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MRCP > Endocrinology > Flashcards

Endocrinology Flashcards

(59 cards)

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1
Q

28F on Lithium
weight gain, oligomenorrhoea, primary infertility

High TSH
Low T4
High Prolactin

Dx?
Mx?

A

Primary hypothyroidism due to Lithium

Mx

  1. Thyroxine
  2. Don’t stop lithium (psych relapse)

NB. high prolactin as hypothyroid -> high TRH -> high prolactin

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2
Q

Advantage insulin analogue e.g. aspart

A

Rapid onset action

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3
Q

45F weight gain and sweating for 1 yr

Dx?

A

Insulinoma

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4
Q

Best intervention for reducing micro/ macro- vascular events in T2DM?

A

anti-HTN medication

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5
Q

1st and 2nd line Rx for Cushing’s Disease

A

surgery (remove ACTH tumour)

2nd line = Ketoconazole

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6
Q

Retrosternal goitre and stridor

Ix for airway obstruction?

A

Flow volume loop (detects tracheal obstruction)

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7
Q

Amyloid polypeptide on pancreas histology

Dx?

A

T2DM

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8
Q

Best intervention for reducing diabetic retinopathy progression

A

anti - hypertensives

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9
Q

Soft exudates

in pre-proliferative or proliferative retinopathy?

A

pre-proliferative retinopathy

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10
Q

48M post colectomy

L1 fracture and wt loss w normal diet

Low Ca
Low Phos

Cause for fracture?

A

Vit D deficiency

get low Ca, and increased PTH -> low Phos

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11
Q

51M HTN obesity T2DM
pituitary-dependent Cushing’s.

preoperative BP is elevated at 175/100 mmHg, BMI is 32 and fasting glucose is 11.2

Rx to improve his metabolic parameters prior to surgery?

A

Metyrapone
inhibits 11-beta hydroxylase inhibits cortisol production
rapid onset of action
without associated weight gain of e.g. insulin

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12
Q

Criteria for metabolic syndrome

A

Central obesity
(≥94 cm for men, ≥80 cm for women) plus any two of:

Hypertriglyceridaemia >1.7 mmol/L
Low HDL concentration <1.03 mmol/L male, <1.29 mmol/L female
BP ≥ 130/85 mmHg, or on treatment for hypertension
Fasting glucose ≥5.6 mmol/L, or known to have type 2 diabetes.

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13
Q 
45F 
chronic diarrhoea.
opening her bowels 8x/day  watery motions
Low K 
abdo US - pancreatic mass

Dx?

Rx?

A

VIPoma

Somatostatin analogues

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14
Q

weight loss
hypokalaemia
chronic diarrhoea
metabolic acidosis

Dx

A

VIPoma

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15
Q

Bromocriptine

MOA

Indication

A

is a dopamine agonist which can be used in the treatment of prolactinoma

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16
Q

Cholestyramine

MOA

Indication

A

is a bile acid sequestrant that can be used in the management of diarrhoea related to small bowel malabsorption or pancreatitis.

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17
Q

Urge incontinence

1st line

2nd line

A

1) bladder training

2) oxybutinin

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18
Q

52M

HGV driver

morbidly obese

On Metformin 1g BD
HbA1c 73

Rx?

A

Exanatide

(as morbidly obese (or risk hypos) give exanatide)

Otherwise give metformin or sulphonylurea

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19
Q

HRT risks

A

HRT increases CVD and stroke

frequently produces a rise in triglyceride concentrations.

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20
Q

Most likely complication anaplastic thyroid cancer

A

upper airway obstruction

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21
Q

When to monitor bgl in diabetes

A

On insulin, sulphonylureas or glinides (repaglinide or netaglinide)

