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SMTS > Endocrinology > Flashcards

Endocrinology Flashcards

(54 cards)

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1
Q

Zones of the adrenal gland and what they produce?

A

Zona Glomerulosa - Mineralocorticoids
Zona Fasciculata - Glucocorticoids
Zona reticularis - Androgens
Adrenal medulla - catecholamines

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2
Q

equivalent doses of glucocorticoids?

A

0.5-1mg dexamethasone = 5mg prednisolone = 30mg hydrocortisone

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3
Q

inheritance of CAH?

A

AR

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4
Q

Primary defect in CAH

A

21 hydroxylase deficiency

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5
Q

What is measured in CAH?

A

17alpha - hydroxyprogesterone

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6
Q

Symptoms of addisons?

A

Weakness, fatigue, anorexia, weight loss.
Hyperpigmentation
Hypotension
N/V
Acute adrenal crisis (shock, hypoglycaemia, fever)

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7
Q

Electrolytes in Addison’s

A

hyperkalaemia +/- metabolic acidosis
hyponatraemia
anaemia of chronic disease
increased ACTH

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8
Q

Treatment of Addison’s disease?

A

Glucocorticoid and mineralocorticoid replacement

Monitor BP, electrolytes

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9
Q

Most common cause of Cushing’s syndrome?

A

Iatrogenic

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10
Q

Management of CAH in females?

A

Corrective surgery in first 12 months, vaginoplasty before intercourse
Lifelong glucocorticoids, may need testosterone to increase growth
mineralocorticoids
monitor growth, skeletal maturity, androgens, 17alpha hydroxyprogesterone

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11
Q

Management of CAH in males?

A

Adrenal crisis; IV fluids, hydrocortisone, dextrose
Lifelong glucocorticoids, may need testosterone to increase growth
mineralocorticoids
monitor growth, skeletal maturity, androgens, 17alpha hydroxyprogesterone

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12
Q

Phaeochromocytoma rule of 10s

A

10% bilateral, 10% extra-adrenal, 10% malignant

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13
Q

Tests for phaeochromocytoma?

A

24 hour urine catecholamines or plasma free metanephrines

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14
Q

What are the contents of the cavernous sinus?

A

CN III, IV, V1, V2, VI

Internal carotid artery

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15
Q

Functions of FSH and LH in males?

A

FSH stimulates spermatogenesis, LH stimulates testosterone release from Leydig cells

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16
Q

If pituitary stalk is damaged, what will happen to levels of pituitary hormones?

A

All will DECREASE except Prolactin

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17
Q

Percentage of Cushing;s disease visible on Pituitary MRI?

A

60%

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18
Q

Symptoms of prolactinoma in women?

A

Infertility, galactorrhoea, amenorrhoea

Postmenopausal; mass effect

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19
Q

Symptoms of prolactinoma in men?

A

Hypogonadism, reduced libido, impotence

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20
Q

Causes of raised prolactin?

A

pregnancy
prolactinoma
PCOS
anxiety

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21
Q

Medical treatment of prolactinoma?

A

Dopamine agonist - Cabergoline/Bromocriptine

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22
Q

Medical management of growth hormone secreting tumour?

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A

Octreotide (somatostatin analogue) inhibits GH

23
Q

Causes of hypopituitarism?

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A 
Pituitary tumour
Surgery
Autoimmune
Haemochromatosis
Sheehan's syndrome
Craniopharyngioma
24
Q

Treatment of panhypopituitarism?

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A 
Hydrocortisone
Thyroxine
OCP
testosterone in males
Gonadotropins if seeking fertility
GH not routine
25
Indications for BMD (bone mineral density) testing?
Risk factors; >3mo steroid use, malabsorption (CD), hypogonadism, premature menopause, RA Age >70 Wedge spinal fracture, Minimal trauma fracture (recommended but NOT essential)
26
Recommended daily calcium?
1300mg/day for women >50, men >70 or anyone with OP | 1000mg for everyone else
27
Recommended Vit.D supplementation
800IU/day if deficient
28
Members of MDT in Diabetes care?
``` Endocrinologist Ophthalmologist Pharmacist Dietician Podiatrist GP Physiotherapist ```
29
overweight ranges for waist circumference
94-102 for men 80-88 for women below = healthy, above = obese.
30
Alcohol recommendations in Australia
No more than 2 standard drinks per day. | No more than 4 standard drinks on any one occasion.
31
1st line pharmacotherapy for T2DM and requirements for initiation?
Metformin. Trial non-pharm for 6 weeks GFR >30
32
Directions for Acarbose tablets
Take with meals, may cause flatulence or diarrhoea
33
Effects of GLP-1?
Enhances insulin secretion and inhibits glucagon. Glucose dependent
34
MoA of DPP4-inhibitors?
Slow degradation of GLP-1, therefore increasing insulin and decreasing glucagon in a glucose dependent manner.
35
Which hypoglycaemic agents cause actual hypoglycaemia?
Sulphonylureas
36
Side effects of Metformin?
Anorexia, N/V, diarrhoea, Lactic acidosis (esp. with CKD, CHD, CLD)
37
Example of DPP4-inhibitor?
Sitagliptin
38
After trying Metformin and a Sulphonylurea, which medications can be added?
Acarbose, Glitazones, DPP4-inhibitors or insulin
39
After trying Metformin and a Sulphonylurea, which medications can be added?
Acarbose, Glitazones, DPP4-inhibitors or insulin (single dose of intermediate or long acting)
40
BP target in T2DM?
130/80
41
How to achieve BP control in T2DM?
1. Lifestyle 2. ACEI/ARB 3. ACEI+Diuretic 4. BB (may mask Sx of hypoglycemia)
42
Frequency of monitoring for complications in T2DM?
6 monthly - foot check Annual - Microalbuminuria, Neuropathy check (reflexes/sensation) 2 yearly - Ophthal review
43
Conditions in MEN I
Pancreatic tumours Parathyroid adenomas Pituitary adenoma
44
Conditions in MEN II
Medullary thyroid carcinoma Phaechromocytoma Parathyroid adenoma
45
Causes of hirsuitism
``` PCOS Cushing's CAH Androgen therapy Obesity Phenytoin ```
46
Patient is taking Hydrocortisone and Fludrocortisone and is now unwell, what changes need to be made to medications?
Double glucocorticoids (Hydrocortisone)
47
definition for DKA? (investigations)
Blood Ketones >3mmol Bicarb <15 pH <7.3 BGL >11 or known T1DM
48
Side effects of Glitazones?
Weight gain, fluid retention (use with caution in CHF)
49
Example of DPP4 inhibitor?
Sitagliptin
50
Example of Sulphonylurea?
Gliclazide
51
What is gastroparesis?
Delayed gastric emptying, often caused by damage to the vagus nerve. Can be seen in DM and leads to vomiting and erratic BGLs.
52
Antibodies found in Hashimoto's?
Anti-TPO, Anti-Tg
53
Investigation for Addison's?
Short Synacthen test; Cortisol measured before and 30 minutes after a dose of Synthetic ACTH, if normal, should rise.
54
Investigation for suspected acromegaly
OGTT and GH measurement. | IGF-1 measurement

SMTS (22 decks)

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