Endocrinology Flashcards
1
Q
A woman presenting with striae, a round face and a hump between the shoulders.
- Diagnosis
- Underlying pathology
- Causes? (4)
- Resulting conditions? (4)
- Diagnostic test?
- Treatment?
A
- Cushing’s syndrome
- Excessive cortisol
- Exogenous steroids
Pituitary adenoma (^ACTH)
Adrenal adenoma
Paraneoplastic (e.g. SCLC) - Hypertension
Type 2 Diabetes
Depression
Osteoporosis - Dexamethasone suppression test
- Treat the cause (e.g. remove the tumour)
2
Q
51 year old with 2 months of fatigue cramps and abdominal pain. He presents acutely with vomiting, drowsiness and hypotension
- Underlying diagnosis?
- Acute diagnosis?
- Cause of skin going from pale to tanned?
- Explain primary, secondary and tertiary disease
- Key biochemical finding?
- Treatment?
A
- Addison’s
- Adrenal crisis (Addisonian crisis)
- Excessive ACTH stimulates melanocytes
- Primary adrenal insufficiency (Addison’s):
- damaged adrenals, decrease in secretion of cortisol and aldosterone
Secondary - decrease in ACTH from the pituitary
Tertiary - decrease in CRH from the hypothalamus
- damaged adrenals, decrease in secretion of cortisol and aldosterone
- Hyponatraemia
- Short synacthen test
- Hydrocortisone to replace cortisol
Fludrocortisone to replace aldosterone
3
Q
Blood results: TSH->Low, T3&T4->Raised, TSH Receptor Antibodies-> +ve
Bulging eyes
- Diagnosis
- Clinical features specific to this diagnosis? (3)
- Other causes of raised T3 & T4? (3)
- Symptomatic treatment?
- Definitive treatment options? (4)
A
- Grave’s Disease
- Exophthalmos (bulging eyes)
Diffuse goitre (no nodules)
Pretibial myxoedema - Toxic Multinodular Goitre
Solitary Toxic Thyroid Nodule
Thyroiditis - Propranolol
- Carbimazole
Propylthiouracil
Radioactive Iodine
Surgery
4
Q
45 year old woman presenting w/ tiredness, weight gain, low mood, dry skin and constipation
Autoimmune inflammation of thyroid
- Diagnosis
- Associated antibodies? (2)
- Expected T3, T4 and TSH
- Other causes of these results? (3)
- Treatment
A
- Hashimoto’s Thyroiditis causing Hypothyroidism
- Antithyroid peroxidase (Anti-TPO) antibodies
Antithyroglobulin antibodies - Low T3 and T4
High TSH - Iodine deficiency
Treatment for hyperthyroidism
Medications (e.g. lithium) - Levothyroxine
5
Q
22 year old presents with weight loss, polyuria, polydipsia, vomiting and drowsiness.
- Acute diagnosis
- Underlying diagnosis
- Criteria for the acute diagnosis? (3)
- Initial management (7)
- Long term treatment?
- Methods for monitoring? (3)
A
- Diabetic Ketoacidosis
- Type I Diabetes
- Hyperglycaemia
Ketosis
Acidosis - '’FIG PICK’’
Fluids
Insulin
Glucose
Potassium
Infection (treat trigger)
Chart fluid balance
Ketone monitoring - Subcutaneous Insulin regime
- HBA1c (3-6 monthly)
Capillary blood glucose
Flash glucose monitoring
6
Q
64 year old lorry drive presents with fatigue, polyuria and numbness in his fingers and toes.
- Diagnosis
- Diagnostic test?
- Criteria for the preceding condition and full diagnosis?
- Treatment targets?
- First-line medication?
- Other drug options? (6)
A
- Type 2 Diabetes Mellitus
- HBA1c
- Prediabetes –> HBA1c 42-47mmol/mol
Diabetes –> HBA1c>= 48 mmol/mol - HBA1c 48 mmol/mol for New Diagnosis
HBA1c 53 mmol/mol for Moving Beyond Metformin - Metformin
- Sulfonylurea (e.g. gliclazide)
Pioglitazone
DPP-4 inhibitor (e.g. sitagliptin)
SGLT-2 inhibitor (e.g. empagliflozin)
GLP-1 mimetics (e.g. exenatide)
Insulin
7
Q
A man presents with an enlarged head with protruding brow and jaw bones
- Which hormone is raised?
- Diagnosis?
- Most common cause?
- Visual field defect?
- Initial blood test?
- Definitive treatment of most common cause?
- Options for blocking the raised hormone?
- Increases risk of which cancer?
A
- Growth hormone
- Acromegaly
- Pituitary adenoma
- Bitemporal hemianopia
- Insulin-like growth factor-1 (IGF-1)
- Trans-sphenodial removal
- GH antagonist (i.e. pegvisomant)
Somatostatin analogues (e.g. ocreotide)
Dopamine agonist (e.g. bromocriptine) - Colorectal
