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Phase 2a Basic Knowledge > Endocine Missed Points > Flashcards

Endocine Missed Points Flashcards

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1
Q

What drug may cause hypokalaemia

A

Salbutamol is associated with hypokalaemia

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2
Q

What drug is associated with Hyperkalaemia

A

ACEi - ramapril

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3
Q

What can inhibit GH in normal physiology

A

Dopamine

Hyperglycaemia

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4
Q

Cause of primary hyperaldosteronism

A

(Unilateral) Adrenal adenoma - 1/3 = conns syndrome

Bilateral adrenal hyperplasia - 2/3

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5
Q

Main cause of secondary hypertension

A

Conns syndrome

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6
Q

1st line investigation for conns syndrome

A

Aldosterone: renin ratio

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7
Q

Investigations for conns syndrome / hyperaldosteronism

A

Aldosterone : renin ratio

AVS (adrenal venous sampling)

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8
Q

What does AVS show

A

AVS = adrenal venous sampling

Shows if excessive hormones are being secreted from the adrenal glands

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9
Q

How do you differentiate from conns syndrome & bilateral adrenal hyperplasia

A

HRCT (high-resolution CT) abdomen + AVS

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10
Q

Primary hyperparathyroidism results..?

A

Calcium = high —> should trigger -ve feedback so PTH should be low, if Normal/high = primary hyperparathyroidism

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11
Q

Secondary hyperparathyroidism results..?

A

Ca2+ low (Vit d deficiency / renal impairment)
High PTH

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12
Q

In pheochromocytoma surgical treatment what else is done

A

Give alpha blocker prior surgery - phenylbenzamine

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13
Q

1st line treatment for T2DM

A

LIFESTYLE ADVICE

Then meds: 1st line medication = metformin

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14
Q

Gold standard investigation / Dx for pheochromocytoma

A

Elevated plasma free metanephrine

Then…

After G.S. Do MRI of adrenal

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15
Q

If Px previously Dx with autoimmune condition remember….

A

If Px has Sx of another autoimmune condition then its probably the new Dx

E.g. Px previous Dx with T1DM and presents with new symptoms like… hypotensive, salt craving, tanned, weight loss/anorexia = Addisons

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16
Q

Signs / symptoms for Addisons

A

Hyperpigmentation

Salt craving (decrease aldosterone —> increased Na+ excretion // increased K+ absorption)

Anorexia / weight loss

Hypoglycaemic

Vitiligo + change in body hair

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17
Q

Which thyroid cancer is most abundant

A

Papillary

Follicular

Medullary + anaplastic

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18
Q

Give a corticotropin independant cause of Cushing’s

A

Iatrogenic (steroid use) - most common overall cause

Adrenal adenoma

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19
Q

Give corticotopin dependant causes of Cushing’s

A

Cushings disease - most common ACTH dependant cause

Ectopic ACTH (SCLC)

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20
Q

What causes pseudo Cushing’s

A

Alcohol use

Resolves in 1-3 weeks

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21
Q

When is IgE seen

A

In allergic diseases

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22
Q

When is IgG seen

A

IgG is most common immunoglobulin

Seen in graves

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23
Q

Which immunoglobulin is seen in graves

A

IgG

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24
Q

Signs / symptoms for Hypercalcaemia

A

Stones - renal / biliary
Bones - bone pain / fractures
Psychiatric moans - depression
Abdominal groans - abdominal pain, constipation, pancreatitis

