Conditions summary Flashcards
(73 cards)
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
2
Q
type 1 diabetes treatment
A
insulin (almost always)
v v v last line;
drugs - not SUs
surgery
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)
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
5
Q
type 2 diabetes treatment (4)
A
- lifestyle changes
- metformin
- metformin + something else (SU (gliclazide), gliptin, GLP1 (exenatide))
- metformin + SU + insulin
6
Q
pregnant lady in 2nd trimester
thirsty
polyuria
hyperglycaemia
A
type 3 diabetes
7
Q
12 week old baby that used to have diabetes but is now fine
A
transient neonatal diabetes
8
Q
treatment of neonatal diabetes
A
insulin/SU (if/until it goes away)
9
Q
baby <6months with hyperglycaemia that doesnt resolve
A
persistent neonatal diabetes
10
Q
20 year old with type 2 diabetes genetic problem polyuria lean high c peptide
A
maturity onset diabetes of the young (MODY)
11
Q
stable/non progressive hyperglycaemia
A
MODY2
12
Q
treatment of MODY1 and MODY3
A
insulin + diet + SU
13
Q
treatment of MODY2
A
diet
nothing
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
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
16
Q
forgot to take insulin this morning vomiting abdo pain kussmauls breathing (hyperventilation) pear drop breath
A
DKA (diabetic ketoacidosis)
17
Q
DKA (diabetic ketoacidosis) treatment (4)
A
oxygen
IV insulin
IV fluids
IV potassium
18
Q
elderly
hyperglycaemia >60
no ketoacidosis
acutely unwell
A
hyperosmolar hyperglycaemic state (HHS)
19
Q
treatment of HHS (hyperosmolar hyperglycaemic state) (2)
A
diet
metformin
IV insulin
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
21
Q
cushings investigations (3)
A
overnight screening test - high dose dexamethasone (exogenous steroids)
then low dose diagnostic test
imaging - depending on location
22
Q
low cortisol in high dose diagnostic test
high ACTH <300
A
ACTH secreting pituitary tumour causing cushings
23
Q
high cortisol
low ACTH <1
A
adrenal tumour causing cushings
24
Q
high cortisol in high dose diagnostic test
v high ACTH >300
A
ectopic ACTH production causing cushings
25
cushings treatment
```
metyrapone - to reduce ACTH production before surgery
fix cause (surgery)
```
26
obese but osteoporosis
cushings
27
excess aldosterone from adrenal adenoma in zona glomerulosa
conns syndrome
28
conns syndrome treatment (2)
surgery
| spironolactone
29
genital ambiguity
CAH
30
CAH treatment (kids and adults)
kids - steroids
| adults - stop androgen excess
31
CAH pathophysiology
no steroid enzyme = increased ACTH = increased androgen precursors (testosterone)
32
addisonian crisis treatment
ASAP
hydrocortisone
fludrocortisone
IV saline
IV insulin
33
```
low cortisol on synacthen test
nausea
vomiting
type 1 diabetic
hyponatraemia
hyperkalaemia
confusion
abdo pain
```
addisonian crisis
34
weight loss
buccal pigmentation
pigmentation in creases of hands
acanthosis nigrans (velvety thick lesions in axillae)
chronic addisons disease
35
```
headache
palpitation
constipation
MEN2a (medullary thyroid cancer too)
neurofibromatosis
weight loss
```
phaeochromocytoma
36
phaeochromocytoma treatment (4)
alpha blocker THEN beta blocker
surgery
chemo
family screening
37
high BMI
bradycardia
cold constipation
heavy periods
give diagnosis and investigation findings
hypothyroidism
low T4/T3
high TSH if primary hypothyroidism, low TSH if secondary hypothyroidism
38
```
middle aged female
high BMI
bradycardia
cold
constipation
puffy/closed eyes
anti-TPO positive
```
hypothyroidism caused by hashimotos thyroiditis
39
hypothyroidism treatment
levothyroxine (T4)
40
```
low BMI
tachycardia
palpitation
diarrhoea
lighter periods
```
give diagnosis and investigation findings
hyperthyroidism
high T4/T3
low TSH if primary hyperthyroidism, high THS if secondary hyperthyroidism
41
```
middle aged female
low BMI
tachycardia
pretibial myxoedema
finger clubbing
lighter periods
protruding eyes
symmetrical smooth goitre
anti-TPO positive
TSH receptor antibody positive
```
