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Y6 Passmed > Endo > Flashcards

Endo Flashcards

1
Q

what investigation is needed if trying to identify Conn’s, and CT abdo is inconclusive?

A

Adrenal venous

  • bilaterally increased aldosterone in adrenal veins = bilateral hyperplasia
  • unilaterally increased aldosterone = Conn’s syndrome
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2
Q

what does radioactive nuclear scintigraphy show for toxic multinodular goiter

A

patchy uptake

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3
Q

what is definitive management for primary hyperparathyroidism (regardless of whether is is a single adenoma / bilat adenomas / hyperplasia)

A

TOTAL parathyroidectomy

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4
Q

causes of raised Prolactin

A 
pregnancy
prolactinoma
polycystic ovarian syndrome
primary hypothyroidism
phenothiazines (antipsychotics), metoclopramide, domperidone
physiological
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5
Q

how do you manage primary aldosteronism (CONNS) if solitary / bilateral adrenal enlargement

A

SOLIITARY > spironolactone /eplerenone > surgery

BILATERAL > spiro only (NOT SURGERY, or you would make them addisonian)

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6
Q

sick day rules for T1DM

A

continue normal insulin regimen
check BP regulary (at least every 4 hours)
drink 3L of water min
change to sugary drinks if struggling to eat (this will maintain carb intake)

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7
Q

features of papillary thyroid cancer

A

young women
excellent prognosis
spreads to LN early

Young women go dancing with men in papillons (PAPILLARY thyroid cancer) and they look happy (good prognosis)

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8
Q

features of follicular thyroid cancer

A

aggressive, associated with NHL (in FOLLICLES that contain lymph)

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9
Q

features of medullary thyroid cancer

A

MEDULLARY > MEN2a/2b

MEN are unhappy > poor prognosis

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10
Q

features of anaplastic thyroid cancer

A

very FAST GROWING
not treatment responsive
can cause pressure sx

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11
Q

what is important to measure if a patient presents as SEVERELY HYPOGLYCAEMIC

A

their C PEPTIDE levels
If C PEPTIDE HIGH: endogenous cause (e.g. insulinoma) / sulphonylurea
C PEPTIDE LOW: exogenous (e.g. injection of insulin)

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12
Q

what is primary polydipsia

A

ADH system functions normally

but person just drinks lots of water > pees out lots of water

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13
Q

explain 2 types of diabetes insipidus

A

CRANIAL: low ADH secretion by pituitary , caused by head trauma / tumour / infection /inflamm

NEPHROGENIC: kidneys are irresponsibe to ADH

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14
Q

causes of nephrogenic diabetes insipidus

A

electrolyte imbalance (hypercalcaemia, hypokalaemia)
Lithium
Genetic
Intrinsic Kidney dsease

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15
Q

what is presentation of diabetes insipidus

A

cannot concentrate their urine, so:
polydipsia, polyuria
dehydration
postural hypotensiion

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16
Q

what electolyte finding occurs in DI and why

A

hypERnatraemia

because you cant drive water back into the blood, the blood is thick and very concentrated essentially

17
Q

when do you add metformin in T1DM mx

A

if BMI >25

18
Q

what are important side effects to excessive levothyroxine therapy (overcompensating)?

A

osteoporosis
AF
worsening of angina
hyperthyroidism

19
Q

how do you investigate a phaeo

A

24 hou urinary metanephrines (have replaced catecholamine collection=

20
Q

what is pheo associated with

A

MEN2
neurofibromatosis
von Hippel Lindau

21
Q

which drug could you give to mx phaeo that blocks both alpha and beta receptors

A

LABETALOL (lABetalol)

22
Q

which alpha blocker is given as first tx of phaemo

A

Phenoxybenzamine

23
Q

what is another name for de quervains thyroiditis

A

subacute thyroidittis

24
Q

how does de quervains thyroiditis present in the first stage

A

hyperthyroidism
painful goiter
raised ESR

25
Q

how do SGLT2 inhibitors e.g. empagliflozin work

A

by making you pee out glucose

26
Q

what are the symptoms of gastroparesis

A

erratic BMs
bloating
N&V
early satiety

27
Q

how do you manage gastroparesis

A

metoclopramide or domperidone

28
Q

what is impaired fasting glucose

A

raised glucose on FASTING BLOOD GLUCOE

at 6.1 - 7

29
Q

What is Impaired glucose tolerance

A

On OGTT at 7.8 to 11.1

30
Q

what is mx of a acromegaly

A

first line: TRANSPHENOIDAL SURGERY

if they refuse: somatostatin analogue (otcreotide) or dopamine agonist (bromocriptine)

31
Q

which drugs can cause SIADH

A

carbamazepine, sulfonylureas, SSRIs, tricyclics

32
Q

MEN 1

A

3 Ps
hyperPPPPPParathyroidism
PPPPituitary disease
PPPPancreas (insulinoma, gastrinoma)

33
Q

men2a

A

2Ps
hyperparathyroidism
phaeochromocytoma

34
Q

Men2b

A

1P
Phaeochromocytoma

Marfanoid body habitus
Neuromas

35
Q

what do you need to do for query undiagnosed osteoporosis in a post menopausal woman with a fracture

A

put on BIPHOSPHONAATES

no need for DEXA scan

Y6 Passmed (8 decks)

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