2 - PM

Question 1

what is cushings

Answer 1

chronic glucocorticoid excess (cortisol)

Question 2

what 3 things do the adrenal codex produce

Answer 2

glucocorticoids (cortisol)
mineralocorticoids (aldosterone)
androgens (testosterone)

Question 3

2 main causes of cushings

Answer 3

oral steroids

pituitary adenoma

Question 4

what is ACTH and what produces it

Answer 4

adrenocorticotrophin hormone - by anterior pituitary

Question 5

Minimal glucocorticoid activity, very high mineralocorticoid activity,

Answer 5

Fludrocortisone

Question 6

Glucocorticoid activity, high mineralocorticoid activity,

Answer 6

Hydrocortisone

Question 7

Predominant glucocorticoid activity, low mineralocorticoid activity

Answer 7

Prednisalone

Question 8

Very high glucocorticoid activity, minimal mineralocorticoid activity

Answer 8

Dexamethasone

Betmethasone

Question 9

What is maturity onset diabetes of the young (MODY)

Answer 9

A group of inherited genetic disorders affecting the production of insulin. Results in younger patients developing symptoms similar to those with T2DM, i.e. asymptomatic hyperglycaemia with progression to more severe complications such as diabetic ketoacidosis

Question 10

What is latent autoimmune diabetes of adults (LADA)

Answer 10

The majority of patients with autoimmune-related diabetes present younger in life. There are however a small group of patients who develop such problems later in life. These patients are often misdiagnosed as having T2DM

Question 11

Who cannot get metformin

Answer 11

Cannot be used in patients with an eGFR of < 30 ml/min

Question 12

Metformin main side effect

Answer 12

Gastrointestinal upset

Lactic acidosis - like for exams not the common in real life

Question 13

Sulfonylureas examples

Answer 13

gliclazide and glimepiride

Question 14

Sulfonylureas: gliclazide and glimepiride main side effects

Answer 14

Hypoglycaemia
Weight gain
Hyponatraemia

Question 15

Which T2DM drug: Hypoglycaemia, Weight gain, Hyponatraemia

Answer 15

Sulfonylureas: gliclazide and glimepiride

Question 16

Which T2DM drug: GI upset and Lactic acidosis

Answer 16

Metformin

Question 17

Which T2DM drug: Urinary tract infection and ketoacidosis

Answer 17

SGLT-2 inhibitors (-gliflozins)

Question 18

Which T2DM drug: Nausea and vomiting and Pancreatitis

Answer 18

GLP-1 agonists (-tides)

Question 19

Which T2DM drug: Weight gain and Fluid retention

Answer 19

thiazolidinedione is pioglitazone

Question 20

normal, pre-diabetes, diabetes cut offs for fasted glucose

Answer 20

normal <6
pre 6.1-6.9
diabetes >7

Question 21

normal, pre-diabetes, diabetes cut offs for Hb1Ac

Answer 21

normal <5.9%
pre 6-6.4%
diabetes >6.5%

Question 22

hypothyroidism + goitre + anti-TPO

Answer 22

Hashimoto’s thyroiditis

Question 23

painful goitre + raised ESR

Answer 23

De Quervain’s thyroiditis

Question 24

Hyperthyroidism: Anti-TSH receptor stimulating antibodies

Answer 24

graves

Question 25

Hypothyroidism: Ab that suggest hashimotos

Answer 25

Anti-thyroid peroxidase antibodies

Question 26

acromegaly diagnostic test:

Answer 26

Oral glucose tolerance test with growth hormone measurement

Question 27

acromegaly screening test:

Answer 27

Serum insulin-like growth factor 1 (IGF-1), which reflects 24-hour GH levels -NOT diagnostic

Question 28

addisonian crisis treatment

Answer 28

hydrocortisone 100 mg im or iv 1 litre normal saline infused over 30-60 mins or with dextrose if hypoglycaemic continue hydrocortisone 6 hourly until the patient is stable. No fludrocortisone is required because high cortisol exerts weak mineralocorticoid action

Question 29

T2DM target Hb1Ac an when do you consider a second drug

Answer 29

target 6.5% add second if >7.5%

Question 30

Anti-thyroid peroxidase antibodies trickery in results

Answer 30

fou din both graves and hashimotos BUT graves is HYPER and hashimotos is HYPO

Question 31

3 P's of MEN 1

Answer 31

Parathyroid Pituitary Pancreas

Question 32

What is Pheochromocytoma

Answer 32

tumour of adrenal medula = that secretes high amounts of catecholamines, mostly norepinephrine, plus epinephrine to a lesser extent

Question 33

P's of MEN IIa

Answer 33

MEN type IIa:Parathyroid (60%) | Phaeochromocytoma

Question 34

P's of MEN IIb

Answer 34

Phaeochromocytoma

Question 35

Pheochromocytoma symptoms

Answer 35

Episodic headache, sweating and tachycardia

Question 36

Pheochromocytoma treatment

Answer 36

Alpha blocker then surgery

Question 37

which T2D drug can't those with heart failure get and why

Answer 37

Glitazones = causes water retention

Question 38

In hyperparathyroidism what would you expect the Ca and PTH levels to be

Answer 38

high Ca | Normal/high PTH (normally high Ca should lower PTH levels)

Question 39

which drug contains high iodine levels and can cause thyroid problems

Answer 39

amiodarone

Question 40

which T2D drug can't be taken in bladder cancer and not recommend din fatties coz it causes weight gain

Answer 40

pioglitazone