Endocrinology Conditions C

Question 1

Hypercalcaemia - Description

Answer 1

increased serum Ca2+

Question 2

Hypercalcaemia - Causes (5)

Answer 2

1) primary hyperparathyroidism
2) tertiary hyperparathyroidism
maligancy
3) myeloma/bone metastasis
4) lymphoma
5) lung/kidney

Question 3

Hypercalcaemia - Pathophysiology (Myeloma/Bone Metastasis) (1)

Answer 3

1) increased bone Ca2+ resorption

Question 4

Hypercalcaemia - Pathophyisology (Lymphoma) (4)

Answer 4

1) 1 α hydroxylase found in macrophages
2) increased calcitriol production
3) increased intestinal Ca2+ absorption
4) increased PCT Ca2+ reabsorption

Question 5

Hypercalcaemia - Pathophysiology (Lung/Kidney Malignancy) (2)

Answer 5

1) PTH related peptide secretion

2) activity same as PTH

Question 6

Hypercalcaemia - Symptoms (8)

Answer 6

1) polyuria
2) dehydration
3) thirst
4) kidney stones
5) confusion -> coma
6) short QT interval
no gut peristalsis
7) nausea
8) constipation

Question 7

Hypercalcaemia - Signs (4)

Answer 7

1) bones
2) kidney stones
3) abdominal groans
4) mental moans

Question 8

Hypercalcaemia - Comrobidities (2)

Answer 8

1) osteoporosis

2) acute pancreatitis

Question 9

Hypercalcaemia - Diagnosis (1)

Answer 9

1) Ca2+ > 3.5mM

Question 10

Hypercalcaemia - Management (4)

Answer 10

1) loop diuretic
2) parathyroidectomy
3) saline
4) bisphosphonates

Question 11

Hypocalcaemia - Description

Answer 11

decreased serum Ca2+

Question 12

Hypocalcaemia - Causes (7)

Answer 12

1) hypoparathyroidism
2) acute pancreatitis
3) vitamin D defiency
4) osteomalacia
5) chronic renal failure
(HAVOC)
6) thyroid or parthyroid surgery
7) pseudoparathyroidism

Question 13

Hypocalcaemia - Pathophysiology (Hypoparathyroidism) (2)

Answer 13

1) decreased PTH

2) decreased serum Ca2+

Question 14

Hypocalcaemia - Pathophysiology (Pseudohypoparathyroidism) (2)

Answer 14

1) target cells don’t respond to PTH

2) decreased serum Ca2+

Question 15

Hypocalcaemia - Symptoms (4)

Answer 15

1) muscle spasm
2) paraesthesia
3) seizures
4) long QT interval

Question 16

Hypocalcaemia - Signs (2)

Answer 16

1) Chvostek’s sign (facial nerve tap -> facial muscle spasm)

2) Trousseau’s sign (20mmHg above systolic blood pressure cuff -> hand spasm)

Question 17

Hypocalcaemia - Comorbidities (1)

Answer 17

1) cataracts

Question 18

Hypocalcaemia - Diagnosis (1)

Answer 18

1) low Ca2+

Question 19

Hypocalcaemia - Management (4)

Answer 19

1) IV Ca2+ - acute
2) alfacalcidiol (vitamin D)
3) adcal
4) calcium gluconate

Question 20

Primary Hyperparathyroidism - Description

Answer 20

increased PTH secretion

Question 21

Primary Hyperparathyroidism - Causes (1)

Answer 21

1) parathyroid adenoma
(one gland - 80%)
(four glands - 15-20%)

Question 22

Primary Hyperparathyroidism - Pathophysiology (2)

Answer 22

1) parathyroid adenoma

2) increased PTH secretion

Question 23

Primary Hyperparathyroidism - Symptoms (2)

Answer 23

1) often asymptomatic

2) hypercalcaemia symptoms

Question 24

Primary Hyperparathyroidism - Comorbidities (1)

Answer 24

1) hypercalcaemia

Question 25

Primary Hyperparathyroidism - Diagnosis (2)

Answer 25

1) high PTH | 2) high Ca2+

Question 26

Primary Hyperparathyroidism - Management (1)

Answer 26

1) parathyroidectomy (1 or 4)

Question 27

Secondary Hyperparathyroidism - Description

Answer 27

increased PTH secretion

Question 28

Secondary Hyperparathyroidism - Causes (3)

Answer 28

1) vitamin D deficiency (main) 2) chronic renal failure 3) hypocalcaemia

Question 29

Secondary Hyperparathyroidism - Pathophysiology (Vitamin D Deficiency / Chronic Renal Failure) (5)

