Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

2MRCP Part 2 > Endocrinology > Flashcards

Endocrinology Flashcards

(76 cards)

Start Studying
1
Q

What are the pathologies of the different types of amiodarone-induced thyrotoxicosis

A

T1 = increased thyroid hormone production driven by iodine

T2 = autoimmune destructive thyroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Management of papillary or follicular thyroid cancer

A

Thyroidectomy (total)
THEN radioiodine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Risk of tamoxifen

A

VTE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Contra-indications to testosterone replacement (4)

A

Prostate cancer
PSA >4
Male breast cancer
Severe OSA (in theory may worsen, increase length and frequency of apnoea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Inconclusive short synacthen test
- possible diagnoses
- investigation

A

Long synacthen test - 1,4,8 and 24 hours
Helps differentiate primary and secondary adrenal failure (steroid use, panhypopituitarism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Success of desmopressin in generating response

A

> 50% rise in urine osmolality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Management of PCOS

A

Clomifene citrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Management of acromegaly if surgery unsuccessful

A

Octreotide
(cabergoline now not in favour - side effects include cardiac fibrosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ectopic ACTH biochemical feature

A

Profound hypokalaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Management of amiodarone-induced hypothyroidism

A

Continue amiodarone
Start levothyroxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Side effects of carbimazole

A

Agranulocytosis
Liver dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When do you see flushing and increased stool frequency in carcinoid?

A

When has metastasised to the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Investigation of suspected phaeochromocytoma

A

MIBG scan
- CT may be negative - remember a proportion are extra-adrenal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hyperthyroidism in early pregnancy

A

Consider molar pregnancy as diagnosis
- need US abdomen, hyperthyroidism will correct itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Medication causing erectile dysfunction

A

SSRI
- will see elevated prolactin in association

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Investigation of choice for Cushing’s
- consideration

A

High dose dexamethasone suppression test
- if on OCP won’t be reliable, need to use 2x urinary free cortisol measurements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Investigation of acromegaly

A

Screen = IGF-1 level
Diagnosis
Oral glucose tolerance test + growth hormone levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Mechanism of SIADH due to head injury
- management

A

Release of stored vasopressin due to damage to hypothalamic axons
(from trauma)
Low plasma osmolality + high urine osmolality
Can then progress to DI = failure to release ADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

MODY - common mutation

A

HNF1a mutation
Respond well to low dose sulphonylurea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Starting a statin in diabetes (4)

A
  • Older than 40 years
  • Had diabetes for more than 10 years
  • Established nephropathy
  • Other CVD risk factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Non visible haematuria
- contraindication to what diabetes management?

A

Pioglitazone due to bladder cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Carcinoid
- associated with what endocrine condition?

A

Cushing’s Syndrome
= cause of ACTH secretion, well circumscribed lesion on XR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Management of proliferative diabetic retinopathy

A

Intravitreal VEGF
e.g. ranibizumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Management of sulphonylurea overdose