Polyuria + polydipsia

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25
Hyperkalaemia ecg changes
GO ; absent p waves GO LONG ; pronged PR interval GO TALL ; tall tented T waves GO UNDER ; wide QRS
26
Type of oedema seen in Graves and in Low serum albumin
Graves - NON-PITTING oedema Low serum albumin - PITTING oedema (Leakage of water in tissue)
27
Results of primary hypothyroidism..?
Low T3/4 High TSH
28
Results of secondary hypothyroidism?
Low T3/4 Low TSH (pituitary adenoma compresses TSH secreting cells
29
Common Sx of PCOS
Hirsutism Acne Oligoamenorrhoea
30
ADH synthesis..?
Supraoptic nuclei of hypothalamus Stored in posterior pituitary
31
Where is glucagon secreted from
Alpha pancreatic cells
32
When is glucagon secreted
In response to hypoglycaemia
33
Role of glucagon
Acts on liver to convert glycogen —> glucose Increases lipolysis + proteolysis
34
Difference in insulin and glucagon structure
Glucagon —> single polypeptide (29 amino-acids) Insulin —> 2 polypeptides (51 amino acids)
35
How’s Vit D activated…
PTH increases activity of 1alpha-hydroxylase enzyme Increased conversion of 25-hydroxycholecaleciferol —> 1, 25-dihydroxycholecaliciferol (active form of Vit D) Helps Ca2+ absorption in small intestine
36
The role of PTH in osteoclast activity
Indirect stimulation of osteoclasts to increase bone resorption OPG (secreted by osteoblasts) binds to block RANK-L : RANK complexes which are used to help mature osteoclasts for reduced bone resorption so… PTH inhibits OPG… theres more complexes formed so more osteoclasts activity
37
Role of PTH…
Vit D activation…. Increases Ca2+ absorption in kidneys Increased Ca2+ gut reabsorption Increased osteoclast activity for bone resorption Decreased phosphate reabsorption
38
Role of round ligament
Maintains anteverted position of uterus
39
Role of ovarian ligament
Connects ovaries to uterus
40
Role of cardinal ligament
Connects cervix —> later pelvic wall (supports vagina + cervix) Contains uterine artery + vein
41
Role of broad ligament
Connect uterus —> pelvic wall Splits pelvic cavity into uteri rectal pouch & uterovesicle pouch
42
Where does uterine arteries + vaginal arteries branch from
Internal pudendal arteries
43
What branch is the ovarian arteries come from
Abdominal aorta
44
Function of laydig cells
Produce testosterone
45
What stimulates wolffian duct to differentiate and into what
Testosterone Into… epididymis, ejaculatory ducts, vas deferens, seminal vesicles
46
More potent version of testosterone and what does that form
Dihydrotestosterone Later leads to penis, scrotum, prostate formation
47
Type of epithelium of vas deferens
Pseudostratified squamous with stereocilia lined by smooth muscle
48
Time frame of fertilisation after ovulation
Within 24-48 hrs
49
Where does fertilisation of egg take place
Ampulla of the fallopian tube
50
Stages of zygote development
Day What happens..? 1. Fertilisation 2-3. Cleavage (increasing cell no. For cell differentiation ) 4. Compaction (flattening of cells) 5. Cavitation and differentiation 21. Implantation
51
Contents of spermatic duct..?
Remember rule of 3… 3 arteries 3 nerves 3 fascia’s 3 others…. Inguinal nerve runs outside spermatic duct outside inguinal canal
52
If Px is being treated with long-term steroids + they stop…. Think of what…
Suppression of adrenal glands Secondary’s adrenal insufficiency
53
What cancers can cause SIADH
Think ectopic ADH… SCLC Pancreatic Prostate Lymphomas
54
Most commonly caused by renal impairment
Hyperkalaemia
55
Causes of renal impairment….
Hyperkalaemia Trauma Addisons DKA
56
Sx for Hyperkalaemia
Palpitations Dyspnoea Hyperreflexia Paraesthesia Abdominal pain + diarrhoea
57
Complications of acromegaly
T2DM Sleep apnoea Cardiomyopathy Colorectal cancers
58
1st line investigation for acromegaly and why
GH is pulsatile so IGF-1 is 1st line investigation
59
1st line treatment for acromegaly
Trans-sphenoidal resection … or … Medication: Dopamine agonists (Cabergoline / Bromocriptine) SST analogue (octreotide) GH antagonist (pegvisomant)
