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endocrinology Flashcards

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1
Q

risk factors for cervical cancer

A

-most important: smoking

-COCs must be taken long term to be a risk factor

-high parity

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2
Q

Most common cause of thyrotoxicosis in pregnancy?

A

Graves Syndrome

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3
Q

Thyrotoxicosis in pregnancy

A

-Elevated levels of Tb globulin … increases total thyroxine level not free thyroxine

-Risk for: Fetal loss, Maternal heart failure, Premature labour

Also transient gestational hyperthyroid may occur drops in 2nd and 3rd trimester

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4
Q

Klinefelter Syndrome

A

-47XXY
-Tall stature
-Small testes
-RAISED GONADOTROPHINS ,LOW TEST

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5
Q

Gitelman Syndrome

A

-Genetic disorder affecting Thiazide sensitive NA-CL transporter in -DCT-
-NORMOTENSIV
-HYPOKALEMIA ,HYPOMAGNESEMIA, HYPOCALCIURIA
-METABOLIC ALKALOSIS

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6
Q

Thyroid acropachy

A

-DIGITAL CLUBBING
-SOFT TISSUE SWELLING OF HANDS AND FEET
-PERIOSTEAL NEW BONE FORMATION

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7
Q

Uterine Fibroids

A

Associated with secondary Polycythaemia due to erythropoietin production

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8
Q

Kallman syndrome

A

CRYPTORCHIDISM

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9
Q

Metabolic syndrome

A

-Doesnt include LDL
-ELEVATED URIC ACID
-PCOS
-NON ALCOHOLIC FATTY LIVER DISEASE

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10
Q

SIADH drug causes?

A

-SSRI
-TRICYCLIC
-CARBAMAZEPINE
-SULFONYLUREA

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11
Q

MEN 2B

A

Pheochromocytoma, MTC, MARFANOID HABITUS, Oral/Intestinal neuroma

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12
Q

Single most useful investigation in MEN 1 ?

A

serum calcium

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13
Q

ALBUMIN CREAT RATIO IN DM1

A

-Less than 70 …BP Goal of less than 140/90

-More than 70….BP Goal of less than 130/80

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14
Q

In Gestational Diabetes if not controlled with metformin what should be added?

A

Insulin
glibenclamide (if met and insulin refused)

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15
Q

Secondary Amenorrhea with raised Gonadotrophins?

A

Premature Ovarian Failure

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16
Q

First Line of SIADH with NA<120 and neurological symptoms (Seizures) ?

A

Hypertonic Saline 3% with increase in NA with MAX 10mmol in 24hr or 0.5 per hour

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17
Q

Most IMP modifiable risk factor for thyroid eye disease?

A

Smoking

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18
Q

Contraindications for Insulin stress test?

A

-Ischemic Heart disease
-Epilepsy
-Adrenal insufficiency

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19
Q

Thyroid Tumors associated with RET

A

MTC
PAPILLARY

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20
Q

First Anti INSULIN Regulatory Hormone to be secreted in Hypoglycemia?

A

GLUCAGON
CORTISOL takes time

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21
Q

In which case would IM GLUCAGON not be appropriate in rx of hypoglycemia?

A

CHRONIC ALCOHOLIC LIVER DISEASE

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22
Q

By how much should thyroxine be increased in pregnancy?

