Endocrinology

Question 1

What is acromegaly?

Answer 1

Hypersecretion of GH by anterior pituitary tumour

Question 2

Acromegaly symptoms

Answer 2

Ring not fitting, growing hands/feet/height, macroglossia, frontal bossing, hypertension, sweating, headache, large teeth spaces, visual disturbances (bitemporal hemianopia)

Question 3

Blood test in acromegaly

Answer 3

Insulin-like growth factor 1 (IGF1)

Question 4

OGTT use in acromegaly

Answer 4

Usually rapid glucose intake leads to suppression of growth hormone; in acromegaly GH will continue to be high

Question 5

Surgery in acromegaly

Answer 5

Transsphenoidal resection of pituitary tumour

Question 6

Which drug can cause both hypo and hyperthyroidism?

Answer 6

Amiodarone

Question 7

Hypothyroidism signs

Answer 7

Weight gain, thinning hair, bradycardia, peripheral neuropathy/oedema, slow cognition, goitre, slow reflexes, loss of lateral third of eyebrows, dry skin

Question 8

Causes of hypothyroidism

Answer 8

Radiotherapy, amiodarone, iodine deficiency, autoimmune e.g. Hashimoto’s, cancer

Question 9

FBC in hypothyroidism

Answer 9

Macrocytic anaemia

Question 10

White patches on skin in hypothyroidism

Answer 10

Vitiligo

Question 11

What is Grave’s disease

Answer 11

Autoimmune disease causes by TSH receptor antibodies

Question 12

Signs of Grave’s

Answer 12

Exophthalmos, pretibial myxoedema (most specific 2), tachycardia, AF/palpitations, warm peripheries, goitre, thin hair, brisk reflexes, lid lag

Question 13

What drugs are used to “block” in hyperhyroidism

Answer 13

Carbimazole / propylthiouracil