Endocrinology Flashcards
(105 cards)
1
Q
What is MODY
A
Maturity onset diabetes in the young
2
Q
Cause and treatment of mody
A
HNF alpha
Glicazide
3
Q
2 positives to DPP4
A
No weight gain
No hypoglycaemia
4
Q
2 hormone changes in klinefelters
A
Increased LH
Reduced testosterone
5
Q
2 hormone changes in Kallman syndrome
A
Reduced FSH/LH
6
Q
Hyperglycaemia and dehydration
A
Give IV fluids
7
Q
What is prolactin inhibited by
A
Dopamine (carbergoline)
8
Q
Insulin during sick days
A
Never stop
Check sugar regularly
You may need to increase
9
Q
3 changes stress can cause to hormones (e.g. surgery)
A
Reduced insulin
Reduced testosterone
Reduced oestrogen
10
Q
Treatment of diabetic neuropahty
A
1st: Duloxetine, Amitriptyline, Gabapentin, Pregabalin
Tramadol - rescue
Capsacin - topical
Pain management clinic
11
Q
Risk factor for graves
A
Smoking
12
Q
Where is a papillary carcinoma found and what is its prognosis
A
Thyroid
Good prognosis
13
Q
3 SGLT-2 inhibitor side effects
A
Increased urinary excretion
Weight loss
Can cause UTI
14
Q
Diagnosis of pheochromocytoma
A
24hr metanephrins (HTN)
15
Q
Thyrotoxicosis with tender goitre
A
Subacute thyroiditis
16
Q
Diagnosis of acromegaly
A
1st: Increased IGF-1
2nd: OGTT and serial GH
17
Q
What is trosseaus sign
A
Carpal spasm on bp cuff inflation
18
Q
Side effect of spironolactone and goserelin
A
Enlarged breasts
19
Q
What is goserelin used for
A
Prostate
20
Q
Side effect of metoclopramide
A
Galactorrhoea
21
Q
3 features of multiple endocrine neoplasia T1
A
Peptic ulceration
Galactorrhoea
Hypercalcaemia
22
Q
Treatment of bladder cancer
A
Thiazolindinediones (Pioglitazone)
23
Q
Addisons and illness
A
Double glucocorticoids
Keep fludrocortisone the same
24
Q
What is myxoedema
A
In hypothyroid
Confusion and hypothermia
25
What is acropachy
Clubbing
26
What thyroid condition is clubbing found in
Graves
27
Side effect of pioglitazine
Fluid retention
28
What should you monitor in hyperosmolar hyperglycaemia state
Serum osmolarity
29
2 electrolyte disturbances in malabsorption
Reduced calcium
Reduced magnesium
Increased phosphate
30
When should you withdraw corticosteroids
Increased 40mg for 1+ week
3+ w treatment
Repeated courses
31
Treatment of hypoglycaemia and impaired GCS
IV glucose if access
32
Insulin dependent diabetic and driving
Check glucose every 2 hours when driving
Inform the DVLA
Commercial = stop
33
Most common exogenous and endogenous cause of cushings syndrome
Exogenous steroids
| Endogenous pituitary adenoma
34
```
What is the name for subacute thyroiditis
What is it caused by
Presenting feature
2 findings
Prognosis
```
DeQuervain's
Reduced iodine uptake
Painful goitre
Increased ESR
Hyperthyroid
Good prognosis
35
T1DM
C-peptide
36
Treatment of hypothyroidism
Increased thyroxine 50%
37
Treatment of galactorrhoea
Bromocriptine
38
Class and MOA of gliptins
DDP4 inhibitors
| Reduce peripheral breakdown of incretins
39
Diabetic targets
48: diet/lifestyle/1 drug
53: single hypoglycaemic drug/ 2 diabetic drugs
40
Hyperosmolar hyperglycaemic state
Hypovolaemia and hyperglycaemia
41
Side effect of SGLT2 inhibitors
UTI
42
Most common cause of primary hyperaldosteronism
Bilateral idiopathic adrenal hyperplasia
43
Hypertension with hypokalaemia and mild alkalosis
Primary hyperaldosteronism
44
What does whipple's triad diagnose
Insulinoma
Hypoglycaemia
Glucose below 2.5
Reversibility of sx on administration of glucose
45
C-peptide on exogenous insulin stress test in pts with insulinoma
Will not fall
46
Multiple endocrine neoplasia (MEN) type 1
parathyroid
pituitary
pancreas e.g. insulinoma
47
MEN type 2a
medullary thyroid cancer
parathyroid
pheochromocytoma
48
MEN type 2b
Medullary thyroid cancer
Phaeochronocytoma
Neurones
Marfanoid
49
viral illness, raised ESR, reduced uptake of iodine, tender goitre and initial hyperthyroid phase
De Quervains subacute thyroiditis
50
Treatment for Dequav
naproxen
51
Sick euthyroid syndrome
low T3/T4
normal TSH
acute illness
52
Which diabetic drug causes weight gain
Gliclazide
| Sulfonylureas
53
Risk of LT steroids
Avascular necrosis, osteopaenia and osteoporosis
54
What metabolic disturbance does cushings cause
Hypokalaemic metabolic alkalosis
55
DIABETES BLOOD PRESSURE IS DIFFERENT TO NORMAL
TARGET BELOW 140/80
56
MOA of DPP-4 inhibitors
Increase levels of incretins
e.g. sitagliptin
57
Treatment of hypoglycaemia if the patient is conscious and able to swallow
Fast acting carbohydrate by mouth e.g. glucose liquids, tablets or gels
58
Assessing diabetic neuropathy in the feet
10G monofilament
59
Elevated T4 and low TSH
thyrotoxicosis
60
AB in hashimotos
Antithyroid peroxidase AB
61
Fasting glucose not quite DM then diagnosed with
Impaired fasting glycaemia
62
Diagnostic criteria for T2DM with Sx
Fasting glucose higher than 7
| Random glucose higher than 11.1
63
Presentation of myxoedema coma
Confusion and hypothermia
64
Adrenal venous sampling (AVS) can be used to distinguish between unilateral adenoma and bilateral hyperplasia in primary hyperaldosteronism
65
How is iodine taken up in graves disease
Homegenous uptake
66
BMI ranges
Under 18.5 - underweight
18.5-25 normal
25-30 overweight
(then obese in 5's)
67
Primary hypoaldosteronism
Addisons
68
test for addisons
Short synacthen test
69
Hyponatraemia and hyperkalaemia in a patient with lethargy
Addisons
70
DKA IV insulin
0.1 unit/kg/hour
71
PTH in primary hyperparathyroidism
Can be normal as the hypercalcaemia supresses it
72
Medication to control Sx in graves
Propanolol
73
Diagnosis of cushings
Low dose dexamethasone supression test
74
What does a high serum parathyroid hormone do to calcium and phosphate
High calcium and low phosphate (causes phosphate excretion)
75
Action of steroids
Fludrocortisone: high mineralocorticoid
Hydrocortisone: glucocorticoid and mineralocorticoid
Prednisolone, Dexamethasone and Betamethasone: high glucocorticoid
76
Ectopic source of ACTH with high dose dexamethasone
Neither cortisol or ACTH suppressed
77
What medication can worsen diabetes control
Corticosteroids
78
rules for taking levothyroxine
empty stomach 30-60 mins before food
| take calcium/iron supplements 4 horus llater
79
medication for acromegaly
octreotide
80
Definite management of hyperparathyroidism
Total parathyroidectomy
81
First line treatment for most patients with a pituitary tumour causing acromegaly
Trans sphenoidal surgery
82
Common cause of primary hyperparathyroidism
Solitary parathyroid adenoma
83
Patchy uptake of iodine
Toxic multinodular goitre
84
The standard HbA1c target in type 2 diabetes mellitus
48 mmol/mol
85
What does over replacement of thyroxine increase the risk of
Osteoporosis
86
Water deprivation test: nephrogenic DI
urine osmolality after fluid deprivation: low
| urine osmolality after desmopressin: low
87
Erratic blood glucose control, bloating and vomiting
Gastroparesis
88
Klinefelter's syndrome
Kallmann syndrome
Kartagener's syndrome
Klinefelter's Above average height and infertility
Kallmann: failure of GnRH, anosmia and infertility
Kartagener's dextrocardia, recurrent sinusitis, bronchiectasis and infertility
89
Levothyroxine is not associated with inducing diabetes
90
LADA
Latent autoimmune diabetes of adulthood
91
Orlistat MOA
Pancreatic lipase inhibitor
92
What is cinacalecet
Drug that mimics calcium
| Used in parathyroid adenoma that can't have surgery
93
LH and FSH in kallmann
LH and FSH low-normal
94
Thyrotoxicosis with tender goitre
De quervains
95
Does graves or hashimotos cause a tender goitre
No
96
Treatment of myxoedema coma
IV thyroid hormone replacement and IV hydrocortisone
97
What haem disorder can give falsely low HbA1c
Sickle cell
98
What is nelsons syndrome
Rapid enlargement of a pituitary corticotroph adenoma (ACTH producing adenoma) that occurs after the removal of both adrenal glands (bilateral adrenalectomy) which is an operation used for Cushing's syndrome
99
Hypoglycaemia with impaired GCS
Give IV GLUCOSE
100
How to distinguish between T2DM and T1DM
C-peptide levels and diabetes autoantibodies e.g. Anti-GAD
101
Presentation of phaeochromocytoma
Sweating
headaches
palpitations
102
First line investigation for phaeochromocytoma
Plasma and urinary metanephrines
103
First line antihypertensive for black T2DM patients with HTN
ARB blocker (sartan)
104
thyroids and periods
Hyperthyroidism is associated with oligomennorhoea, or amennorhoea, whereas hypothyroidism is associated with menorrhagia
105
Headaches, amenorrhoea, visual field defects
Prolactinoma