A

50% As early as 4-6 weeks of pregnancy

-TSH Should be measured each trimester and 6-8 weeks postpartum

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23
Q

stress incontinence regimen

A

-Pelvic floor muscles exercises for 3 months

-Surgery

-Duloxetine

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24
Q

Urge incontinence regimen

A

-Bladder training

-Antimuscarinic drugs: Oxybutynin, tolterodine, darifenacin

-Mirabergon

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25
PCOS Hirsutism treatement
-COCs -EFLORNITHINE -Spironolactone, finasteride, flutamide
26
Gastroparesis (Autonomic dysfunction) in DM1 Treatement?
-BLOATING, VOMITING, ERRATIC GLUCOSE -METOCLOPROMIDE, DOMPERIDONE ,ERYTHROMYCIN
27
High and low HBA1C ?
HIGH: -VIT B12/ FOLATE/ IRON DEFICIENCY -SPLENECTOMY LOW: -HEMODIALYSIS -HEMOGLIBONOPATHY -HEMOLYSIS
28
Systemic glucocorticoids rash?
monomorphic papular rash without comedones or cysts -treated by tapering steroid dose
29
presentation of non functioning pit. adenoma
-Mainly compression symptoms -Hypopituitarism
30
when not to use antichollinergics in urge incontinence?
Old people as it may cause confusion Closed angle glaucoma
31
Normal TSH FT3 FT4 BUTT HIGH TOTAL FT3 FT4?
Normal pregnancy due to increase thyroid binding globulin TBG which increases TOTAL T3 T4
32
MODY
-Autosomal Dominant -Under 25 years old - Family hx of early onset DM -Sensitive to sulfonylurea
33
Side effect of RAI in hyperthyroid
HYPOTHYROIDISM GRAVES EYE DISEASE
34
FAMILIAL HYPERCHOLESTEROLEMIA
50% OF FIRST DEGREE RELATIVES
35
HIGH INSULIN AND C-PEPTIDE
EXOGENOUS INSULIN SULFONYLUREA NESIDIOBLASTOSIS (IN NEONATES, FOLLOWING BARIATRIC SURGERY)
36
Hypercalcemia relation to pancreas
CA increases pancreatic secretions causing actue pancreatitis and gallstones
37
DM in Ramadan
-Doses should be split ; 2/3 befor fitar 1/3 befor suhoor -once daily sulfonylurea after sunsuet (fitar) -PIOGLITAZONE NO CHANGE
38
Hyperlipidemia and NA
-PSEUDOHYPONATREMIA -High plasma protein or lipid content, such as hyperlipidaemia, because these substances displace water and hence sodium in the plasma, leading to a falsely low sodium reading.
39
Acute pancreatitis relation to calcium
causes HYPOCALCEMIA: -SAPONIFICATION of calcium combining with fatty acids forming insoluble soaps -CAPILLARY LEAK SYNDROME: losing calcium to extravascular space
40
Renal impairement in DM
DPP4 as they dont need to be adjusted for renal patients sglt2 and glp1 avoided in renal impairement
41
MIRABERGON
BETA 3 AGONIST
42
ANTIMUSCARINIC CONTRAINDICATED IN
OLD NIBBAS CONFUSION HISTORY OF URINARY RETENTION
43
Metformin in GFR cases
GFR 45-30= dose reduction GFR <30 STOP METFORMIN
44
ALCOHOL IN DM
INCREASES INSULIN PRODUCTION by inc blood flow from exocrine to endocrine IMPAIRS THE COUNTER REGULATORY MECHANISMS TO HYPOGLYCEMIA
45
STRONGEST POINTER TO DIAGNOSE DM1
KETONURIA
46
EUGLYCEAMIC KETOACIDOSIS
-SGLT2 -INTERRUPTION OF INSULIN INFUSION PUMP -PROLONGED FASTING -PREGNANCY
47
OSMOTIC DEMYELINATION SYNDROME
-Rapid correction of hyponatremia leading to dehydration of ASTROCYTES and OLIGODENDROCYTES leading to their apoptosis -to avoid: NA INCREASED BY 4-6 PER 24HR -CAUSES LOCKED IN SYNDROME
48
Early morning weakness and diplopia with weight gain
INSULINOMA
49
CARBIMAZOLE
INHIBTS THYROID PEROXIDASE FROM COUPLING AND IODINATING THE TYROSINE RESIDUE
50
ECG IN HPER AND HPOCALCEMIA
HYPO: QT PROLONGATION AFIB TORSADE DE POINTES] HYPER: QT SHORTENING OSBORN OR J WAVES
51
HIGHEST RISK OF FOOT AMPUTATION OUT OF SGLT2 DRUGS
CANAGLIFLOZIN NOT EMPA OR DAPA
52
RIEDEL THYROIDITIS
FIXED HARD NECK MASS RETROPERITONEAL FIBROSIS EU OR HYPOTHYROID ELEVATED SYSTOLIC PRESSURE
53
URGENT OPTHALMOLOGY REFERRAL IN GRAVES
-AWARENESS IN CHANGE IN QUALITY OR INTENSITY OF COLOR VISION means optic nerve compression -unexplained deterioration in vision awareness of change in intensity or quality of colour vision in one or both eyes history of eye suddenly 'popping out' (globe subluxation) obvious corneal opacity cornea still visible when the eyelids are closed disc swelling
54
LITHIUM IN NEPHROGENIC DI
decreases expression of aquaporin channels
55
Calculation of HBA1C from glucose levels
2x HBA1C% - 4.5
56
PENDRED'S
-AUTOSOMAL RECESSIVE -GOITER -EUTHYROID -SENSORINEURAL DEAFNESS -VESTIBULAR BALANCE WEAKNESS
57
AMYTRIPTYILINE
AVOIDED IN BENIGN PROSTATIC HYPERPLASIA - CAUSES URINE RETENTION
58
DIABETES GENETICS
CONCORDANCE BETWEEN TWINS IS HIGHER IN TYPW 2THAN 1 TYPE 1 ... DR3 , DR4 POLYGENIC HEMOCHROMATOSIS .... EXAMPLE OF SECONDARY DM
59
graves antibody type
IGg
60
increased risk for edema with concominant administration of which medication with pioglitazone?
INSULIN
61
Electrolyte disturbance in Nasogastric feeding
Hypophostphatemia caused by REFEEDING SYNDROME -ALSO BY DKA , ALCOHOL EXCESS, ACUTE LIVER FAILURE
62
Dynamic pituitary function test
-Give insulin, TRH, LHRH -All hormones will rise except ADH -Metoclopromide can be given for prolactinoma but requires a blunted response to diagnose it
63
Food highest in potassium
bananas, oranges, kiwi fruit, avocado, spinach, tomatoes

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