Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

AKT > Endocrinology 3 > Flashcards

Endocrinology 3 Flashcards

(62 cards)

Start Studying
1
Q

What is the triad of thyroid acropachy?

A

Clubbing
Soft tissue swelling of hands and feet
Periosteal new bone formation

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

Autoantibodies in Grave’s disease (2)

Hashimotos (2)

A

TSH receptor stimulating antibodies
Anti-thyroid peroxidase antibodies

Anti-TPO and anti-thyroglobulin (Tg)

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

What do you see on scintigraphy in Grave’s

A

increased uptake of radioactive iodine

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

When would you start carbimazole and how?

A

If propranolol hasn’t worked for symptom control.

Start at 40mg and reduce gradually - continued for 12-18 months.

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

SE of carbimazole (1)

A

agranulocytosis

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

What is the block and replace regime for Grave’s mx

When should it be used?

A

Carbimazole 40mg, thyroxine when euthyroid - rx lasts 6-9 months

Pregnancy

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

Contraindications to radioiodine treatment (3)

A

Pregnancy and avoid for 4-6 months after treatment
<16yo
Thyroid eye disesae

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

Hashimotos associations (4)

A

Vitiligo
Coeliac
MALT lymphoma
T1DM

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

Mx hypothyroidism

Following a change in medication when should the TFTs be repeated

A

Start at 50-100mcg OD
Unless:
Cardiac disease OR
Severe hypo OR
>50yo
Start at 25mcg

8-12 weeks

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

In pregnancy in hypothyroidism how should the thyroxine be changed?

A

Increase by 25-50mcg

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

SE thyroxine (4)

A

reduce bone mineral density
hyperthyroid
AF
worsening of angina

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

Which two drugs interact with thyroxine?

How to prevent this?

A

Iron
Calcium carbonate

Take 4 hours apart

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

Secondary causes of hypothyroidism (3)

A

Down’s
Turners
Coeliacs

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

How often should you test TSH in pregnancy?

A

Each trimester and 6-8 weeks post partum

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

Mx thyrotoxicosis in pregnancy and why

A

Propylthiouracil if first trimester, switched to carbimazole second and third

Carbimazole can cause congential abnormalities
Propylthiouracil can cause severe hepatic injury

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

Why should maternal free thyroxine levels be kept in the upper third of the normal reference range?

A

to avoid fetal hypothyroidism

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

Most common type of pituitary adenoma

A

Prolactinoma

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

Classification of pituitary adenomas

A

Size:
Micro <1cm
Macro >1cm

Hormonal status

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

Features of prolactinoma
Women (4)

Male (3)

A

Galactorrhoea
Infertility
Amenorrhea
Osteoporosis

Galactorrhoea
Loss of libido
Impotence

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

Dx of prolactinomas (1)

Mx (2)

A

MR

Dopamine agonist e.g cabergoline, bromocriptine

surgery - transpheroidal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Causes of raised prolactin (6)

A

prolactinoma
pregnancy
oestrogens
primary hypothyroidism
PCOS
acromegaly

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

Drug causes of raised prolactin (4)

A

Metoclopramide
Domperidone
Haloperidol
SSRIs

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

Features of primary hyperparathyroidism

A

Bones, stones, abdominal groans and psychic moans

polydipsia, polyuria
depression
anorexia, nausea, constipation
peptic ulceration
pancreatitis
bone pain/fracture
renal stones

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

Primary hyperparathyroidism
associations (2)

