Endo

Question 1

What can carpal tunnel syndrome be associated with and what to investigate?

Answer 1

Can be associated with hypothyroidism
-Thyroid function test

Question 2

What can untreated hypothyroidism lead to and what do we use to treat it?

Answer 2

Can lead to myxedema and treated with hydrocortisone and levothyroxine

Question 3

What happens to eyebrow in hypothyroidism?

Answer 3

Lose lateral third of eyebrow(queen anne sign)

Question 4

What is de quervain’s thyroiditis?

Answer 4

-Post viral thyroiditis
-Hypothyroiditis

Question 5

What is sick euthyroid syndrome?

Answer 5

Sick euthyroid syndrome is an abnormality of the thyroid function tests that can occur in any systemic illness. The most common abnormality is that the free T3 is low with a normal to low free T4 and TSH. These patients tend to have no symptoms of thyroid disease and it is usually seen in critical illness or in starvation states. Repeat thyroid function tests should be performed in 6 weeks after the patient has recovered.

Question 6

Most common → Least common Thyroid Cancers

Answer 6

Papillary, Follicular, Medullary, Anaplastic, Lymphoma(non-hodgkins)
Please feel my awkward lump

Question 7

What is a side effect of carbimazole and proplthiouracil?

Answer 7

Agranulocytosis which can lead to neutropenia and severe sepsis
-Must stop if pt comes in with sign of infection or neutropenia

Question 8

How does anaplastic carcinoma present?

Answer 8

Presents with airway compromise(stridor), dysphagia and in older women

Question 9

What would you screen for in a patient after a thyroidectomy due to medullary carcinoma?

Answer 9

Calcitonin as medullary carcinoma is a cancer of the parafollicular cells that secretes it

Question 10

What is the Ix if pt comes in with mass on thyroid which is fast growing?

Answer 10

-Concern of malignancy
-Fine needle aspiration

Question 11

What is carbimazole mechanism of action?

Answer 11

Inhibits thyroid peroxidase

Question 12

Post pregnancy and showing symptoms of hyperthyroidism

Answer 12

Most likely transient hyperthyroidism and therefore symptomatic relief like propanolol

Question 13

What diabetic drug is contraindicated in pregnancy?

Answer 13

Perindopril(ACE inhibitor)

Question 14

What to give patient with hypoglycemia with no symptoms?

Answer 14

Glucogel

Question 15

What to give patients with hypoglycemia with syncope?

Answer 15

Glucagon

Question 16

Mx for steroid induced hyperglycemia?

Answer 16

Gliclazide

Question 17

What does DKA present with?

Answer 17

Metabolic acidosis and raised anion gap >16

Question 18

What would subclinical hyperthyroidism look like?

Answer 18

-Low TSH
-Normal T4

Question 19

What would subclinical hypothyroidism look like?

Answer 19

-High/Normal TSH
-Normal T4

Question 20

Target BP for diabetics <80

Answer 20

<140/90

Question 21

What is recommended in patients who have diabetes as well as CKD if they are already on metoformin?

Answer 21

SGLT2 inhibitor

Question 22

If goitre is tender what is that most likely?

Answer 22

De quervain’s which comes post viral illness

Question 23

What drug in diabetes mx has a side effect of hypoglycemia?

Answer 23

Glimepiride is a sulfonylurea, these medications work by stimulating the pancreatic beta cells to promote insulin secretion. Hypoglycaemia is a well recognised and serious side effect of sulfonylureas and the likely cause of this gentleman’s hypoglycaemic episode.

Question 24

How would you diagnose acromegaly

Answer 24

Insulin like growth factor → acromegaly → colorectal cancer

Question 25

What is used to routinely check for excessive GH?

Answer 25

IGF 1alpha

Question 26

What drug causes excessive thirst and nocturia and why?

Answer 26

Lithium -can cause pts to get nephrogenic diabetes insipidus(AVP resistance)

Question 27

What is the most common cause of primary hyperparathyroidism?

Answer 27

parathyroid adenoma

Question 28

What is the most common cause of cushing's syndrome?

Answer 28

oral corticosteroids

Question 29

What glucose levels can you diagnose gestational diabetes? what is first line treatment

Answer 29

>=5.6 -First line if between 5.6-7 is diet and exercise --if no improvement then metformin

Question 30

What causes addissons?

Answer 30

Destruction of the adrenal glands (i.e. primary adrenal insufficiency) can be caused by: Autoimmune process - around 90% of people in the UK Infections, such as tuberculosis, especially in areas where TB is endemic. Other (less common) infections include fungal infections and opportunistic infections secondary to HIV Infiltrating diseases, such as amyloidosis, sarcoidosis Tumours, including both primary and metastatic cancers