60
Differential; diagnosis for polyuria and polydipsia
DM DI Primary polydipsia Hypercalcaemia Hyperparathyroidism
61
Most likely cause of primary hyperparathyroidism
Solitary adenoma (80%)
62
Definitive treatment hyperparathyroidism
Total parathyroidectomy
63
Differential Dx for T2DM
Acromegaly Cushing Hypothyroidism
64
1st line investigation for Cushing’s
Overnight dexamethasone
65
Most common cause Cushing’s syndrome
Exogenous steroids
66
Differential Dx for conns
Primary hyperparathyroidism DM Renal artery stenosis SIADH
67
Hypercalcaemia ECG changes
Short QT interval
68
Sx / sign of hypocalcaemia
CATs go numb Convulsion Arrythmias Tetany Numbness Chvostek Troussoea
69
When do you see… Chvostek Troussoea
Hypocalcaemia
70
Where does superior thyroid artery branch off from
External carotid artery
71
Where does inferior thyroid artery branch off from
3rd branch of subclavian (Thyrocervical branch)
72
Define Hypercalcaemia of malignancy
Caused by excessive secretion of PTHrP (parathyroid hormone peptide)
73
Generalised Sx of pituitary adenoma
Headaches Visual disturbance N&V Fatigue Unexplained weight loss/gain
74
Signs / symptoms of carcinoid tumour /// syndrome
Flushing Diarrhoea Asthma-like wheeze // SoB Tricuspid incompetence (murmur)
75
Define carcinoid syndrome
Poorly malignant tumour of enterochromaffin cells that secrete serotonin
76
What drug decreases thyroid hormone production
Carbimazole
77
Mechanism of action of carbimazole for decreased thyroid hormone production
Blocks thyroid peroxidase from coupling & iodinating the tyrosine residues on thyroglobulin Decreasing thyroid hormone production
78
Signs / Sx of DKA
Reduced consciousness Fruity breath Kausmauls breathing Tachycardia + hypotensive
79
Tx of Hyperkalaemia
Calcium gluconate (if showing ecg changes / Arrythmias) Insulin + dextrose
80
First line treatment type 2
ALWAYS CONSERVATIVE ; Dietary and lifestyle changes Then if asks about medication; metformin
81
ECG changes seen in hypokalaemia
U waves Prolonged QT Inverted t waves
82
What Sx does carcinoid syndrome come with
Diarrhoea Itching SOB Facial flushing
83
Complications of hyperthyroidism
Hyperthyroid crisis Atrial fibrillation
84
Side effect of carbimazole
Used for hyperthyroidism Tx **Agranulocytosis** **Pancytopenia; bone marrow suppression**
85
Most common cause of hypothyroidism
Autoimmune condition; Hashimoto’s
86
Complication of Addison’s
Addisonian crisis + Osteoporosis
87
Tx for Addisonian crisis
Aggressive IV fluids and iv steroids + Glucose if hypoglycaemic
88
Side effect of Amiodarone
Hypothyroidism Can also cause hyperthyroidism
89
What’s a byproduct of insulin
Serum-C peptide protein is a product of insulin PRODUCTION
90
How do you tell the difference between exogenous and endogenous insulin effects
If serum-C peptide is raised it means the insulin is excessive endogenous production
91
Most common cause of Addison’s
Autoimmune adrenalitis
92
Give a severe complication of DKA
Cerebral oedema
93
Which DI does lithium toxicity cause
Nephrogenic diabetes insipidus
94
Which condition is linked to meningitis that decreases glucose
Waterhouse - friderichson syndrome
95
What is the Tx of diabetic neuropathy
Pregabalin
96
Target blood pressure for under 80s
<140/90
97
Target blood pressure for over 80s
<150/90
98
Which diabetes medication can give weight gain as a side effect
Sulfonylurea
99
Symptomatic relief for hyperthyroidism
Propranolol
100
Commonest cause of hypopituitarism
Pituitary adenoma
101
A non-GI side effects of metformin
B12 deficiency Lactic acidosis
102
3 complications of HHS
MI Stroke Cerebral oedema
103
What Sx is described as darkening of the skin folds and which disease can it be seen in
Acyanthosis nigracans Sx of T2DM; seen under armpits, back of neck and groin
104
Which diabetic medication can cause pulmonary oedema
Pioglitazone
105
Which diabetic medication is related to UTIs
Dopagliflozin

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