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J Endocrine > Conditions summary > Flashcards

Conditions summary Flashcards

1
Q 
4 year old 
peeing lots 
v tired at preschool 
hungry all the time but lean
hyperglycaemia  
low c peptide
islet cell auto-antibodies present
A

type 1 diabetes

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2
Q

type 1 diabetes treatment

A

insulin (almost always)

v v v last line;
drugs - not SUs
surgery

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3
Q 
28 year old male 
lean 
hyperglycaemia 
peeing lots 
hungry all the time  
islet cell auto-antibodies present
A

latent autoimmune diabetes on adulthood (LADA)

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4
Q 
50 year old male 
BMI 35 
family history of diabetes
tired all the time (TATT) 
thirsty 
polyuria  
high c peptide
A

type 2 diabetes

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5
Q

type 2 diabetes treatment (4)

A
  1. lifestyle changes
  2. metformin
  3. metformin + something else (SU (gliclazide), gliptin, GLP1 (exenatide))
  4. metformin + SU + insulin
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6
Q

pregnant lady in 2nd trimester
thirsty
polyuria
hyperglycaemia

A

type 3 diabetes

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7
Q

12 week old baby that used to have diabetes but is now fine

A

transient neonatal diabetes

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8
Q

treatment of neonatal diabetes

A

insulin/SU (if/until it goes away)

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9
Q

baby <6months with hyperglycaemia that doesnt resolve

A

persistent neonatal diabetes

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10
Q 
20 year old with type 2 diabetes 
genetic problem 
polyuria 
lean 
high c peptide
A

maturity onset diabetes of the young (MODY)

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11
Q

stable/non progressive hyperglycaemia

A

MODY2

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12
Q

treatment of MODY1 and MODY3

A

insulin + diet + SU

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13
Q

treatment of MODY2

A

diet

nothing

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14
Q 
20 year old male 
hasn't been feel right so hasn't eaten all day 
BMI 21
addisons disease 
low glucose
A

hypoglycaemia

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15
Q

hypoglycaemia treatment (3)

A

conscious - Lucozade, glucotabs
conscious but drowsy - glucogel subbuccal
unconscious - IV glucose 12 mins or 1mg IM glucagon

check after 15 mins

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16
Q 
forgot to take insulin this morning 
vomiting 
abdo pain 
kussmauls breathing (hyperventilation) 
pear drop breath
A

DKA (diabetic ketoacidosis)

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17
Q

DKA (diabetic ketoacidosis) treatment (4)

A

oxygen
IV insulin
IV fluids
IV potassium

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18
Q

elderly
hyperglycaemia >60
no ketoacidosis
acutely unwell

A

hyperosmolar hyperglycaemic state (HHS)

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19
Q

treatment of HHS (hyperosmolar hyperglycaemic state) (2)

A

diet
metformin
IV insulin

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20
Q 
20 year old female 
proximal myopathy 
osteoporosis 
thin skin, easy bruising  
central fat distribution 'lemon on sticks' 'moon face' 
hirsutism 
acne 
amenorrhoea (period stops) 
abdominal stretch marks (striae)
A

cushings

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21
Q

cushings investigations (3)

A

overnight screening test - high dose dexamethasone (exogenous steroids)

then low dose diagnostic test

imaging - depending on location

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22
Q

low cortisol in high dose diagnostic test

high ACTH <300

A

ACTH secreting pituitary tumour causing cushings

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23
Q

high cortisol

low ACTH <1

A

adrenal tumour causing cushings

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24
Q

high cortisol in high dose diagnostic test

v high ACTH >300

A

ectopic ACTH production causing cushings

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25
Q

cushings treatment

A 
metyrapone - to reduce ACTH production before surgery 
fix cause (surgery)
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26
Q

obese but osteoporosis

A

cushings

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27
Q

excess aldosterone from adrenal adenoma in zona glomerulosa

A

conns syndrome

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28
Q

conns syndrome treatment (2)

A

surgery

spironolactone

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29
Q

genital ambiguity

A

CAH

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30
Q

CAH treatment (kids and adults)

A

kids - steroids

adults - stop androgen excess

31
Q

CAH pathophysiology

A

no steroid enzyme = increased ACTH = increased androgen precursors (testosterone)

32
Q

addisonian crisis treatment

A

ASAP

hydrocortisone
fludrocortisone
IV saline
IV insulin

33
Q 
low cortisol on synacthen test
nausea 
vomiting 
type 1 diabetic 
hyponatraemia 
hyperkalaemia 
confusion 
abdo pain
A

addisonian crisis

34
Q

weight loss
buccal pigmentation
pigmentation in creases of hands
acanthosis nigrans (velvety thick lesions in axillae)

A

chronic addisons disease

35
Q 
headache 
palpitation
constipation 
MEN2a (medullary thyroid cancer too) 
neurofibromatosis 
weight loss
A

phaeochromocytoma

36
Q

phaeochromocytoma treatment (4)

A

alpha blocker THEN beta blocker
surgery
chemo
family screening

37
Q

high BMI
bradycardia
cold constipation
heavy periods

give diagnosis and investigation findings

A

hypothyroidism

low T4/T3
high TSH if primary hypothyroidism, low TSH if secondary hypothyroidism

38
Q 
middle aged female 
high BMI 
bradycardia 
cold
constipation 
puffy/closed eyes 
anti-TPO positive
A

hypothyroidism caused by hashimotos thyroiditis

39
Q

hypothyroidism treatment

A

levothyroxine (T4)

