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Year 6 Passmed > Endo > Flashcards

Endo Flashcards

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1
Q

What is the classical presentation of Waterhouse Friderichsen sydrome

A

Profound sepsis and coagulopathy - it is a pre-terminal event

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2
Q

What are the structural characteristics of a benign adenoma?

A

Well defined and often wiht a rich lipid core

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3
Q

What causes thyrotoxicosis with a tender goitre?

A

De Quervain’s thyroiditis

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4
Q

What is the time course of DeQuervain’s thyroiditis?

A

Hyper - 5 weeks
Eu - 2 weeks
Hypo - weeks to months
Normality resumed

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5
Q

What is seen on 131 scans in Thyroiditis?

A

Globally reduced uptake

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6
Q

What are the side effects of pioglitazone?

A 
Weight gain
Liver impairment
Fluid retention
Fractures 
Bladdercancer
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7
Q

What are Trosseau’s and Chvoitek’s signs?

A

Trosseau’s - Carpal spasm on BP cuff inflation

Chvostek’s - tapping parotid causes facial twitching

Both seen in hypOcalcaemia

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8
Q

At what stage should another anti-diabetic drug be added?

A

If HbA1c is above58/7.5%

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9
Q

What are the differences between HHS and DKA?

A

No hyperketonuria
No metabolic acidosis
Higher blood glucose
Normal pH

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10
Q

Do DDP4 inhibitors e.g. Sitagliptin cause weight gain?

A

No, nor do they cause hypos

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11
Q

Which element is required for PTH secretion and action other than Ca?

A

Mg

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12
Q

What endocrine abnormality can quinines precipitate?

A

Hypogylcaemia

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13
Q

What is the TFT profile seen in subclinical hypothyroidism?

A

Elevated TSH with normal T4

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14
Q

Which diabetes medication is contraindicated in patients with recurrent thrush?

A

SGLT2 inhibitors

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15
Q

What are the various DM diagnostic criteria for a symptomatic patient?

A

Fasting glucose >=7
Random glucose>=11.1
2Hr 75g OGTT>= 11.1
HbA1C>=48/6,5%

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16
Q

What criteria must be met for an asymptomatic patient to be diagnosed with DM?

A

Same numbers as for a symptomatic patient but mutst be met twice

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17
Q

Hyponatraemia and hyperkalaemia in a patient with lethargy most likely indicates…..? And what diagnostic test should be done?

A

Addison’s disease

Short SynACTHen test

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18
Q

What is the single most important measure to prevent gangrene development in diabetic foot patients/

A

Education about foot care and appointment with diabetic foot clinic

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19
Q

True or false - long term steroid use causes osteomalacia?

A

False - it causes osteopaenia and osteoporosis but not osteomalacia

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20
Q

What should be done for all patients with pituitary masses?

A

Hormonal profiling

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21
Q

Which diabetic meds are contraindicated in heart failure?

A

Thiazolinediones (pioglitazone)

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22
Q

What should be done for patients with Addison’s taking hydro and fludrocortisone who are unwell?

A

Double the hydrocortisone ONLY

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23
Q

Men 1, 11a, 11b?

A

1 - 3Ps - Parathyroid, pituitary, pancreas

2a - 2Ps - Parathyroid, phaeo, thyroid

2b - 1P - Phaeos, thyroid, Marfans

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24
Q

What is the commonest side effect of radio thyroid treatment?

