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Finals flashcards > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What’s the mechanism and SE of SGLT2 inhibitors?

A

Inhibit SGLT2 channels in PCT, so less glucose is reabsorbed, more is excreted. End in -ozin.
SE: UTIs, necrotising fasciitis of penis, increased risk of lower limb amputation.

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2
Q

Indication and SE of carbimazole

A

Mx of thyrotoxicosis. SE: agranulocytosis- FBC.

Administer in high doses for 6 weeks till euthyroid, then reduce.

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3
Q

Primary hyperparathyroidism sx and cause

A 
Thirst, bones (pain/#), stones, abdominal groans, psychiatric moans (depression).
Polydipsia and uria.
Associated with hypertension.
Often old thirsty ladies.
Most caused by solitary adenoma.
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4
Q

Investigations for primary hyperparathyroidism

A

Raised or inappropriately normal PTH,
Raised Ca,
Low phosphate
Technetium scan (MIBI)

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5
Q

Mx for primary hyperparathyroidism

A

Parathyroidectomy

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6
Q

How many units of insulin in 1ml?

A

1 ml = 100 units

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7
Q

How does hypothyroidism affect periods?

A

Causes menorrhagia. Whilst hyperthyroid causes amenorhoea or oligo.

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8
Q

TFTs for primary hypothyroidism

A

High TSH
Low free T4

Poor compliance with meds = high TSH, normal free T4

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9
Q

TFTs for secondary hypothyroidism

A

V rare

Low TSH, low free T4

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10
Q

4 phases of de quervain’s thyroiditis (subacute)

A

1) painful goitre, raised esr, hyperthyroid
2) euthyroid
3) hypothyroid
4) structure and function return to normal

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11
Q

Cause of subacute thyroiditis

A

Usually follows viral infection. Usually self limiting.

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12
Q

Investigation for subacute thyroiditis

A

Decreased iodine uptake on scan.

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13
Q

Most common drug cause of gynaecomastia

A

Spiranolactone

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14
Q

Which signs on examination are specific to Grave’s?

A

Exophthalmos

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15
Q

Symptoms of acromegaly

A

Glossitis and enlarged gum spaces
Prognathism (jaw extends/bulges out)
Features of pituitary tumour: headache, bitemporal hemianopia (tumour on chiasm)
Increase in hand/shoe size
Potentially galactorrhea (increased prolactin)

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16
Q

What type of hemianopia would you expect in a stroke, and in acromegaly?

A

Stroke or other lesion distal to optic chiasm: homonymous

Acromegaly: bitemporal hemianopia

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17
Q

Features of raised prolactin in women

A

Amenorrhoea

Galactorrhea

18
Q

Features of raised prolactin in men

A

Impotence
Reduced libido
Galactorrohea

19
Q

Causes of raised prolactin

A

Obs/gynae: PCOS, pregnancy, oestrogens
Endocrine: prolactinoma, acromegaly, primary hypothyroidism- TRH stimulates prolactin release
Physiological: stress, exercise, sleep

20
Q

Drug causes of raised prolactin

A

Anti-psychotics: haloperidol and phenothiazines

Anti-sickness: domperidone, metoclopramide

21
Q

Tx of raised prolactin and mechanism

A

Bromocriptine

Dopamine inhibits prolactin release, so use a dopamine agonist.

22
Q

Carcinoid syndrome: what is it and how does it present

A

Neuroendocrine tumour, can be GI, resp, other places. Usually occurs from mets in liver.
Secretes serotonin so causes flushing, diarrhoea, bronchospasm, abdo pain

23
Q

Cardiac associations of carcinoid syndrome

A

TIPS
Tricuspid insufficiency
Pulmonary stenosis

24
Q

Inv for carcinoid

A

Urinary 5-HIAA

25
Q

Mx for carcinoid

A

Somatostatin analogues like ocreotide. (Somatostatin inhibits release of somatotropins which are growth factors)

26
Q

How does alcoholic ketoacidosis present clinically and in investigations?
Management?

A

Alcoholics who have an episode of reduced food intake. Start to metabolite fats. Nausea, vom, abdo pain.
Ketones, normal or low glucose, acidotic.
Saline with thiamine for wernickes.

27
Q

Presentation of Wilsons

A

Neuro: psychiatric and speech problems
Liver: hepatitis, cirrhosis

28
Q

Investigating and tx Wilson’s

A

Total Serum copper is reduced as serum caeroloplasmin carries 95% and is reduced, free copper is increased, increased urinary copper excretion

Penicillamine

29
Q

How do you mx hypercalcaemia?

A

IV 0.9% saline 3/4 litres then bisphosphonates later

30
Q

Causes of hypercalcaemia

A

Primary hyperparathyroidism

Malignancy like Squamous cell LC

31
Q

Antibodies in Grave’s

A

TSH-receptor stimulating autoantibodies

Anti-thyroid peroxidase autoantibodies (lower %)

32
Q

Investigations for Grave’s

A

Low TSH

Raised free T4

33
Q

Effects of mineralocorticoids vs glucocorticoids

A

Fluid-retention vs. anti-inflammatory

34
Q

Which mineralocorticoid exerts the highest mineralo effect but lowest gluco effect?

A

Fludrocortisone

35
Q

Which glucocorticoid exerts the highest glucocorticoid effect but lowest mineralo?

A

Dexamethasone

36
Q

What’s the most important modifiable RF for thyroid eye disease?

A

Stop smoking

37
Q

How does myxoedema coma present?

A

Confusion, hypotension, bradycardia, hypothermia, profoundly hypothyroid

38
Q

Mx of myxoedema coma

A

IV thyroid hormone replacement + IV hydrocortisone (may have co-existing adrenal insufficency so must avoid precipitating a crisis)

39
Q

Sick euthyroid syndrome: cause, investigations and mx

A

Severe systemic illness causes low everything.
Low or normal TSH, low thyroxine, T3.
Reverses naturally upon recovery.

40
Q

Which haematological disease can produce falsely low HbA1cs?

A

Sickle cell- decreased RBC lifespan

41
Q

2 aspects of diabetic foot disease

A

1) Neuropathy- 10g filament test

2) Ischaemia- Doppler DP pulse, ABPI is reduced

42
Q

5 types of hormones released by adrenal glands (stimulated by ACTH)

A
  • Androgens
  • Oestrogen
  • Mineralocorticoid
  • Glucocorticoids
  • Catecholamines (adrenaline, noradrenaline, dopamine)

Finals flashcards (15 decks)

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