Endocrine

Question 1

Drug causes of SIADH?

Answer 1

Carbamazepine, SSRI, SUs, TCAs

Question 2

Hashimotos thyroid cancer association?

Answer 2

MALT

Question 3

MEN 1?

Answer 3

PTH
Pituitary
Pancreas

Question 4

MEN IIa?

Answer 4

Phaeo
Medullary Thyroid Ca
PTH

Question 5

MEN IIb?

Answer 5

Phaeo
Medullary Thyroid Ca
Marfanoid
Fibromas

Question 6

Hypokalaemia but normotensive, often presenting in childhood with failure to thrive?

Answer 6

Bartters

Question 7

Bartters defect?

Answer 7

Sodium potassium chloride pump in ascending limb of LoH

Question 8

Hypercalcaemia with (inappropriately) high PTH?

Answer 8

Primary HPTH

Question 9

SU mechanism?

Answer 9

Potassium ATP channel
Increase stimulation of insulin secretion by pancreatic B-cells and decrease hepatic clearance of insulin

Question 10

Mainstay of treatment for MODY?

Answer 10

Gliclazide

Question 11

Most common thyroid tumour, esp in young females?

Answer 11

Papillary

Question 12

Thyroid malignancy in elderly females causing pressure symptoms?

Answer 12

Anplastic

Question 13

Solitary nodule thyroid cancer?

Answer 13

Follicular

Question 14

Gestational diabetes thresholds?

Answer 14

fasting glucose is >= 5.6 mmol/L
2-hour glucose is >= 7.8 mmol/L

Question 15

First line for suspected acromegaly

Answer 15

IGF-1 measurement

Question 16

DPP4s, examples and mechanism?

Answer 16

Gliptins
Think incretins

Question 17

Hypothyroid
TPO
Goitre

Answer 17

Hashimoto’s

Question 18

Congenital adrenal hyperplasia cause? What specific blood marker will be elevated?

Answer 18

21-hydroxylase deficiency
17-hydroxyprogesterone

Question 19

Grave’s disease management?

Answer 19

Initially propranolol for symptoms
Then carbimazole
If euthyroid add thyroxine

Question 20

RET oncogene?

Answer 20

Men IIa and IIb

Question 21

First line hormonal treatment for prolactinoma?

Answer 21

Cabergoline

Question 22

Glitazones mechanism and SEs

Answer 22

agonists of PPAR-gamma receptors, reducing peripheral insulin resistance

Weight gain
Fluid retention - not used in CCF
Liver injury

Question 23

Hashimoto’s antibiody?

Answer 23

Anti TPO

Question 24

Drug therapy in stress incontinence?

Answer 24

Duloxetine

Question 25

Gynaecomastia drug causes?

Answer 25

Spiro Digoxin Finasteride Gosrelin

Question 26

Most common cause of Conn's?

Answer 26

Bilateral adrenal hyperplasia

Question 27

PCOS management: 1. Infertility 2. Acne and hirsutism

Answer 27

1. Weight loss Metformin if obese, clomifene 2. COCP, if fails then topical eflornithene

Question 28

Statins safe in pregnancy?

Answer 28

No

Question 29

Antibodies in Grave's?

Answer 29

TSH receptor-stimulating

Question 30

Extrathyroid features unique to Grave's?

Answer 30

Pretibial myxoedema Thyroid acropachy

Question 31

Gitelmans features?

Answer 31

Normotension Hypokalaemia Hypocalciuria Hypomagnasaemia Metabolic alkalosis

Question 32

History that sounds like a brief period of hyperthyroidism followed by hypothyroidism?

Answer 32

Subacute (de Quervein's) thyroiditis

Question 33

Presentation of insulinoma?

Answer 33

Hypoglycaemia: typically early in morning or just before meal, e.g. diplopia, weakness etc Rapid weight gain may be seen!!

Question 34

Hypocalaemia ECG finding?

Answer 34

Long QT

Question 35

Most common non-iatrogenic cause of Cushing's?

Answer 35

Pituitary tumour

Question 36

Very high cholesterol and slight hyponatraemia?

Answer 36

Pseudohyponatraemia

Question 37

Criteria for parathyroidectomy?

Answer 37

Age under 50 years. Adjusted serum calcium concentration that is 0.25 mmol/L or more above the upper end of the reference range. Estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2 although this threshold depends on other factors, such as age. Renal stones or presence of nephrocalcinosis on ultrasound or CT. Presence of osteoporosis or osteoporotic fracture. Symptomatic disease

Question 38

PTU or carbimazole in pregnancy?

Answer 38

PTU first trimester Carbimazole after that

Question 39

General HbA1c target in T1DM?

Answer 39

48

Question 40

Target after commencing statin use in primary CVD prevention?

Answer 40

A greater than 40% reduction in non-HDL cholesterol

Question 41

Familial hypercholesterolaemia inheritance and management?

Answer 41

AD High dose statins

Question 42

Tall, infertile, small firm testicles? Karyotype?

Answer 42

Kleinfelter's 47XXY

Question 43

Mention of some secondary sexual characteristics in a largely female phenotype with "hernia"?

Answer 43

Androgen insensitivity syndrome - those herniae are undescended testicles

Question 44

Most common MODY gene?

Answer 44

HNF-1 alpha

Question 45

Mechanism responsible for hypercalcaemia in malignancy?

Answer 45

Parathyroid-hormone-related peptide

Question 46

Increased cancer risk in acromegaly?

Answer 46

Colorectal

Question 47

Phaeo and large port wine naevus on one side of the face?

Answer 47

Sturge-Weber syndrome

Question 48

Amenorrhoea and clitoromegaly?

Answer 48

CAH

Question 49

Drug therapy you can use in lithium induced diabetes insipidus to help with polyuria?

Answer 49

A thiazide

Question 50

When is classical congenital adrenal hyperplasia diagnosed? (and can be helpful therefore in questions)

Answer 50

At birth (therefore presentation in an older girl likely to be non-classical

Question 51

First line antiemetic in gastroparesis?

Answer 51

Domperidone

Question 52

Amenorrhoea and high FSH, low oestrogen?

Answer 52

Primary ovarian failure

Question 53

What complication will the vast majority of diabetic patients have?

Answer 53

Retinopathy

Question 54

Cushings-sounding history but mildly raised cortisol and loads of alcohol?

Answer 54

Pseudocushings

Question 55

Number one cause of dialysis dependant ESRF in UK/US?

Answer 55

Diabetic nephropathy

Question 56

High alk phos, bone lesions in otherwise well man?

Answer 56

Paget's

Question 57

Most frequently reported SE of HRT

Answer 57

Breast tenderness

Question 58

Preferred alpha blocker in phaeo?

Answer 58

Phenoxybenzamine (preferred over doxasocin)

Question 59

What hormone suppresses LH and FSH?

Answer 59

Prolactin

Question 60

Prolactinoma - micro or macro more common?

Answer 60

Micro

Question 61

Retinal haemangioblastomas?

Answer 61

VHL

Question 62

Parathyroid sounding question with short neck, short 4th and 5th metacarpals?

Answer 62

Pseudohypoparathyroidism

Question 63

Chromaffin cells produce what?

Answer 63

Dopamine

Question 64

Delayed puberty and anosmia?

Answer 64

Kallmans