr urinary cortisol
