Diagnosis in Endocrine Flashcards Preview

Endocrinology > Diagnosis in Endocrine > Flashcards

Flashcards in Diagnosis in Endocrine Deck (36):
1

Diagnosis of Addison's?

on bloods: low Na, high K and hypoglycaemia
Also do SHORT SYNACTHEN test - serum cortisol should rise substantially

2

Diagnosis of Addison's?

on bloods: low Na, high K and hypoglycaemia
Also do SHORT SYNACTHEN test - serum cortisol should rise substantially, but in Addison's disease, it will not

3

Secondary adrenal insufficiency

SHORT SYNACTHEN, serum cortisol will rise, but steadily instead of substantially

4

Cushing's syndrome

Overnight dexamethasone suppresion test
Cortisol and ACTH should decrease due to negative feedback, but in Cushing's, cortisol will not be decreased

5

Primary aldosteronism?

confirm aldosterone excess by measuring renin and aldosterone and expressing in in a ratio, if ratio is high then investigate further with a saline suppression test
Confirm subtype with CT scan

6

Congenital adrenal hyperplasia?

basal progesterone
genetic mutation analysis

7

Phaeochromocytoma?

Biochem abnormalities: hyperglycaemia, low K level, raised Hb, mild hypocalcaemia, lactic acidosis
Cataclamine excess in urine and plasma
Identify source of cetecholamine excess using MRI scan, MIBG, PET scan

8

Diagnosis of Hashimotos?

presence of thyroid peroxidase antibodies in blood and T cell infiltrate and inflammation on microscopy
TSH high, T4/3 low
High CK
increased LDL

9

What happens to prolactin in Hashimoto's?

increases (increased TRH leads to increased prolactin secretion)

10

Myxoedema coma?

ECG - bradycardia, heart block, T wave inversion, QT prolongation
Type 2 resp failure: hypoxia, hypercarbia, resp acidosis

11

Grave's?

antibody positive (TRAbs)
High T3/T4, low TSH
Scintigraphy, assymmetrical goitre

12

Sub acute thyroiditis (De Quervians)?

T4 is high in early stages, low in late, then normal
TSH is low, then high then normal

13

Thyroid cancer?

ultrasound guided FNA of lesion
Excision biopsy of lymph nodes
(No role for isotope scan or CT/MRI)

14

Hypercalcaemia?

raised calcium, raised PTH, increased urine calcium excretion

15

Primary Hyperparathyroidism?

PTH and Ca raised

16

Secondary Hyperparathyroidism?

PTH raised, Ca low

17

Tertiary Hyperparathyroidism?

PTH and Ca raised

18

PseudoHyperparathyroidism?

PTH raised, Ca low

19

PseudoPseudoHyperparathyroidism?

PTH raised, Ca normal

20

Paget's?

X ray
Raised ALP
Isotope bone scan

21

Cervical lymphadenopathy?

CXR
ENT opinion
Fine need aspiration

22

Branchial cyst?

fine needle aspiration will show cholesterol crystals

23

Cystic hygroma?

transillumination

24

Diabetes insipidus?

urine osmolality is less than 300 and serum osmolality is more than 300
Dyname test- water deprivations test

25

Diagnosis of DM?

fasting glucose > 7
Random >11.1

26

Diagnosis of type?

mostly history based

27

Reduced ovarian reserve?

raised TSH, low anti mullerian hormone, reduced antral follicle count US

28

POS?

ultrasound

29

Endrometriosis?

uterus may be fixed and retroverted, scan may show CHOCOLATE CYSTS on ovary

30

Discrimanatory test between diabetes T1 and T2?

GAD/anti-islet cell antibodies, ketone, C-peptide

31

DKA?

blood glucose
urine dipstick may show glucose and ketones
ABGs show metabolic acidosis

32

Hyperosmolar hyperglycaemic non-kerotic state?

urinalysis - marked glucose in urine with NORMAL KETONE levels

33

Acromegaly

glucose tolerance test
Ig GH levels are not suppressed by glucose and levels of IGF-1 are elevated then diagnosis is confirmed
MRI scan pituitary and hypothalamus

34

Imperforate hymen?

ultrasound

35

Asherman syndrome?

sonohysterography
hysterosalpinography

36

Struma ovarii?

TFTs only in patients with symptomatic hyperthyroidism