A

HTN
MEN I+II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Elderly female, unquenchable thirst =
primary hyperparathyroidism
26
Physiology of parathyroid gland Role of PTH How does it do this? (3) What is the purpose of vit D?
Low calcium leads to increase in PTH Role of PTH is to increase calcium levels PTH causes: 1. Increased gut absorption 2. Increased reabsorption of calcium from the kidneys 3. Increased osteoclast activity, to break down bone to increase calcium levels Vit D does the same as PTH, increase PTH leads to increase conversion of vit D into active form so it can help with above effects.
27
Explain primary hyperparathyroidism Causes (1) Mx
High PTH High calcium Low phosphate Caused by parathyroid gland tumour Mx surgery
28
Explain secondary hyperparathyroidism Causes (2) Mx
High PTH Low (or normal) calcium High phosphate Caused by vit D deficiency or CKD Mx treat deficiency or renal transplant
29
Explain tertiary hyperparathyroidism Mx
High PTH High calcium Low phosphate Secondary to hyperplasia of parathyroid gland due to secondary hyperparathyroidism after it has been corrected Mx surgery
30
Characteristic XR finding for hyperparathyroidism
pepperpot skull
31
When would you consider conservative mx of primary hyperparathyroidism?
the calcium level is less than 0.25 mmol/L above the upper limit of normal AND the patient is > 50 years AND there is no evidence of end-organ damage
32
Medical management of primary hyperparathyroidism if pt not suitable for surgery
Cinacalcet - mimics calcium on tissues
33
Primary hyperaldosteronism Conns define:
bilat idiopathic adrenal hyperplasia is the cause in up to 70% Conns is secondary to an adrenal tumour
34
Features Conns (4)
HTN Hypernatramiea Hypokalaemia - muscle weakness Alkalosis
35
Primary hyperaldosteronism Ix (3)
1. Aldosterone/renin ratio High aldosterone, low renin (due to low feedback system) 2. high resolution CT abdomen 3. Adrenal vein sampling to differentiate between unilat and bilat sources
36
Primary hyperaldosteronism Mx (2)
Adrenal adenoma - surgery Bilateral adrenocortical hyperplasia - aldosterone antagonist e.g spiro
37
Pheochromocytoma associated with (3)
MEN II Neurofibromatosis von Hippel Lindau syndrome
38
Pheochromocytoma Ix
24 hour urinary collection of metanephrines
39
Pheochromocytoma Mx Must be stabilised on which four medications
Surgery Must be medically stabilised with an AB and BB phenoxybenzamine and propranolol
40
Prediabetes/ Impaired glucose regulation numbers Fasting HbA1c
Fasting BM 6.1-6.9 OR HbA1c of 42-48 (6.0-6.4)
41
Mx of prediabetes (3)
Lifestyle modification Yearly FU with bloods Metformin in adults who are high risk
42
Obesity Mx (3)
Lifestyle factors Medical - orlistat Surgical
43
Orlistat criteria
BMI >=28 with associated RF BMI >=30 Continued weight loss at 3 months To be used for <1 year
44
Most common cancer in infants
Neuroblastoma
45
What is a neuroblastoma
Tumour from the neural crest tissue of the adrenal medulla and sympathetic nervous system
46
Neuroblastoma features (6)
abdominal mass pallor weight loss bone pain limp hepatomegaly
47
MEN = multiple endocrine neoplasia Type I, IIa, IIb
I 3Ps hyperPTH, pituitary, pancreas MEN I = most common presentation hypercalcaemia IIa 2Ps PTH, pheo RET oncogene IIb 1P pheo, marfans, neuromas RET oncogene medullar thyroid and pheo for both types of II
48
Common causes of hypercalcaemia (2)
1. Primary hyperPTH 2. Malignancy e.g myeloma
49
Other causes of hypercalcaemia (8)
Sarcoidosis Vitamin D intoxication Acromegaly Thyrotoxicosis Thiazides Dehydration Addison's Pagets SVAT DAPT
50
Mx hypoglycaemia
1. Oral gluc 10-20g OR glucogel PO/SC/IM Hospital As above but if unconscious then SC/IM glucogel OR IV 20% glucose
51
Hypoparathyroidism Caused by
Low PTH, low calcium, high phosphate Secondary to thyroid surgery
52
Hypoparathyroidism Mx
Alfaclcidol
53
Features hypoparathyoidism (6)
Secondary to hypocalcaemia Muscle twitching Trousseau's sign Chvostek's sign Periooral parasthesia Depression/ cataracts Long QT
54
What is Trousseau's sign
occlude brachial artery with a BP cuff, wrist flexes, thumb adducts
55
What is Chvostek's sign
tapping over parotid causes facial muscles to twitch
56
PseudohypoPTH What is it? Biochem
target cells are insensitive to PTH So low calcium, high phosphate but high PTH
57
Pseudopseudohypoparathyroidism Biochem
Normal biochem
58
What is Kallman's?
delayed puberty secondary to hypogonadotrophic hypogonadism X linked recessive
59
A boy with lack of smell with delayed puberty =
Kallmans
60
Features of Kallmans (6)
Anosmia Delayed puberty Hypogonadism Cryptorchidism (absence of one testicle) LH and FSH low Normal and above average height
61
What is Klinefelter's karyotype Features (6)
XXY Tall Small firm testes Infertile Gynaecomastia Low testosterone LH and FSH raised
62
Glucagon dosing for hypo's in children Under 1 yo >1yo and <25kg >1yo >25kg
Under 1 yr old - 500mcg Over 1 yr old AND <25kg - 500mcg Over 1 yr old AND >25kg - 1mg

AKT (52 decks)

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