Answer 29

1) no vitamin D activation - no calcitriol formed 2) decreased intestinal Ca2+ absorption 3) decreased PCT Ca2+ reabsorption 4) decreased serum Ca2+ 5) increased PTH secretion

Question 30

Secondary Hyperparathyroidism - Symptoms (2)

Answer 30

1) often asymptomatic | 2) hypercalcaemia symptoms

Question 31

Secondary Hyperparathyroidism - Comorbidities (2)

Answer 31

1) hypercalcaemia | 2) tertiary hyperparathyroidism

Question 32

Secondary Hyperparathyroidism - Diagnosis (2)

Answer 32

1) high PTH | 2) low Ca2+

Question 33

Secondary Hyperparathyroidism - Management (2)

Answer 33

1) calcium control | 2) treat underlying cause

Question 34

Tertiary Hyperparathyroidism - Description

Answer 34

increased PTH secretion

Question 35

Tertiary Hyperparathyroidism - Causes (1)

Answer 35

1) secondary hyperparathyroidism (generally chronic renal failure related)

Question 36

Tertiary Hyperparathyroidism - Pathophysiology (3)

Answer 36

1) prolonged secondary hyperparathyroidism 2) parathyroid hyperplasia 3) increased PTH secretion

Question 37

Tertiary Hyperparathyroidism - Symptoms (2)

Answer 37

1) often asymptomatic | 2) hypercalcaemia symptoms

Question 38

Tertiary Hyperparathyroidism - Comorbidities (1)

Answer 38

1) hypercalcaemia

Question 39

Tertiary Hyperparathyroidism - Diagnosis

Answer 39

1) very high PTH | 2) high Ca2+

Question 40

Tertiary Hyperparathyroidism - Management (1)

Answer 40

1) parathyroidectomy (1 or 4)

Question 41

Hypoparathyroidism - Description

Answer 41

decreased PTH secretion

Question 42

Hypoparathyroidism - Causes (4)

Answer 42

1) autoimmunity 2) radiation 3) Mg2+ deficiency 4) Di George syndrome

Question 43

Hypoparathyroidism - Pathophysiology (Mg2+ Deficiency) (2)

Answer 43

1) Mg2+ required for PTH secretion | 2) decreased PTH secretion

Question 44

Hypoparathyroidism - Symptoms (1)

Answer 44

1) hypocalcaemia symptoms

Question 45

Hypoparathyroidism - Diagnosis (2)

Answer 45

1) low PTH | 2) low Ca2+

Question 46

Hypoparathyroidism - Management (1)

Answer 46

1) alfacalcidol (vitamin D)

Question 47

Prolactinoma - Description

Answer 47

increased PRL secretion

Question 48

Prolactinoma - Causes (1)

Answer 48

1) pituitary adenoma

Question 49

Prolactinoma - Pathophysiology (2)

Answer 49

1) pituitary adenoma | 2) increased PRL secretion

Question 50

Prolactinoma - Symptoms

Answer 50

1) amenorrhoea (F) 2) oligomenorrhoea (F) 3) galactorrhoea (F) 4) low libido (F) 5) erectile dysfunction (M) 6) decreased facial hair (M) 7) infertility/impotence

Question 51

Prolactinoma - Comorbidities (1)

Answer 51

1) bitemporal hemianopia

Question 52

Prolactinoma - Diagnosis (1)

Answer 52

1) high PRL

Question 53

Prolactinoma - Management (1)

Answer 53

1) cabergoline (dopamine agonist)

Question 54

Carcinoid Syndrome - Description

Answer 54

increased serotonin secretion

Question 55

Carcinoid Syndrome - Causes (1)

Answer 55

1) carcinoid tumour

Question 56

Carcinoid Syndrome - Pathophysiology (3)

Answer 56

1) carcinoid (neuroendocrine) tumour of enterochroffin-like cells 2) metastases to liver 3) increased serotonin secretion drains into hepatic vein

Question 57

Carcinoid Syndrome - Symptoms (6)

Answer 57

1) asymptomatic (as tumour develops) 2) alcohol intolerance 3) weight loss 4) diarrhoea 5) bronchospasm 6) skin flushing

Question 58

Carcinoid Syndrome - Diagnosis (2)

Answer 58

1) 24 hour urine sample for 5-HIAA (serotonin metabolite) | 2) imaging

Question 59

Carcinoid Syndrome - Management (3)

Answer 59

1) serotonin antagonist 2) octreotide (somatostatin analogue) 3) surgical removal of tumour