Endocrine

Question 1

modifiable RF in thyroid eye disease in Graves

Answer 1

smoking

Question 2

thiazide electrolyte

Answer 2

hypercalcaemia

Question 3

pheo test

Answer 3

24h collection urinary metanephrines

Question 4

cushings test

Answer 4

resposne to high dose dex not low dose

Question 5

prolactin high but hypogonadism and hypothyroidism

Answer 5

think stalk compression by non-functioning pituitary adenoma

Question 6

DKA treated with insulin what can happen

Answer 6

hypokalaemia

Question 7

what to give in initially if bad graves symptoms

Answer 7

propranolol for symptom relief

Question 8

serum osmolality equation

Answer 8

2 x serum sodium + serum glucose + serum urea

Question 9

low testosterone possible cause

Answer 9

pituitary adenoma eg prolactinoma caused low sex hormones

Question 10

post-mi complication causing acute hypotension and pulmonary oedema with systolic murmur

Answer 10

papillary muscle rupture which causes acute mitral regurgitation

Question 11

anterior pituitary hormone

Answer 11

flat pig
FSH, LH, ACTH, TSH, prolactin, intermediate MSH and GH

Question 12

posterior pit hormones

Answer 12

ADH and oxytocin

Question 13

sick day rules

Answer 13

sadman
SGLT2i, ACEi, diuretics, metformin, ARBs and NSAIDs

Question 14

myxoedemic coma treatment

Answer 14

thyroxine and hydrocortisone

Question 15

thyrotoxic storm treatment

Answer 15

beta blockers, propylthiouracil and hydrocortisone

Question 16

when to add second diabetes drug

Answer 16

HbA1c >58

Question 17

metformin not tolerated due to side effects

Answer 17

1) try modified release
2) switch to second line therapy

Question 18

primary hyperparathyroidism

Answer 18

high PTH
high Ca
low phosphate

solitary adenoma or multifocal disease

Question 19

secondary hyperparathyroidism

Answer 19

high PTH
low or normal Ca
high phosphate
low vit D

low calcium causes parathyroid hyperplasia

Question 20

tertiary hyperparathyroidism

Answer 20

high or normal Ca
high PTH
low phosphate
high ALP

hyperplasia of the parathyroid glands after correction of underlying renal disorder

Question 21

osteomalacia bloods and symptoms

Answer 21

bone pain, tenderness and proximal myopathy
low ca, low phosphate and low vit D with high ALP and PTH

Question 22

management of primary hyperaldosteronism caused by bilateral adrenocortical hyperplasia

Answer 22

spironolactone

Question 23

causes and symptoms of primary hyperaldosteronism

Answer 23

hypertension and hypokalaemia
bilateral adrenal hyperplasia
adrenal adenoma

Question 24

C peptide in T1DM

Answer 24

low

Question 25

Cushing’s syndrome biochemical abnormality

Answer 25

hypokalaemic metabolic alkalosis

Question 26

when is metformin contraindicated

Answer 26

eGFR <30 then metformin contraindicated so give another agent eg gliptin

Question 27

what drug is linked to nec fash of the genitalia

Answer 27

SGLT2i

Question 28

what do you need to do if patient presenting with polyuria and polydipsia and you think maybe DI

Answer 28

remember to do calcium levels before water deprivation to make sure there isn’t hyperparathyroidism