fasting and pre-prandial glucose levels

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22
Q

Thyroidectomy commonest complication

A

transient hypoparathyroidism

low Ca

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23
Q

TB drug interrupts thyroxine absorption

A

Rifampicin

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24
Q

Drugs for PCOS

hirsutism
conception

Study These Flashcards
A

hirsutism - COCP

conception - metformin

25
Artery close to recurrent laryngeal nerve
inferior thyroid artery
26
Rx to reduce risk renal failure in diabetic nephropathy (proteinuria)
ACEi e.g. lisinopril
27
Headache Vomiting Visual disturbance Hormonal dysfunction
Pituitary apoplexy (acute haemorrhage/infarct to pituitary) - initially worried about no ACTH -> Addisonian crisis -> give hydrocortisone - then can get low TSH and low LH/FSH
28
Low BP Low Na High K Low glucose
Addisonian crisis
29
Galactorrhoea and amenorrhoea for 1 year Visual fields normal Prolactin 10500 Dx? Rx?
Dx = macroprolactinoma | Rx = DA carbergoline or bromocriptine lowers prolactin and normalises oestrogen
30
Changes to TFTs during pregnancy
High total T4 (as higher thyroid binding globulin) | Low TSH
31
Low Ca High Phos High PTH Short stature Short 4th/5th metatarsals Intellectual impairment
Pseudohypoparathyroidism | PTH resistance
32
Low Ca High Phos Low PTH
Hypoparathyroidism
33
Thigh pain Progresses to proximal muscle wasting loss knee reflexes Dx? Ix?
Diabetic amyotrophy (as vasa nervorum occlusion for lumabr plexus +- femoral nerve Ix = (test for DM), so OGTT or BGL
34
Flu-like illness hyperthyroid -> hypothyroid then recovert Gland diffusely tender Dx? Rx?
Dx = de Quervains thyroiditis Rx = NSAIDs (no need to give thyroid meds)
35
32F amenorrhoea 4m FSH low LH low raised prolactin 800
MRI mpituitary Hypogonadotrophic hypogonadism in the presence of raised prolactin is likely secondary to microprolactinoma
36
23F T1DM Weight loss, no other Sx microcytic anaemia Ix?
anti - TTG Ab ?coeliac in bg of T1DM as well can have Fe and B12 deficiency and have few Sx with coeliac
37
Leptin function
satiety made by adipocytes acts on hypothalamus
38
31F T1DM Pain R shoulder Reduced passive and active movements R side
Adhesive capsulitis | associated w diabetes
39
diffuse tender goitre hyperthyroidism very low uptake on radioactive iodine uptake scan
de Quervain's thyroiditis get hyperthyroidism due to rapid release preformed thyroid hormones
40
de Quervain's thyroiditis Rx?
symptomatic control BB for tremor/anxiety Pred or NSAIDs for thyroiditis
41
Lipaemia retinalis associated with
hypertriglyceridaemia
42
Xanthelasma and corneal arcus associated with
hypercholesterolaemia
43
Dx for gestational diabetes
75 g oral glucose tolerance test at 16-18 weeks rpt at 28wks if normal
44
Rx gestational diabetes
diet and exercise if fails after 1-2 weeks give meds (METFORMIN, GLEBENCLAMIDE, INSULIN) if evidence fetal macrosomia start meds immediately
45
Cause osteoporosis in young men
Hypogonadism do testosterone level first (before prolactin)
46
Drug causing nephrogenic DI
Lithium
47
K and Na in primary hyperaldosteronism other Ix?
K low Na high K CAN BE NORMAL IN 12% PATIENTS do aldosterone: renin ration (stop BB before doing this)
48
amenorrhoea raised LH:FSH ratio insulin resistance hyperandrogenism -raised androstenedione + slightly raised testosterone
PCOS
49
important predictor of potential ulceration in diabetic foot
callus formation
50
Prolactin levels <1000 1000 - 3000 >3000
<1000 = drug induced high prolactin/ hypothyroid 1000-3000 = microprolactinoma >3000 = macroprolactinoma
51
h ypoaldoseteronism -> reduction in PCT ammonium excretion mild (normal anion gap) metabolic acidosis
type 4 RTA
52
exanatide MOA
GLP 1 analogue suppresses appetite inhibits glucose production in the liver slows gastric emptying stimulates insulin release
53
Alpha subunit G protein mutation
pseudohypoparathyroidism (pth resistance) hypothyroidism
54
neuroendocrine tumour xs SEROTONIN flushing, diarrhea and wheezing
carcinoid SYNDROME - commonly in SI, appendix tumours - but NOT commonly w/ carcinoid tumours Lung carcinoid TUMOUR a/w Cushings (as produces ectopic ACTH)
55
Carinoid tumour Rx
Octreotide somatostatin analogue (also used in acromegaly)
56
exanatide rare SE
pancreatitis
57
Rare renal disorder (AR) defect in Loop of Henle Low K high renin + aldosterone Normal BP
Barrters syndrome
58
Hasimotos's thyroiditis increased risk of which cancer
thyroid lymphoma
59
amenorrhea hypergonadotropinism - high fsh low oestrogen
primary ovarian failure

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