hyperthyroidism caused by graves disease
42
hyperthyroidism treatment (3)
carbimazole or propylthiouracil (PTU)
radioiodine
surgery
43
```
rough asymmetrical thyroid goitre
cervical lymphadenopathy
hashimotos thyroiditis
histology - 'orphan annie' eyes and psammoma bodies
family history
radiation exposure
```
diagnosis and investigation
papillary thyroid carcinoma
TFTs and US guided FNA
44
```
rough asymmetrical thyroid goitre
phaeochromocytoma
young patient
high calcitonin
family history
radiation exposure
```
diagnosis and investigation
medullary thyroid cancer (MTC)
TFTs and Us guided FNA
45
rough asymmetrical thyroid goitre
family history
radiation exposure
hoarse voice
diagnosis and investigation
anaplastic thyroid carcinoma (hoarse voice bc v aggressive tumour = vocal cord palsy)
TFTs and US guided FNA
46
treatment of benign thyroid cancer
nothing, symptomatic
47
treatment of malignant thyroid cancer
lobectomy/thyroidectomy
48
renal stones - polyuria, thirsty
abdo pain
frequent fractures
confusion
hypercalcaemia
49
hypercalcaemia treatment (1 symptomatic and 1 curative)
symptomatic: fluids - bc theyre
curative: bisphosphonates
50
```
other autoimmune conditions (eg rheumatoid)
muscle spasms/weakness
paraesthesia
QT prolongation on ECG
chovsteks and trousseau sign positive
```
autoimmune destruction of parathyroid gland = hypocalcaemia
51
4th metacarpal brachdactyly
learning disability
low Ca, high PTH (bc of resistance), high phosphate
pseudohypoparathyroidism
52
acute treatment of hypocalcaemia
IV calcium (calcium gluconate)
53
chronic treatment of hypocalcaemia
Ca supplements
| vit D supplements
54
osteomalacia/rickets cause
vit D deficiency
55
RET gene 10q mutation (autosomal dominant)
hyperparathyroidism (parathyroid hyperplasia)
medullary thyroid carcinoma (MTC)
phaeochromocytoma (paraganglioma)
MEN2a
56
RET gene 10q mutation (autosomal dominant)
medullary thyroid carcinoma (MTC)
phaeochromocytoma
mucosal erosions (tongue)
MEN2b
57
```
5Ps;
pituitary tumour
parathyroid hyperplasia (hyperparathyroidism)
pancreas tumour
peptic ulcers (recurrent)
prolactin high
gene 11q mutation
```
MEN1
58
```
female
oligomenorrhoea
infertility
galactorrhoea
headaches
```
prolactinoma (prolactin secreting pituitary tumour)
59
male
headaches
bitemporal hemianopia
impotence
prolactinoma (prolactin secreting pituitary tumour)
60
prolactinoma (prolactin secreting pituitary tumour) treatment
cabergoline - dopamine analogue/agonist
61
```
headache
bitemporal hemianopia
fatigue, sleep apnoea
proximal limb weakness, joint pain
high IGF1
colorectal cancer
```
acromegaly
also has enlarged features (hands, feet, jaw etc) if you ask (wouldnt present with that
62
acromegaly treatment (3)
transsphenoidal surgery
radiotherapy
drugs - somatostatin analogues
63
short stature
obesity
menstrual irregularities/erectile dysfunction
headache
pan hypopituitarism
64
pan hypopituitarism treatment (5)
```
hydrocortisone
thyroxine
ADH (desmospray or desmopressin PO/IM)
GH
testosterone/estradiol
```
65
recent head trauma
polyuria
thirst
hypernatraemia
diabetes insipidus
66
diabetes insipidus treatment (2)
```
synthetic ADH (desmospray or desmopressin PO/IM)
fluids (bc dehydrated)
```
67
v concentrated low volume urine
hyponatraemia
ADH problem
SIADH
68
SIADH treatment (1)
tolvaptan (ADH receptor antagonist)
69
```
PMH of addisons (autoimmune)
amenorrhoea
osteoporosis
infertility
high LH and FSH
low oestradiol
```
POF (premature ovarian failure)
70
premature ovarian failure (POF) treatment
hormone replacement therapy (contraceptive pill)
71
```
girl
widespread nipples
horseshow kidney
genetic problem
primary amenorrhoea (>16 never had a period)
```
turners syndrome (XO)
72
```
diabetic
amenorrhoea
hirsutism
infertility
positive findings on US
```
polycystic ovarian syndrome (PCOS)
73
polycystic ovarian syndrome (PCOS) treatment (4)
weight loss (metformin if ineffective) - bc of diabetes
antioestrogens eg clomifere citrate
FSH/LH injections
surgery - drill holes to stimulate ovulation
