Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

5th Year > Endocrine Stuff > Flashcards

Endocrine Stuff Flashcards

(62 cards)

Start Studying
1
Q

What will U+Es show in Addison’s?

A

Lowered Na+

Raised K+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why is potassium raised in Addison’s?

A

Lack of aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Will glucose be raised or lowered in Addison’s?

A

Lowered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In a GP, what are the cortisol level cutoffs when investigating Addison’s?

A 
<100 = likely Addison's
100-500 = synachten test
>500 = unlikely Addison's
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the synachten test?

A

ACTH stimulation test - give ACTH and measure cortisol 30mins later
Addison’s = no cortisol peak

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What other investigations are required if investigating Addison’s? (2)

A

CXR - TB and lung cancer

Anti-21-hydroxylase Ab - indicates immune destruction, +ve in 80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the management of Addison’s?

A

Steroid replacements
Hydrocortisone = glucocorticoid
Fludrocortisone = mineralcorticoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the sick rule for Addison’s?

A

Double hydrocortisone, no change to fludrocortisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the management of an Addisonian crisis?

A

IV Hydrocortisone 100mg

IV fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What malignancy may cause Cushing’s syndrome?

A

Small cell lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What ABG picture will Cushing’s syndrome give?

A

Metabolic alkalosis with hypokalaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why do you get hypokalaemia in Cushing’s syndrome?

A

Overload of cortisol can have some knock-on aldosterone effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How are Cushing’s causes categorised?

A

ACTH-dependent and ACTH-independent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the ACTH-dependent causes of Cushing’s? (2)

A

Cushing’s disease (80%)

Ectopic ACTH production (eg. SCLC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Cushing’s disease?

A

Pituitary tumour secreting ACTH -> adrenal hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the ACTH-independent causes of Cushing’s? (2)

A

Iatrogenic/steroids

Adrenal adenoma/carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What 3 investigations will help in the diagnosis of Cushing’s?

A

Overnight dexamethasone suppression test
24hr urinary cortisol
Insulin stress test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How is the dexamethasone suppression test conducted?

A

Give dex at 10pm, measure cortisol at 9am

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why may an insulin stress test be performed?

A

Allows differentiation between Cushing’s and pseudo-Cushing’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the two stages to the overnight dex suppression test?

A

Low-dose (1mg)

High-dose (8mg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does the low-dose ODST indicate?

A

Whether someone has Cushing’s syndrome
Low cortisol = NORMAL person
Normal/high cortisol = Cushing’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does the high-dose ODST indicate?

A

The cause of the Cushing’s syndrome
Low cortisol = Cushing’s disease
Normal/high cortisol = Adrenal/ectopic cushing’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How do you differentiate between adrenal and ectopic Cushing’s on laboratory tests?

A

Low ACTH after high-dose ODST = adrenal cushing’s

High ACTH after high-dose ODST = ectopic ACTH production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the management of Cushing’s?

A 
Iatrogenic = stop steroids
Mifepristone = decreases steroid secretion
Tumours = surgical removal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the symptoms of diabetes insipidus?
Polyuria Polydipsia Dilute urine
26
What laboratory test will indicate diabetes insipidus?
Low urine osmolality | High serum osmolality
27
How is diabetes insipidus classified?
``` Cranial = not producing ADH Nephrogenic = not responding to ADH ```
28
What 3 investigations should be performed if suspect diabetes insipidus?
Rule out DM - BGL/HbA1c Rule out CKD - U+E Water deprivation test - deprive fluids for 8hrs then check osmolality
29
What is the management of CRANIAL diabetes insipidus?
Desmopressin
30
What is the management of NEPHROGENIC diabetes insipidus?
Bendroflumethiazide
31
In practice, what is often done to distinguish between cranial and nephrogenic diabetes insipidus?
Give Desmopressin and see if it works
32
What is the management of acute hypercalcaemia?
0.9% saline 1L 4hrly 24hrs, then 1L 6hrly 48-72hrs Furosemide if overloaded IV Pamidronate
33
What are Chvostiks and Trousseau signs indicative of?
Hypercalcaemia
34
What is the management of secondary hyperparathyroidism?
Alfacalcidol (active vitD)
35
What are the criteria for familial hyperlipidaemia?
Total cholesterol >7.5 AND FHx of premature CHD | OR Total cholesterol >9.0
36
What are the features of a pituitary adenoma?
Excess GH -> acromegaly Bitemporal hemianopia Raised prolactin (1/3) -> galactorrhoea
37
What syndrome are pituitary adenomas associated with?
MEN-1 (6% of pituitary adenomas)
38
What is the management of a pituitary adenoma?
Transphenoidal surgery to remove | Octreotride to decrease GH
39
What is Addison's disease?
Autoimmune destruction of adrenal glands Resulting in decreased cortisol and aldosterone Most common primary hypoadrenalism in UK (80%)
40
What are the symptoms of Addison's disease?
``` Lethargy, weakness, anorexia, weight loss Nausea and vomiting Salt craving Hyperpigmentation esp. palmar creases Vitiligo Loss of pubic hair in females ```
41
What are the physiological features of Addison's disease?
Hypotension Hypoglycaemia Hyponatraemia Hypokalaemia
42
What are the features of an Addisonian crisis?
Shock Collapse Pyrexia
43
What are the non-Addison's causes of primary hypoadrenalism? (5)
``` TB Metastatic cancer (eg. bronchial) Meningococcal sepsis = Waterhouse-Friderichson syndrome HIV Anti-phospholipid syndrome ```
44
What are the causes of secondary hypoadrenalism? (2)
Pituitary disorders | Exogenous glucocorticoids
45
From inside to out, name the parts of the adrenal gland?
Medulla Zona reticularis Zona fasciculata Zona glomerulosa
46
What percentage of the adrenals is medulla?
20%
47
What is secreted from the adrenal medulla?
Catecholamines
48
What percentage of the adrenals is cortex?
80%
49
What percentage of cortex is zona reticularis, and what does it secrete?
7% | Androgens ie. oestrogen and testosterone
50
What percentage of cortex is zona fasciculate, and what does it secrete?
78% | Glucocorticoids ie. cortisol
51
What percentage of the cortex is zona glomerulosa, and what does it secrete?
15% | Mineralcorticoids ie. aldosterone
52
Which hormone stimulates the adrenal cortex?
ACTH
53
What stimulates the adrenal medulla?
Nerve fibres
54
What is the function of mineralocorticoids?
Na+ and water retention in kidneys -> increase BP and blood volume
55
What is the function of glucocorticoids?
Increased protein and fat breakdown to glucose -> increase BGL Immune system suppression
56
What are the causes of primary HYPERaldosteroniam? (3)
``` Idiopathic adrenal hyperplasia (70%) Adrenal adenoma = Conn's syndrome Adrenal carcinoma (rare) ```
57
What are the features of HYPERaldosteronism?
Hypertension Hypokalaemia -> muscle weakness (10-40% in practice) Alkalosis
58
What is the 1st line investigation for HYPERaldosteronism?
Aldosterone/Renin Ratio
59
What will the ARR show for HYPERaldosteronism?
High aldosterone with low renin - due to -ve feedback from Na+ retention -> decreased renin
60
What investigations should be performed if you get a high ARR?
High-resolution CT - identifies bilateral vs unilateral causes Adrenal venous sampling - identifies the gland secreting the excess hormone
61
What is the management of an adrenal adenoma (Conn's syndrome)?
Surgical removal
62
What is the management of bilateral adrenal hyperplasia?
Spironalactone (aldosterone antagonist)

5th Year (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions