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Y3 MedEd > Endo > Flashcards

Endo Flashcards

(75 cards)

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1
Q

Causes of cranial DI (3)

A

Cranial: pituitary tumour, infection (meningitis), sarcoidosis

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2
Q

Causes of nephrogenic DI (5)

A

↑ Ca, ↓ K, lithium, inherited (AVPV2 gene), idiopathic

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3
Q

Presentation of DI

A

Presentation:
Polyuria (including nocturia) – UO often >3L
Polydipsia
Symptoms of hypernatremia: lethargy, irritability, confusion

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4
Q

What are symptoms of hypernatraemia (3)

A

lethargy, irritability, confusion

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5
Q

Ix for DI

A

General: U&Es (Ca, Na, K), glucose (to exclude DM)

Water deprivation test

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6
Q

What is the water deprivation test

A

Water is restricted for 8 hours
Plasma and urine osmolality are measured every hour
After 8 hours, give desmopressin and measure urine osmolality

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7
Q

Mx of cranial DI

A

Cranial: intranasal desmopressin

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8
Q

Mx of nephrogenic DI

A

Nephrogenic: thiazide diuretic or NSAIDs

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9
Q

Signs of DKA (5)

A

N&V, abdo pain, Kussmaul breathing, sweet breath

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10
Q

Which genes involves in DM

A

HLA DR3/4

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11
Q

RF of DMT2 (5)

A

Obesity, FH, ethnicity, endocrine, drugs

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12
Q

Diagnosis criteria of DM

A

Blood glucose measurement
Fasting ≥7 mmol/L
Random >11.1 mmol/L

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13
Q

Mx of DKA

A

Fluids, correct Na K

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14
Q

1st line and 2nd line treatment of T2DM

A

1st line = diet and lifestyle
2nd line = metformin
+/- sulphonylurea +/- insulin

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15
Q

Main 3 causes of hypovolaemic hyponatraemia

A

Diarrhea
Vomiting
Diuretics

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16
Q

Main 3 causes of euvolaemic hyponatraemia

A

Hypothyroidism,
Hypoadrenalism,
SIADH (pneumonia/cancer)

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17
Q

Main 3 causes of hypervolaemic hyponatraemia

A

HF
Cirrhosis
Nephrotic syndrome

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18
Q

Ix for hypovolaemic hyponatraemia (1)

A
  • Clinically hypovolaemic
  • Low urine sodium  kidneys will detect  volume and hang on to salt
    (measure off diuretics)
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19
Q

Ix for euvolaemic hyponatraemia (6)

A

TFTs
Short synACTHen: ACTH injection (cortisol will not rise)
Drug review, breast examination, CXR, brain MRI

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20
Q

Ix for hypervolaemic hyponatraemia (2)

A

Fluid overloaded

Low urine sodium   aldosterone secretion –> retention of Na

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21
Q

Signs of severe hyponatraemia (2)

A

seizures/↓ consciousness

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22
Q

Causes of hypernatraemia (4)

A

vomiting, diarrhea, diabetes insipidus, primary aldosteronism

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23
Q

Presentation of hypernatraemia (7)