A

Hypothyroidism

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25
What is the commonest complication - and thus CIs- of carbimazole (ATD)?
Agranulocytosis
26
What is the commonest type of thyroid cancer, and how does it spread?
Papillary carcinoma | Lymphatic spread
27
Which thyroid cancer typically has a hereditary historyt to it?
Medullary - as part of MEN2A
28
what causes impaired hypoglycaemic awareness in diabetics?
ANS Neuropathy
29
What is the first line investigation for acromegaly?
Serum IGF1
30
What is Nelson's syndrome?
Rapid enlargement of an ACTH producing pituitary adenoma following a bilateral adrenalectomy for Cushings
31
What is the inheritance pattern of MODY
AD
32
Thiazides cause hyper or hypocalcaemia?
Hypercalcaemia
33
Whatis the difference between Hashimoto's and De Quervain's thyroiditis?
Time frame - the former is over 6-12 months whereas the latter over a matter of weeks
34
What does 'unrecoreable' blood glucose mean?
Too HIGH rather than low
35
Wht is the HbA1C definition of Prediabetes?
42-47/6-6.4%
36
What are the drug causes of gynaecomastia?
Spiro - commonest Cimetidine Digoxin Goserelin
37
Which antibodies are seen in Hashimotos?
anti-TPO
38
What is the first line management of prolactinomas?
Da agonists e.g. cabergoline or bromocriptine
39
What effect does iron have on thyroid function?
Iron reduces thyroxine absorption, therefore causing a hypothyroidism
40
What are the drug causes of gynaecomastia?
Spiro - commonest Cimetidine Digoxin Goserelin
41
Which antibodies are seen in Hashimotos?
anti-TPO
42
What is the first line management of prolactinomas?
Da agonists e.g. cabergoline or bromocriptine
43
What effect does iron have on thyroid function?
Iron reduces thyroxine absorption, therefore causing a hypothyroidism
44
What insulin regiment should DKA patients be on?
Fixed rate | COntinue regular LA injectables but stop short acting insulin
45
What may cause a diabetiv with poor glucose control to experience bloating and vomiting?
Gastroparesis due to vagal neuropathy
46
Which diabetic med is contraindicated in bladder cancer and causes weight gain?
Pioglitazone (thiazolidinediones)
47
What is the mechanism of sitagliptin?
DDP4 inhibitor
48
What are the blood glucose targets for T1DM?
5-7 on waking | 4-7 before other meals of the day
49
Chronic alcohol abuse may mimic which endocrine syndrome?
Cushing's
50
What is the first line treatkent for cerebral metastases?
Dexamethasone
51
What is the most important modifiable risk factor for the development of thyroid eye disease?
Smoking cessation
52
When should a second diabetic agent be added?
when HbA1c is above 58 or 7.5%
53
What is the management of a post menopausal woman with a fracture?
Bisphosphonates and calcium supplementation - there is no need for a DEXA scan
54
What is the most common cardiac complication of thyrotoxicosis?
High output cardiac failure
55
What is the management of hypoglycaemia with impaired GCS?
IV 100ml 20% dextrose STAT if access | IM glucagon 1mg IV STAT if not
56
What are the common side effects of sulphonylureas (and name one)
Gliclazide Hypos Weight gain
57
What is the HbA1c targetin T1DM?
48/6.5%
58
What is the biochemical marker of response to levothyroxine?
TSH normalisation
59
What complication should be monitored while fluid resuscitating young DKA patients?
Cerebral oedema
60
What are the features and management of a thyroid storm?
Fx Fever, tachy, confusion, N&V, HTN, HF, jaundice ``` Rx Treat the precipitant IV propranolol Anti thyroids e.g. propylthiouracel Lugols iodine Dexamethasone - blocks T4-=>T3 convesion ```
61
What is the acid base balance in Cushings?
Hypokalaemic metabolic alkalosis due to potassium excretion and primary HCO3 loss
62
What are the characteristic features of an insulinoma?
Whipples triad Hyooglycaemia with fasting or exercise Reversal of symptoms with glucose Recorded hypose at time of symptoms
63
Which one of the following drugs is not a cause of galactorrhoea? ``` Metoclopramide Bromocriptiner Chlorpromazine Haloperidol DOmperidone ```
Bromocriptine is a treatment for galactorrhoea rather than a cause
64
Subacute thyroiditis shows what picture on 131-I scintigraphy?
Globally reduced uptake
65
What are the features of a myxoedema coma?
Hypothermia Hyporefleia Bradycardia Seizures
66
Which drugs cause galactorrhoea?
Metoclopromide Domperidone CHlorpromazine Haloperidol
67
Treatment with which hormone is recommended in Turner's patients?
GH
68
Which steroids have the following profiles: i) Minimal glucocorticoid but high mineralocorticoid activity ii) Glucocorticoid activity with high minteralocorticoid activity iii) Predominant glucocorticoid activity with low mineralocorticoid activity
i) Fludrocortisone ii) Hydrocortisone iii) Prednisolone
69
Which hormone is reduced in surgery?
Insulin
70
What is the mechanism of action of orlistat?
Pancreatic lipase inhibitor which therefore reduces fat digestion
71
What is the primary cardiac manifestation of acromegaly?
Agromegalic cardiomyopathy
72
Every person on insulin should also receive what?
Glucagon kit
73
What should be the next step in the management with a palpable abdo mass or unexplained organomegaly?
V urgent refurral (<48hrs) for ?neuroblastoma and Wilm's tumour
74
Cortisol not suppressed by low dose dex but is suppressed by high dose dex?
Cushing's disease
75
Ehat asre the casuses of hyopoglycaemia?
Explain ``` Exogenous drugs Pit insufficiency Liver failure Addison's Insulinomas Non pancreatic neoplasia ```
76
Which diabetes drugs increase risk of osteoporosis?
Thiazolidinediones (pioglitazone)
77
What are the key features of latent autimmune diabetes of adulthood?
Basically T1DM but presents later
78
What might causea falsely low HbA1C?
Sickle cell and other Hbopathies due to decreased red cell lifespan
79
What is the management of amyxoedema coma?
Hydrocortisone | Levothyroxine
80
What is the bvest treatment for a toxic multinodular goitre?
Radioactive iodine
81
Can HbA1c be used to rule out diabetes?
No - needs a fasting glucose test
82
What is the management of an addisonisn crisis?
Hydrocortisone 100mg IV Saline +-dextrose NO Fludrocortisone needed
83
What is the first line for pituitary tumours causing acromegaly?
Trans-sphenoidal surgery | Otreotide if this fails
84
What are the gynae manifestations of thyroid disease?
Hyper -> oligo/amenorrhoea | Hypo -> menorrhagia
85
What is a good screening test for medullary thyroid carcinoma?
Calcitonin
86
What is the management of primary hyperaldosteronism?
Spironolactone
87
What is the first line insulin regimen for newly diagnosed T1DM?
Basal bolus with twice daily detemir
88
How many units of insulin are there in 1ml?
100U
89
What is a good diabetes med to give someone who is obese?
Sitabliptin (DDP4 inh)
90
What does a gliclazide OD cause?
Hyperinsulinaemia with high C-peptide levels
91
What should be given first to a phaeo patient/
Phenoxybenzamine (alpha before beta)

Year 6 Passmed (22 decks)

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