Endocrine

Question 1

What signalling pathway does growth hormone use?

Answer 1

A tyrosine kinase receptor that uses JAK/STAT pathway

Question 2

what is the most appropriate first line investigation for acromegaly?

Answer 2

Serum IGF1 levels

Question 3

What is Reifenstein syndrome?

Answer 3

X-linked genetic disease associated with partial androgen insensitivity

Question 4

T/F - Patients with DKA are at low risk of thromboembolism?

Answer 4

false - all patients with DKA are at high risk of thromboembolism and should be given LMWH

Question 5

What is the action of the parotid gland?

Answer 5

it has secretomotor action via the glossopharyngeal and auriculotemporal nerves

Question 6

what should be given to commence preparation for the surgery of removal adrenal phaechromocytoma?

Answer 6

Alpha-adrenergic receptor blockers

Question 7

what causes low calcium, high phosphate, albumin and PTH in renal failure?

Answer 7

impaired formation of calcitriol, reduced phosphate excretion due to renal impairment. PTH is elevated in response to the low calcium level

Question 8

which structure lies posterior to the left suprarenal gland on MRI imaging?

Answer 8

Crus of diaphragm

Question 9

How is the left crus of diaphragm described?

Answer 9

tendinous structure arising from the anterior bodies of the L1 and L2 vertebrae

Question 10

What are the symptoms of hyperprolactinaemia?

Answer 10

amenorrhoea, discharge from breast, normal secondary sexual characteristics

Question 11

what is the most common thyroid cancer?

Answer 11

Papillary carcinoma of the thyroid

Question 12

what are the neoplasms associated with MEN1?

Answer 12

Pituitary, parathyroid, and pancreatic

Question 13

what are the neoplasms associated with MEN2a?

Answer 13

Phaeochromocytoma, parathyroid and medullary thyroid cancer

Question 14

what are the neoplasms associated with MEN2b?

Answer 14

Phaeochromocytoma, medullary thyroid cancer, and marfanoid habitus/ mucosal neuromas

Question 15

what is the overall effect of raised PTH?

Answer 15

increased Ca2+ and decreased phosphate, albumin is usually normal or low.

Question 16

What is the most important cause of signs and symptoms in primary hyperparathyroidism?

Answer 16

Elevated Ca2+ which is what causes patients to be weak, tired, and depressed

Question 17

what causes pseudohypoparathyroidism?

Answer 17

the failure of target cell response to PTH - this means that PTH is elevated

Question 18

What does lack of response to PTH result in?

Answer 18

Low Ca2+ and raised phosphate

Question 19

what do raised aldosterone levels cause?

Answer 19

renin levels to fall through negative feedback loops

Question 20

how does PTH increase calcium levels?

Answer 20

stimulating bone resorption by increasing action of osteoclasts

decreasing urinary excretion of calcium by stimulating reabsorption

stimulating the production of vitamin D in the kidneys

Question 21

What are Phaeochromocytomas?

Answer 21

catecholamine secreting tumours

Question 22

what are some signs and symptoms suggestive of Phaeochromocytoma?

Answer 22

sweating, palpitations and weight loss, postural pressure drop and a high bounding pulse. tremor and looking pale.

Question 23

what is the most common cause of Addisons disease in the UK?

Answer 23

autoimmune destruction

Question 24

what are symptoms of Addison disease?

Answer 24

lethargy, dizziness when changing posture, reduced appetite, hyperpigmentation around mouth

Question 25

what is metabolic syndrome defined as?

Answer 25

``` 3 or more of: increased waist circumference BMI >30kg/m2 raised triglycerides reduced HDL cholesterol hypertension raised fasting glucose ```

Question 26

what is a feature of congenital adrenal hyperplasia due to 21-hydroxylase deficiency?

Answer 26

adrenocortical insufficiency - this is due to decreased cortisol synthesis and commonly reduces aldosterone synthesis

Question 27

does follicular carcinoma spread through blood or lymph?

Answer 27

blood