40
Q 
low BMI 
tachycardia 
palpitation 
diarrhoea 
lighter periods

give diagnosis and investigation findings

A

hyperthyroidism

high T4/T3
low TSH if primary hyperthyroidism, high THS if secondary hyperthyroidism

41
Q 
middle aged female 
low BMI 
tachycardia 
pretibial myxoedema 
finger clubbing 
lighter periods 
protruding eyes 
symmetrical smooth goitre
anti-TPO positive 
TSH receptor antibody positive
A

hyperthyroidism caused by graves disease

42
Q

hyperthyroidism treatment (3)

A

carbimazole or propylthiouracil (PTU)
radioiodine
surgery

43
Q 
rough asymmetrical thyroid goitre
cervical lymphadenopathy 
hashimotos thyroiditis 
histology - 'orphan annie' eyes and psammoma bodies
family history 
radiation exposure

diagnosis and investigation

A

papillary thyroid carcinoma

TFTs and US guided FNA

44
Q 
rough asymmetrical thyroid goitre 
phaeochromocytoma 
young patient 
high calcitonin 
family history 
radiation exposure

diagnosis and investigation

A

medullary thyroid cancer (MTC)

TFTs and Us guided FNA

45
Q

rough asymmetrical thyroid goitre
family history
radiation exposure
hoarse voice

diagnosis and investigation

A

anaplastic thyroid carcinoma (hoarse voice bc v aggressive tumour = vocal cord palsy)

TFTs and US guided FNA

46
Q

treatment of benign thyroid cancer

A

nothing, symptomatic

47
Q

treatment of malignant thyroid cancer

A

lobectomy/thyroidectomy

48
Q

renal stones - polyuria, thirsty
abdo pain
frequent fractures
confusion

A

hypercalcaemia

49
Q

hypercalcaemia treatment (1 symptomatic and 1 curative)

A

symptomatic: fluids - bc theyre
curative: bisphosphonates

50
Q 
other autoimmune conditions (eg rheumatoid) 
muscle spasms/weakness
paraesthesia 
QT prolongation on ECG 
chovsteks and trousseau sign positive
A

autoimmune destruction of parathyroid gland = hypocalcaemia

51
Q

4th metacarpal brachdactyly
learning disability
low Ca, high PTH (bc of resistance), high phosphate

A

pseudohypoparathyroidism

52
Q

acute treatment of hypocalcaemia

A

IV calcium (calcium gluconate)

53
Q

chronic treatment of hypocalcaemia

A

Ca supplements

vit D supplements

54
Q

osteomalacia/rickets cause

A

vit D deficiency

55
Q

RET gene 10q mutation (autosomal dominant)
hyperparathyroidism (parathyroid hyperplasia)
medullary thyroid carcinoma (MTC)
phaeochromocytoma (paraganglioma)

A

MEN2a

56
Q

RET gene 10q mutation (autosomal dominant)
medullary thyroid carcinoma (MTC)
phaeochromocytoma
mucosal erosions (tongue)

A

MEN2b

57
Q 
5Ps;
pituitary tumour 
parathyroid hyperplasia (hyperparathyroidism)
pancreas tumour
peptic ulcers (recurrent)  
prolactin high 
gene 11q mutation
A

MEN1

58
Q 
female 
oligomenorrhoea
infertility 
galactorrhoea 
headaches
A

prolactinoma (prolactin secreting pituitary tumour)

59
Q

male
headaches
bitemporal hemianopia
impotence

A

prolactinoma (prolactin secreting pituitary tumour)

60
Q

prolactinoma (prolactin secreting pituitary tumour) treatment

A

cabergoline - dopamine analogue/agonist

61
Q 
headache 
bitemporal hemianopia
fatigue, sleep apnoea 
proximal limb weakness, joint pain 
high IGF1
colorectal cancer
A

acromegaly

also has enlarged features (hands, feet, jaw etc) if you ask (wouldnt present with that

62
Q

acromegaly treatment (3)

A

transsphenoidal surgery
radiotherapy
drugs - somatostatin analogues

63
Q

short stature
obesity
menstrual irregularities/erectile dysfunction
headache

A

pan hypopituitarism

64
Q

pan hypopituitarism treatment (5)

A 
hydrocortisone 
thyroxine 
ADH (desmospray or desmopressin PO/IM) 
GH 
testosterone/estradiol
65
Q

recent head trauma
polyuria
thirst
hypernatraemia

A

diabetes insipidus

66
Q

diabetes insipidus treatment (2)

A 
synthetic ADH (desmospray or desmopressin PO/IM)
fluids (bc dehydrated)
67
Q

v concentrated low volume urine
hyponatraemia
ADH problem

A

SIADH

68
Q

SIADH treatment (1)

A

tolvaptan (ADH receptor antagonist)

69
Q 
PMH of addisons (autoimmune)
amenorrhoea 
osteoporosis 
infertility 
high LH and FSH 
low oestradiol
A

POF (premature ovarian failure)

70
Q

premature ovarian failure (POF) treatment

A

hormone replacement therapy (contraceptive pill)

71
Q 
girl 
widespread nipples 
horseshow kidney 
genetic problem 
primary amenorrhoea (>16 never had a period)
A

turners syndrome (XO)

72
Q 
diabetic 
amenorrhoea 
hirsutism
infertility  
positive findings on US
A

polycystic ovarian syndrome (PCOS)

73
Q

polycystic ovarian syndrome (PCOS) treatment (4)

A

weight loss (metformin if ineffective) - bc of diabetes
antioestrogens eg clomifere citrate
FSH/LH injections
surgery - drill holes to stimulate ovulation

J Endocrine (12 decks)

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