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Flashcards in Diagnosis in Endocrine Deck (36)
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1
Q

Diagnosis of Addison’s?

A

on bloods: low Na, high K and hypoglycaemia

Also do SHORT SYNACTHEN test - serum cortisol should rise substantially

2
Q

Diagnosis of Addison’s?

A

on bloods: low Na, high K and hypoglycaemia

Also do SHORT SYNACTHEN test - serum cortisol should rise substantially, but in Addison’s disease, it will not

3
Q

Secondary adrenal insufficiency

A

SHORT SYNACTHEN, serum cortisol will rise, but steadily instead of substantially

4
Q

Cushing’s syndrome

A

Overnight dexamethasone suppresion test

Cortisol and ACTH should decrease due to negative feedback, but in Cushing’s, cortisol will not be decreased

5
Q

Primary aldosteronism?

A

confirm aldosterone excess by measuring renin and aldosterone and expressing in in a ratio, if ratio is high then investigate further with a saline suppression test
Confirm subtype with CT scan

6
Q

Congenital adrenal hyperplasia?

A

basal progesterone

genetic mutation analysis

7
Q

Phaeochromocytoma?

A

Biochem abnormalities: hyperglycaemia, low K level, raised Hb, mild hypocalcaemia, lactic acidosis
Cataclamine excess in urine and plasma
Identify source of cetecholamine excess using MRI scan, MIBG, PET scan

8
Q

Diagnosis of Hashimotos?

A

presence of thyroid peroxidase antibodies in blood and T cell infiltrate and inflammation on microscopy
TSH high, T4/3 low
High CK
increased LDL

9
Q

What happens to prolactin in Hashimoto’s?

A

increases (increased TRH leads to increased prolactin secretion)

10
Q

Myxoedema coma?

A

ECG - bradycardia, heart block, T wave inversion, QT prolongation
Type 2 resp failure: hypoxia, hypercarbia, resp acidosis

11
Q

Grave’s?

A
antibody positive (TRAbs)
High T3/T4, low TSH
Scintigraphy, assymmetrical goitre
12
Q

Sub acute thyroiditis (De Quervians)?

A

T4 is high in early stages, low in late, then normal

TSH is low, then high then normal

13
Q

Thyroid cancer?

A

ultrasound guided FNA of lesion
Excision biopsy of lymph nodes
(No role for isotope scan or CT/MRI)

14
Q

Hypercalcaemia?

A

raised calcium, raised PTH, increased urine calcium excretion

15
Q

Primary Hyperparathyroidism?

A

PTH and Ca raised

16
Q

Secondary Hyperparathyroidism?

A

PTH raised, Ca low

17
Q

Tertiary Hyperparathyroidism?

A

PTH and Ca raised

18
Q

PseudoHyperparathyroidism?

A

PTH raised, Ca low

19
Q

PseudoPseudoHyperparathyroidism?

A

PTH raised, Ca normal

20
Q

Paget’s?

A

X ray
Raised ALP
Isotope bone scan

21
Q

Cervical lymphadenopathy?

A

CXR
ENT opinion
Fine need aspiration

22
Q

Branchial cyst?

A

fine needle aspiration will show cholesterol crystals

23
Q

Cystic hygroma?

A

transillumination

24
Q

Diabetes insipidus?

A

urine osmolality is less than 300 and serum osmolality is more than 300
Dyname test- water deprivations test

25
Q

Diagnosis of DM?

A

fasting glucose > 7

Random >11.1

26
Q

Diagnosis of type?

A

mostly history based

27
Q

Reduced ovarian reserve?

A

raised TSH, low anti mullerian hormone, reduced antral follicle count US

28
Q

POS?

A

ultrasound

29
Q

Endrometriosis?

A

uterus may be fixed and retroverted, scan may show CHOCOLATE CYSTS on ovary

30
Q

Discrimanatory test between diabetes T1 and T2?

A

GAD/anti-islet cell antibodies, ketone, C-peptide

31
Q

DKA?

A

blood glucose
urine dipstick may show glucose and ketones
ABGs show metabolic acidosis

32
Q

Hyperosmolar hyperglycaemic non-kerotic state?

A

urinalysis - marked glucose in urine with NORMAL KETONE levels

33
Q

Acromegaly

A

glucose tolerance test
Ig GH levels are not suppressed by glucose and levels of IGF-1 are elevated then diagnosis is confirmed
MRI scan pituitary and hypothalamus

34
Q

Imperforate hymen?

A

ultrasound

35
Q

Asherman syndrome?

A

sonohysterography

hysterosalpinography

36
Q

Struma ovarii?

A

TFTs only in patients with symptomatic hyperthyroidism