A

lethargy, irritability, thirst, signs of dehydration, confusion, coma, fits

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24
Q

Mx of hypernatraemia

A

Drink water/IV fluids

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25
Mx of hypervolaemic hyponatraemia
fluid restrict and treat cause
26
Mx of euvolaemic hyponatraemia
fluid restrict and treat cause
27
Mx of hypovolaemic hyponatraemia
Saline
28
Why do you hyperprolactinaemia in hypothyroidism
TRH stimulates prolactin release
29
Causes of hyyperprolactinaemia (4)
Pituitary prolactinoma (commonest) Hypothyroidism Drugs e.g. metoclopramide, antipsychotics (DA antagonists) Physiological! Pregnancy, breast feeding
30
Drug causes of hyperprolactinaemia (2)
Metoclopramide, antipsychotics
31
Presentation of hyperprolactinaemia in women (4)
galactorrhoea, amenorrhoea, infertility, loss of libido
32
Presentation of hyperprolactinaemia in men (3)
loss of libido, infertility, galactorrhoea uncommon
33
Mass effects of prolactinoma (2)
Mass effects of tumour: headache, loss of visual fields
34
Ix of prolactinoma (2)
Prolactin TFTs Pituitary MRI
35
Mx of hyperprolactinaemia (2)
1st line = DA agonist e.g. bromocriptine and carbergoline 2nd line = surgery
36
Features of de Quervains thyroiditis (4)
Post-viral, fever, high ESR. Causes painful goitre
37
Mx of de Quervains thyroiditis (4)
Self-limiting (treat with NSAIDs)
38
Grave’s triad
Grave’s triad = exophthalmos, pretibial myxedema and thyroid acropachy
39
Toxic multinodular goitre common population
In elderly and iodine deficient areas
40
Describe a thyroid adenoma
Solitary nodule producing T3/T4
41
Radioisotope scan findings of Grave's disease
Diffuse increased uptake (smooth diffuse goitre)
42
Radioisotope scan findings of de Quervain's thyroiditis
NO uptake
43
Radioisotope scan findings of toxic multi nodular goitre
Multiple areas of increased uptake
44
Radioisotope scan findings of thyroid adenoma
Single area of increased uptake
45
Commonest cause of hypothyroidism in the West
Autoimmune Hashimoto’s thyroiditis (commonest cause in the West)
46
Commonest cause of hypothyroidism worldwide
Iodine deficiency (commonest cause worldwide)
47
What are the three iatrogenic causes of hypothyroidism
Iatrogenic: post-surgery, radioiodine, amiodarone
48
What happens in de Quervain's thyroiditis briefly
hyperthyroidism then hypothyroidism.
49
Mx of hypothyroidism
levothyroxine 25-200 micrograms/day (monitor TFTs at 6 weeks and adjust dose accordingly)
50
5 types of thyroid cancer
``` Papillary Follicular Medullary Lymphoma Anaplastic ```
51
Which is the most common type of thyroid cancer
Papillary
52
Buzzwords for papillary thyroid cancer (2)
Psammoma bodies, Orphan Anne nuclei
53
What do Orphan Anne nuclei suggest
Papillary thyroid cancer
54
What do Psammoma bodies suggest
Papillary thyroid cancer
55
RF for papillary thyroid cancer
Radiation exposure
56
Which age group does papillary thyroid cancer affect
Younger patients
57
Buzzword for follicular thyroid cancer
Hurthle cells
58
What do Hurthle cells suggest
Follicular thyroid cancer
59
Which thyroid cancer is associated with MEN2
Medullary
60
What is medullary thyroid cancer associated with
MEN2
61
Which gender is lymphoma more common in
Gemales
62
When does lymphoma thyroid cancer generally occur
After pre-existing Hashimoto's thyroiditis
63
What is the usual population of anapaestic thyroid cancer
Elderly females
64
What are the buzzwords for anapaestic thyroid cancer (2)
giant cells, pleomorphic hyperchromatic nuclei
65
What do giant cells suggest in thyroid cancer
Anaplastic thyroid cancer
66
What do pleomorphic hyperchromatic nuclei suggest in thyroid cancer
Anaplastic thyroid cancer
67
S/s of acromegaly (9)
rings and shoes become right, ↑ sweating, coarse facial features, sleep apnoea, weight gain, headaches/visual disturbance, carpal tunnel syndrome, hypertension, insulin resistance
68
Diagnostic test of acromegaly
Diagnostic: OGTT  acromegalics fail to suppress GH after 75g glucose load
69
Mx of acromegaly (20
1st line = transphenoidal hypophysectomy | 2nd line = somatostatin analogue e.g. ocreotide
70
MEN1 glands
Parathyroid adenoma/hyperplasia Pancreas Pituitary
71
MEN2 glands
Thyroid Adrenal Parathyroid hyperplasia
72
MEN3 features
MEN2 thyroid carcinoma + phaeo + Mucosal neuromas: bumps on lips/cheeks/tongue/eyelids + Marfanoid appearance NO hyperparathyroidism
73
Presentation of carcinoid syndrome (6)
paroxysmal flushing, diarrhea, crampy abdominal pain, wheeze, sweating, palpitations
74
Ix for carcinoid syndrome (2)
urine collection: ↑ 5-HIAA levels (serotonin metabolite) | CT/MRI to localize tumour. Also consider looking for underlying MEN 1
75
Common sites of carcinoid tumours (2)
Appendix and rectum

Y3 MedEd (34 decks)

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