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Flashcards in Endocrine Deck (48)
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1
Q

Modifiable risk factor for Grave’s?

A

Smoking

2
Q

Management of an asymptomatic patient with raised HbA1c?

A

Repeat test to confirm diagnosis

3
Q

Management of fluids in SIADH?

A

Fluid restriction

4
Q

What 3 endocrine parameters decrease in stress response?

A

Insulin
Testosterone
Oestrogen

5
Q

ABG in Cushing’s?

A

Hypokalaemia metabolic alkalosis

6
Q

Which diabetic drug has increased risk of bladder cancer?

A

Pioglitazone (thiazolidinediones)

7
Q

Management of Grave’s disease in pregnancy?

A

Propylthiouracil

8
Q

Biochemistry in primary hyperparathyroidism?

A

Raised ALP, PTH
Low PO4

9
Q

Cause of tertiary hyperparathyroidism?

A

Ongoing hyperplasia of parathyroid glands following correction of underlying cause

10
Q

Differentiation between primary and secondary hyperaldosteronism?

A

Primary = normal renin
Secondary = raised renin

11
Q

Thyroxine in osteoporosis ?

A

Increase replacement dose

12
Q

Uptake of iodine-131 on thyroid scintigraphy in De Quervian’s (subacute) thyroiditis?

A

Decreased

13
Q

TFTs in sick euthyroid syndrome?

A

TSH: normal
T3&4: low

14
Q

SIADH urine osmolality and urinary sodium?

A

Raised urinary osmolality
Raised urinary sodium
(management with fluid restriction)

15
Q

TFTs in nephrotic syndrome?

A

May be isolated low total thyroxine level

16
Q

Type of diabetes that Lithium causes?

A

Nephrotic Diabetes Insipidus

17
Q

In DM with CVD, high risk of CVD or CHF, what 2 drugs should be prescribed initially?

A

Metformin and SGLT-2 inhibitors (empagliflozin)

18
Q

SGLT2 inhibitors example?

A

Gliflozins

19
Q

SE of SGLT2 inhibitors?

A

Thrush
Noroglycaemic ketoacidosis
Fournier’s gangreen

20
Q

SE of pioglitazone and therefore when is it contraindiacted?

A

Fluid retention in HF

21
Q

Where do antibodies target in pemphigus vulgarism?

A

Desmosomes (connect cells)
Easily ruptured vesicles
Common in Ashkenazi Jewish population

22
Q

False raised HbA1c?

A

Splenectomy (due to increased lifespan on RBCs)

23
Q

Thyroid cancer with excellent prognosis?

A

Papilliary (even though early spread to cervical lymph nodes)

24
Q

Initial therapy in DM2 with metformin an SGLT2?

A

Ensure metformin is titrated up first, then start SGLT2 regardless of glycemic control

25
Q

Example of DPP4 inhibitor?

A

Sitagliptin
Saxagliptin

26
Q

Diagnostic marker for carcinoid syndrome (24 hour urinary collection)?

A

5 HIAAA (5-hydroxyindolacetic acid)

27
Q

Use of ocreotide?

A

Acromegaly
Symptom control (diarrhoea) of carcinoid tumours

28
Q

When do you treat sub-clincal hypothyroidism?

A

When TSH is > 10 on 2 separate occasions, 3 months apart

29
Q

Trousseau’s sign?

A

Carpal spasm if the brachial artery occluded by inflating the blood pressure cuff and maintaining pressure above systolic

30
Q

Chvostek’s sign?

A

Tapping over parotid causes facial muscles to twitch

31
Q

What causes patchy uptake on scintigraphy?

A

Toxic multinodular goitre

32
Q

Addison’s patient with intercurrent illness?

A

Double hydrocortisone
Same fludricortisone

33
Q

Why do you get a postural drop in DM?

A

Autonomic dysfunction

34
Q

When should insulin-dependent diabetic check their blood glucose with regards to driving?

A

Before driving and every 2 hours regardless of whether they have eaten or not

35
Q

Levothyroxine and pregnancy?

A

Women with hypothyroidism may need to increase their thyroid hormone replacement dose by up to 50% as early as 4-6 weeks of pregnancy

36
Q

Inheritance of MODY?

A

Autosomal dominant

37
Q

Acropatchy?

A

Clubbing with hyperthyroidism (Grave’s disease)

38
Q

Iodine uptake in Grave’s disease?

A

Increased homogenous uptake

39
Q

Increased IGF-1 on bloods, what investigation do you do next to confirm diagnosis?

A

OGTT with serial GH measurement

40
Q

DVLA and dm patient with 2 hypoglycaemic episodes requiring help?

A

Need to surrender their driving licence

41
Q

Impaired fasting glucose definition?

A

A fasting glucose greater than or equal to 6.1 but less than 7.0 mmol/l implies impaired fasting glucose (IFG)

Impaired glucose tolerance (IGT) is defined as fasting plasma glucose less than 7.0 mmol/l and OGTT 2-hour value greater than or equal to 7.8 mmol/l but less than 11.1 mmol/l

42
Q

What should people with impaired glucose tolerance receive?

A

Oral glucose tolerance test to rule out a diagnosis of diabetes

A result below 11.1 mmol/l but above 7.8 mmol/l indicates that the person doesn’t have diabetes but does have IGT

43
Q

Whipple’s triad?

A

Insulinoma
1. Hypoglycaemia with fasting or exercise
2. Reversal of symptoms with glucose
3. Recorded low CBG at time a symptoms

44
Q

C-peptide raised?

A

Insulin produced by own pancreas
If c-peptide not raised = exogenous insulin

45
Q

Sevelamer?

A

Non-calcium based phosphate binder, used in CKD mineral bone disease

46
Q

Platelets in alcoholics?

A

Decreased

47
Q

Men I

A

3 p’s
Pituitary
Pancreas
Parathyroid

48
Q

Men 2

A

Phaeochromocytoma
Parathyroid
Medullary thyroid cancer