Endocrinology Flashcards by Charlotte cleasby

symptoms of thyroid storm

hyperthermia
tachycardia
jaundice
altered mental state
cardiac (AF/high output HF)

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symptoms of thyroid storm

hyperthermia
tachycardia
jaundice
altered mental state
cardiac (AF/high output HF)

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Riedel’s thyroiditis

hypothyroidism caused by chronic inflammatory thyroid gland fibrosis

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2 medications that interact with Levothyroxine

Iron
Calcium carbonate

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symptoms of myxoedema coma

hypothermia
hyporeflexia
bradycardia
seizures

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causes of pseudo-Cushing’s

alcoholism
severe depression
use insulin stress test to tell difference with Cushing’s

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screening test for Cushing’s

11pm salivary cortisol (high)
LDDST

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how to determine cause of hyperaldosteronism

HR-CT and adrenal vein samplinh

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renal and non-renal causes of hypernatraemia

renal: osmotic diuresis (T2DM) or DI
non-renal: GI losses, sweat losses of water

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renal and non-renal causes of hypernatraemia

renal: osmotic diuresis (T2DM) or DI
non-renal: GI losses, sweat losses of water

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causes of pseudohyponatraemia

hyperlipidaemia
hyperproteinaemia

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imaging in myeloma

whole body low dose CT

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refeeding syndrome symptoms

rhabdo
low RR
arrythmias
shock
seizures
coma

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management of fibromuscular dysplasia

stop smoking
anti-platelets
anti-HTN
surgical stenting

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causes of hypoMg

diuretics/PPIs
diarrhoea
TPN
ETOH
HypoK, HypoCa

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visual defect with lesion in optic radiation

superior quandrantopia

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visual defect with lesion in optic tract

homonymous hemianopia

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when do you switch the insulin infusion to SC insulin in DKA?

when blood ketones <0.3mmol/L

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SE’s of carbimazole

maculopapular rash
bone marrow suppression = agranulocytosis
pruritis
jaundice

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how should insulin regimes be managed pre-operatively

reduce dose insulin on day of operation and day before

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what to do if you have subclinical hypothyroidism?

repeat TFTs in 6-8 weeks
1. if T4 normal, TSH> 10 = treat
2. TSH 5-10, thyroid Ab +ve = repeat annually, commence thyroxine when TSH >10
3. TSH 5-10, thyroid Ab -ve = check every 3-5 years

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TSH dec/normal and low fT4, cause?

secondary hypothyroidism
?pituitary dysfunction - check cortisol

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TSH dec/normal and low fT4, cause?

secondary hypothyroidism
?pituitary dysfunction - check cortisol

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cause of a high Ca and low PTH

cancer

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cause of a high Ca and high PTH

parathyroid disease

what is Chvostek's sign?

tap facial nerve = facial muscle twitch

what is Trousseau's sign?

inflate arm cuff = carpopedal spasm

when is hypoCa an emergency and how to treat?

if QT prolonged, signs of tetany Tx: Ca gluconate 10% Cardiac monitoring, check serum Mg and PTH

when it is not emergency, how to manage?

bloods for PTH/Vit D Endo clinic Calchichew tabs

causes of hypercalcaemia

primary hyperparathyroidism malignancy myeloma sarcoid thiazides

diabetic neuropathy abdo pain

gastroparesis = vagus neuropathy management = metaclopramide

when do you start ACEi in T2DM if ACR

ACR >3.0mg/mmol

insulin monitoring when sick?

continue normal insulin (more monitoring)

examples of sulphonylureas

Glibenclamide Gliclazide

examples of DPP4 inhibitor

Sitagliptin

classification of thyroid

Thy 1 classification

low uptake thyroiditis

subacute thyroiditis post-partum thyroiditis

thyroid storm management

IV propanolol = thionamides Hydrocortisone = Iodine

Interactions of thyroxine

Iron CaCO3

Addison's

9am plasma cortisol synACTH test

ACTH dependent causes

Cushing's disease ectopic ACTH

ACTH independent causes

steroids adenoma/carcinoma

Pseudo-Cushing's causes

alcohol excess severe depression detect by insulin stress test

Cushing's test

11pm salivary cortisol LDDST

Hypernatraemia - increase in Na causes

- medical/dietary high intake - Conn's - RAS

Hypernatremia - loss of water

renal losses: osmotic diuresis, DI non-renal losses: GI loss, sweat loss

SIADH drug causes

SSRI TCA PPI Carbamazepine

SIADH investigations

plasma and urine osmolality

main causes of hyperkalaemia

renal impairment Drugs (ACEi, ARBs, spirnolactone) Low aldosterone (Addison's, T4RA) Release from cells - Rhabo

Main causes of hypokalaemia

GI losses Renal losses (MR excess, osmotic diuresis) Redistribution in cells (insulin, alkalosis) Rare (RTA, T1+T2, hypoMg)

HyperCa and QT

short QT

HypoCa and QT

low QT, low Mg

Management of myeloma

induction = thalidomide + dexa bone disease = bisphosphonate + analgesia

Refeeding syndrome S/S

Rhabdo, low RR, arrhythmias, shock, seizures

Refeeding management

phosphate supplements

common causes of polyuria

diuretics, caffeine, ETOH, DM, Lithoum, HF

infrequent causes of polyuria

HyperCa, Hyperthyroidism

rare causes of polyuria

CRF, primary polydipsia, dec potassium

investigations in polyuria

bloods (including paired serum + urine osmolarity) water deprivation test

Abs in Vit B12

Anti-IF AB

Causes of HypoMg

Drugs (diuretics, PPI) Diarrhoea TPN ETOH dec K, dec Ca

S/S of HypoMg

paraesthesia, seizures, tetany, arryhtmias

ECG of HypoMg

similar to HypoKa

when to use Mg IV replacement?

<0.4

complications of diabetes

Macrovascular (MI, CVA) Microvascular (Eyes, Kidneys, Nerves) These need monitoring

when is metformin contraindicated?

GFR < 30

what is exanatide?

GLP-1 agonist

how do you know when DKA is resolved?

ketones < 0.3 mM + venous pH > 7.3

hypoglycaemia symptoms

autonomic (2.5-3): sweating, anxiety, hunger, tremor, palpitations neuroglycopenic (<2.5): confusion, drowsiness, seizures, personality change

important treatment in thyrotoxicosis

first carbimazole then Lugol's iodine 4 hours later to inhibit thyroid

early complications of thyroid surgery

haematuria laryngeal oedema recurrent laryngeal nerve palsy hypoparathyroidism thyroid storm

hypokalaemia symptoms

weakness hypotonia hyperreflexia cramps

what is secondary hyperaldosteronism?

increase renin from decrease renal perfusion

MEN 1

pitutary adenoma parathyroid adenoma pancreatic tumour

MEN 2

thyroid Ca, phaeo A: hyperthyroid B: Marfanoid

what cranial nerve palsies can pituitary tumours cause?

CN 3, 4, 5, 6 palsies

normal relationship between PTH, Ca and PO4

PTH causes inc Ca and dec PO4

causes of hypoCa with increased PO4

CKD inc PTH dec Mg

causes of hypoCa with decreased or normal PO4

osteomalacia pancreatitis

Endocrinology Flashcards

(79 cards)