Endocrinology 2

Question 1

What cardiac defect is acromegaly associated with?

Answer 1

Cardiomyopathy

(also HTN)

Question 2

What are 4 key complications of acromegaly?

Answer 2

1) HTN

2) diabetes

3) cardiomyopathy

4) colorectal cancer

Question 3

Rules surrounding schizophrenia & driving?

Answer 3

Patients with schizophrenia must not drive and must notify the DVLA, until stable and well for 3 months and following a suitable psychiatristy report.

Question 4

What metabolic disturbance is seen in Cushing’s syndrome?

Answer 4

Hypokalaemic metabolic alkalosis

(due to increased cortisol levels)

Question 5

Interpretation of 9am serum cortisol levels in Addison’s:

a) >500 nmol/l

b) <100

c) 100-500

Answer 5

a) Addison’s very unlikely

b) definitely abnormal

c) should prompt ACTH stimulation test to be performed

Question 6

What investigation is used to confirm diagnosis of acromegaly?

Answer 6

OGTT with serial GH measurements

Question 7

Dosing regime in Addison’s?

Answer 7

Majority of dose in morning, remainder in evening

Question 8

Mx of medications in Addison’s patient with intercurrent illness?

Answer 8

Double glucocorticoids (hydrocortisone), keep fludrocorticoids (fludrocortisone) the same