Endo'cryin'shame
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| Name the 3 R’s of Animal research | replacement, use alternatives where possible, Reduction: fewest animals used as possible, Refinement: minimise pain and suffering by design of study (Mnemonic: alternative therapy causes less pain)
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| Define Pseudodementia | depression presenting as dementia in elderly
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| Name most common cause of hypothyroidism in Western World and Globally | Hashimotos and iodine deficiency, thyroiditis is next on the list
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| What is the Rx for Hyperthyroidism | I think you give Beta Blockers and then Carbimazole....check...?
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| What is the diagnostic test for adrenal insufficiency? And what is it testing for | Synacthen Test measuring Cortisol production at 0, 30, 60 mins
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| Name 5 common signs for Cushings | moon face, buffalo hump, striae, inc bruising, thin skin, menstrual irregular, osteoporosis, hursuit, trunkal obesity, acne, weakness, hyperglycaemia, poor wound healing
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| How do you test for Cushings? | Give Dexamethasone (glucocorticoid) which should red. CRH and ACTH means red. Urinary cortisol
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| A Dexamethasone test yields normal urine cortisol, what can u summise? | Must have pituitary adenoma (Cushing’s Disease) or ectopic ACTH production (SCC lung?)
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| What screening test would u perform before conducting a Dexamethasone Test on suspected over active adrenal gland? | Urinary free cortisol collection. Excess quickly exceeds binding and overflows into urine. IF+ve then overnight Dexa
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| What does CONNS syndrome result in? | Aldosterone-Producing Adenoma, excess aldo means incr. Na red. K and thus incr. BP with REDUC. Renin from RAAS inhibition
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| What findings would u expect in biochem with renal artery stenosis? | Incr. RAAS means incr. aldosterone and incr. Renin
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| What are the 5 P’s of Phaechromocytoma? | Pressure (inc. BP), Pain, Perspiration, Palps, Pallor
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| What does TRH production stimulate? (2 things) | TSH and Prolactin
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| What is the action of T3? (4 B’s) | Stimulation/growth of Brain, Bone, BMR and B adrenergics
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| What does GnRH stimulate release of and what do they act on? | LH and FSH, bollock and ovaries to produce sex hormones
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| Pt has high TSH and low T4, what they got? | Hypothyroidism
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| Pt has high TSH and norm T4, what they got? (2) | treated hypothyroid or subclinical hypothy
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| Pt has high TSH and high T4 (2), what they got? | TSH tumour or TH resistance
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| Pt had low TSH and high T4, what they got? | hyperthyroid
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| What does GHRH stimulate release of and what inhibits/promotes its release? | GH, +ve: exercise, stress, sleep, -ve: glucose, insulin like growth factor
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| What condition would GH insufficiency cause in a young child? | Severe dwarfism?
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| Name at least 3 features of acromegaly? | course facial features, soft tissue thickening, spade like hands, prognathism, sweating, impaired glucose tolerance, DM
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| How do you test for acromegaly? | oral glucose tolerance test (75g), if this fails to suppress GH the +ve
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| Name 2 microvascular conseq. From DM? | retinal neuropathy, nephropathy
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| Name 2 macrovascular consequences of DM? | CV cerebrovascular disease
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| Name 3 symptoms of DKA | kussmaul’s breathing (deep rasping), drowsy, inc. HR, flushed, N+V, abdo pain, confusion, thirst, polyuria
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| What are the causes of DKA? | lack of insulin often with stress, infection, pregnancy
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| What are the Ix for DKA, which is arguably the most important and why? | ABG acidosis, BM>11.1, urine dip ++ ketones. Acidosis is lethal so ABG arguably most important
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| Rx for DKA? | Fast insulin, fast fluids, K if <5.5 LMWH and monitor
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| Define HONK and physio effect | DM crisis of incr. glucose causing incr osmolality causing intra cellular dehydration as all fluid drawn out into vessels to balance hyperosmolar state
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| Name 3 symptoms of pt with HONK | incr. confusion, incr. coaguable, v unwell, incr. Na driven by dehydration
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| Would u try to give a HONK pt fluids quickly to reverse their dehydration? | Not unless you want to give them cerebral oedema
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| Define SIADH and how it presents | Syndrome of inappropriate ADH release, inc. ADH means H20 retained means dilutional hypoNa, urine osmolality>plasma osmolality
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| Patient presents with incr. thirst, H2O loss and very dilute urine..what condition presents in this way...? | Diabetes insipidus
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| What NT stimulates the release of Prolactin? | TRH NOT Dopamine which inhibits release of Prolactin
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| What does Prolactin inhibit the stimulation of? | GnRH
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| Give 2 possible causes for hyper secretion of Prolactin? | Prolactinoma, Dopamine Antagonist eg, antipyschotics
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