Endocrinology & Diabetes — Flashcards

Flashcard 21: What is the main cause of Primary Hyperparathyroidism?

Answer: • Parathyroid Adenoma (85% of cases)

Flashcard 22: What can be the symptomatic features of primary hyperparathyroidism? 4

Answer: • 'bones, stones, abdominal groans and psychic moans" - Bone pain/fracture - Renal Stones - Peptic ulceration, nausea, constipation, anorexia - Depression *polydipsia, polyuria, pancreatitis, hypertension

Flashcard 23: What can cause Hypercalcaemia? 2

Answer: Two conditions account for 90% of cases of hypercalcaemia: 1. Primary Hyperparathyroidism 2. Malignancy - PTHrP from tumour e.g. squamous cell lung cancer - Bone Mets - Myeloma * measuring parathyroid hormone level is ley

Flashcard 24: What do carcinoid tumours secrete?

Answer: • bradykinin • serotonin • ACTH (pituitary hormone) -> Cushing syndrome signs

Flashcard 25: What can cause postural hypotension + erectile dysfunction?

Answer: • Diabetes

Flashcard 26: What are the Bone Profile Results of Osteomalacia?

Answer: • Low calcium • Low phosphate • Raised ALP • Raised PTH *hypocalcaemia, hypophosphataemia due to impaired intestinal absorption. Raised ALP due to response of calcium absorption on bone

Flashcard 27: What is the recommended blood glucose monitoring in T1DM?

Answer: • Atleast 4 times a day, including before each meal and before bed

Flashcard 28: What can corticosteroids do to glycaemic control?

Answer: • They can worsen glycaemic control • due to anti-insulin effects • Can cause hyperglycaemia

Flashcard 29: What is osteomalacia?

Answer: • The softening of bones due to inadequate Vit D

Flashcard 30: What is the likely diagnosis if Cortisol is Low and ACTH is Low after a Dexamethasone Suppression Test (or at baseline)?

Answer: Secondary Adrenal Insufficiency (Exogenous steroid use) :: Diagnosis?

Extra: In Cushing's syndrome (hypercortisolism) workup: 1. If Cortisol is HIGH after High-Dose DST + ACTH is HIGH -> Cushing Disease (Pituitary). 2. If Cortisol is HIGH after High-Dose DST + ACTH is LOW -> Adrenal Cushing's. However, the prompt asks for LOW Cortisol AND LOW ACTH after a suppression test: - This pattern (suppression of the axis) is seen in Secondary Adrenal Insufficiency, most commonly due to chronic exogenous steroid use leading to suppression of CRH and ACTH. - Adrenal Cushing's (Back content original) would have HIGH cortisol (failure to suppress) and LOW ACTH.