Endocrinology

Question 1

Viruses linked to causing T1DM

Answer 1

Coxsackie B (COX A causes hand foot and mouth

Enterovirus

Question 2

Blood glucose range

Answer 2

4.1-6.1 mmol/l

Question 3

Where is insulin secreted from

Answer 3

Beta cells in Islets of Langerhans (pancreas)

Question 4

Where is glucagon secreted from

Answer 4

Alpha cells in Islets of Langerhans (pancreas)

Question 5

Classic triad of hyperglycaemia symptoms

Answer 5

Polyuria, polydipsia, weight loss (dehydration)

Question 6

What is secondary enuresis

Answer 6

Bed wetting in previously dry child

Associated with T1DM

Question 7

Important bloods in newly presented T1DM (not in DKA)

Answer 7

FBC UE HBA1C

TFTs, TPO - autoimune thyroid disease
anti-TTG
Insulin antibodies, anti-GAD antibodies, islet cell antibodies - destruction of pancreas

Question 8

Consequence of injecting insulin into the same spot repeatedly

Answer 8

Lipodystrophy

Subcutaneous fat hardens and prevents normal adsorption

Question 9

What is Lipodystrophy

Answer 9

Subcutaneous fat hardens and prevents normal adsorption.

Should change site to inject

Question 10

Most common insulin regime and meaning?

Answer 10

Basul bolus

Basal - long acting such as Lantus (normally in evening)

Bolus - short acting such as Actrapid (before meals)

Question 11

IV treatment and does of dextrose for a hypo

Answer 11

10% at 2mg/kg as a bolus

Question 12

Neurological DKA risk

Answer 12

Cerebral oedema

Question 13

Cause of cerebral oedema in DKA

Answer 13

Rapid correct of dehydration

Question 14

DKA criteria

Answer 14

BM >11, ketones >3, pH <7.3

Question 15

2 key DKA treatment principles

Answer 15

Correct dehydration OVER 48 HOURS
Fixed rate insulin infusion

(add potassium)

Question 16

Test for adrenal insufficiency

Answer 16

ACTH stimulation test (short synacthen)

Question 17

Caution with adrenal insufficiency patients in other illnesses

Answer 17

Higher steroid demand and increased risk of hypoglycaemia

Question 18

Addisionian crisis signs and symptoms

Answer 18

Hyperkalaemia, hyponatremia, hypoglycaemia

Reduced GCS, hypotension

Question 19

Enzymes causing congenital adrenal hyperplasia

Answer 19

21-hydroxylase

11-beta- hydroxylase

Question 20

Genetic inheritance of congenital adrenal hyperplasia

Answer 20

AR

Question 21

Congenital adrenal hyperplasia effect on hormone levels

Answer 21

Low cortisol and aldosterone

High androgens

Question 22

Testosterone hormone type

Answer 22

Androgen

Question 23

Aldosterone hormone type

Answer 23

Mineralcorticosteroid

Question 24

21-hydorxylase enzyme function

Answer 24

Progesterone to aldosterone and cortisol

Question 25

Congenital adrenal hyperplasia pathophysiology

Answer 25

No conversion of progesterone to aldosterone and cortisol as defect in 21-hydorxylase. Extra progesterone gets converted to testosterone

Question 26

Congenital adrenal hyperplasia symptoms in young babies

Answer 26

Virilised genitalia | Poor feeding, dehydration, vomiting, arrhythmias

Question 27

Congenital adrenal hyperplasia in boys and girls

Answer 27

F: tall, facial hair, no periods early puberty M: tall, deep voice, large penis, early puberty SKIN PIGMENTATION

Question 28

Skin changes in congenital adrenal hyperplasia

Answer 28

Pigmentation - increased ACTH -> increased melanocyte stimulating hormone

Question 29

Congenital adrenal hyperplasia management

Answer 29

``` Cortisol replacement Aldosterone replacement (fludrocortisone) ```

Question 30

Growth hormone deficiency presentation

Answer 30

Micropenis, hypoglycaemia, severe jaundice Poor growth (ESPECIALLY AFTER 2-3 YEARS), short, late puberty

Question 31

Cause of acquired hypothyroidism

Answer 31

Hashimotos (anti TPO)

Question 32

Newborn hypothyroidism symptoms

Answer 32

Neonatal jaundice, poor feeding, constipation, increased sleeping, reduced growth

Question 33

Associated conditions with acquired hypothyroidism

Answer 33

T1DM, coeliacs

Question 34

Release of growth hormone is from where and mediated by what

Answer 34

GHRH (hypothalamus) -> anterior pituitary

Question 35

most common mutations in growth hormone deficiency

Answer 35

GH1 or GHRHR (receptor)

Question 36

Condition that results in underdeveloped pituitary gland

Answer 36

Empty sella syndrome

Question 37

What is empty sella syndrome

Answer 37

Shrinking of pituitary gland (leads to growth hormone deficiency)

Question 38

What does growth hormone do?

Answer 38

Acts on liver to release IGF-1

Question 39

What cell maintains bone

Answer 39

Osteocyte Cite (citation)=maintains credibility

Question 40

What cell forms bone matrix

Answer 40

Osteoblast Blast=build

Question 41

What cell reabsorbs damaged bone

Answer 41

Osteoclast