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Alski's Stack No. 2


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)
Define Pseudodementia depression presenting as dementia in elderly
Name most common cause of hypothyroidism in Western World and Globally Hashimotos and iodine deficiency, thyroiditis is next on the list
What is the Rx for Hyperthyroidism I think you give Beta Blockers and then Carbimazole....check...?
What is the diagnostic test for adrenal insufficiency? And what is it testing for Synacthen Test measuring Cortisol production at 0, 30, 60 mins
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
How do you test for Cushings? Give Dexamethasone (glucocorticoid) which should red. CRH and ACTH means red. Urinary cortisol
A Dexamethasone test yields normal urine cortisol, what can u summise? Must have pituitary adenoma (Cushing’s Disease) or ectopic ACTH production (SCC lung?)
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
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
What findings would u expect in biochem with renal artery stenosis? Incr. RAAS means incr. aldosterone and incr. Renin
What are the 5 P’s of Phaechromocytoma? Pressure (inc. BP), Pain, Perspiration, Palps, Pallor
What does TRH production stimulate? (2 things) TSH and Prolactin
What is the action of T3? (4 B’s) Stimulation/growth of Brain, Bone, BMR and B adrenergics
What does GnRH stimulate release of and what do they act on? LH and FSH, bollock and ovaries to produce sex hormones
Pt has high TSH and low T4, what they got? Hypothyroidism
Pt has high TSH and norm T4, what they got? (2) treated hypothyroid or subclinical hypothy
Pt has high TSH and high T4 (2), what they got? TSH tumour or TH resistance
Pt had low TSH and high T4, what they got? hyperthyroid
What does GHRH stimulate release of and what inhibits/promotes its release? GH, +ve: exercise, stress, sleep, -ve: glucose, insulin like growth factor
What condition would GH insufficiency cause in a young child? Severe dwarfism?
Name at least 3 features of acromegaly? course facial features, soft tissue thickening, spade like hands, prognathism, sweating, impaired glucose tolerance, DM
How do you test for acromegaly? oral glucose tolerance test (75g), if this fails to suppress GH the +ve
Name 2 microvascular conseq. From DM? retinal neuropathy, nephropathy
Name 2 macrovascular consequences of DM? CV cerebrovascular disease
Name 3 symptoms of DKA kussmaul’s breathing (deep rasping), drowsy, inc. HR, flushed, N+V, abdo pain, confusion, thirst, polyuria
What are the causes of DKA? lack of insulin often with stress, infection, pregnancy
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
Rx for DKA? Fast insulin, fast fluids, K if <5.5 LMWH and monitor
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
Name 3 symptoms of pt with HONK incr. confusion, incr. coaguable, v unwell, incr. Na driven by dehydration
Would u try to give a HONK pt fluids quickly to reverse their dehydration? Not unless you want to give them cerebral oedema
Define SIADH and how it presents Syndrome of inappropriate ADH release, inc. ADH means H20 retained means dilutional hypoNa, urine osmolality>plasma osmolality
Patient presents with incr. thirst, H2O loss and very dilute urine..what condition presents in this way...? Diabetes insipidus
What NT stimulates the release of Prolactin? TRH NOT Dopamine which inhibits release of Prolactin
What does Prolactin inhibit the stimulation of? GnRH
Give 2 possible causes for hyper secretion of Prolactin? Prolactinoma, Dopamine Antagonist eg, antipyschotics
Created by: alski
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