A

= octreotide
(BMs will not respond well to glucose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Urine sodium in Addison's
High = no hormone action instructing kidneys to retain sodium
26
Low testosterone Normal FSH/LH Lack of secondary sexual characteristics
Kallman's Syndrome = hypogonadotrophic hypogonadism FSH and LH should be high to try and increase testosterone
27
Addison's disease - what should they always have?
IM hydrocortisone
28
Over replacement with levothyroxine - risk?
Osteoporosis
29
How can you assess how steroid replete someone is in Addison's?
Cortisol day curve
30
Early 2y sexual characteristics in man Hypokalaemia
11 beta hydroxylase deficiency
31
Addison's + T1DM (or + autoimmune thyroid disease) - diagnosis
Autoimmune polyendocrine syndrome type 2
32
Advice for steroids in excessive exercise in Addison's
Double glucocorticoid and mineralocorticoid
33
Advice for diabetic on insulin + HGV
Can keep licence as long as - have not suffered hypo in last 12 months that needed 3rd party assistance - No visual field impairment Need annual review by diabetologist
34
Gestational diabetes - decision about insulin
Give insulin if fasting glucose >7
35
Management of relapse of Grave's Disease - contraindications (2)
Radioiodine treatment = pregnancy, thyroid eye disease
36
Investigation of choice for GH deficiency
GNRH arginine stimulation test
37
Raised calcium Raised/normal PTH - diagnosis?
Familial benign hypocalciuric hypercalcaemia
38
Raised C peptide Raised insulin levels - differential?
SU abuse Insulinoma Insulin levels in insulinoma > SU abuse
39
Diagnosis of Wilson's disease
Elevated 24 hour urinary copper Low ceruloplasmin
40
What medication should you stop in acute thyrotoxicosis?
Stop aspirin = binds to thyroxine B globulin Displaces fT4 means there is more in circulation = makes everything worse
41
Slate grey appearance New diagnosis of diabetes Diagnosis?
Haemochromatosis
42
If you give insulin what should happen to internal insulin production?
Should supress insulin production If insulinoma present, will continue regardless - will see raised c-peptide reflecting insulin production
43
Hyperthyroid Reduced uptake on scan
Consider thyrotoxicosis factitita = taking exogenous levothyroxine
44
Contraindications to radio-iodine
Pregnancy Thyroid eye disease Under 16 years old
45
Management in thyroid storm
PTU not carbimazole - PTU has additional action to inhibit peripheral conversion to T3
46
Family history of diabetes Raised C-peptide - diagnosis - management
MODY Gliclazide
47
>2 hypoglycaemic episodes requiring assistance
Need to surrender driving licence
48
Diagnosis of Addison's disease
Short synacthen
49
Initial investigation of 2y amenorrhoea
Prolactin (TSH and FSH)
50
Target HbA1c in pancreatectomy
53 - don't going chasing dreams
51
Autoimmune polyendocrinology syndrome Type 1
Addison's Primary hypoparathyroidism Chronic candidiasis
52
Autoimmune polyendocrinology syndrome Type 2
Addison's T1DM or autoimmune thyroid condition
53
Differentiating between Cushing's and pseudo-Cushing's (e.g. XS alcohol)
Insulin stress test
54
Biochemical features of PCOS
High testosterone Insulin resistance Increased LH/FSH ration (due to raised LH)
55
Management of bilateral adrenal hyperplasia
Aldosterone antagonist
56
Management of PCOS - main concern hirsutism or acne
Co-cyprindol
57
Repeated admission due to DKA/issues with insulin omission - management
Switch long acting insulin to ultra long acting e.g. tresiba
58
Thyroid cancer monitoring - what are you aiming for with TSH
Keep them very low - don't want TSH activating any naughty thyroid tissue
59
Management of lithium induced hypothyroidism
Levothyroxine
60
Irreversible effects of excessive steroid use
Male pattern baldness
61
Reversible effects of steroid use (4)
Acne Erectile Dysfunction Oedema Libido change
62
Management of non-functioning adenoma causing hypopituitarism
Surgical management
63
BM recommendations T1DM
Morning - 5-7 Pre meal - 4-7 90 mins post meal - 5-9
64
Management of lithium induced diabetes insipidus
Thiazide diuretics
65
Consideration in management of panhypopituitarism
Must be steroid replete prior to starting treatment for hypothyroidism - may trigger adrenal crisis
66
Post partum management of gestational diabetes
Need fasting blood glucose 6-12 weeks later
67
Grave's disease treated with radioiodine Planning child
Ensure long enough has passed Check for TSH antibodies - can cross placenta: if present will need treatment even if euthyroid
68
Cause of pseudohyponatraemia
IV immunoglobulin
69
Investigation of choice adrenal hyperplasia VS adenoma
Adrenal vein sampling
70
Management of withdrawing anabolic steroids
Nil taper needed
71
Congenital adrenal hyperplasia - mutation - diagnosis
21 hydroxylase mutation Short synacthen test
72
What is subacute granulomatous thyroiditis?
de Quervain's thyroiditis
73
Thyroid mass <1cm on imaging Euthyroid
Needs no invasive investigation
74
Urine osmolality in hyponatraemia
Urine >100 = increasingly concentrated e.g. SIADH, hypothyroidism, ACTH deficiency Urine <100 = dilute urine e.g. primary polydipsia, beer potomania
75
What manifestations are reversible in haemochromatosis with treatment?
Fatigue Transaminitis
76
What insulin do you use in DKA?
Fixed rate

2MRCP Part 2 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions