Endocrine

Question 1

Glycaemic HbA1c target?

Answer 1

48 mmol/mol

Question 2

Glycaemic HbA1c target for elderly/CVD?

Answer 2

53mmol/mol

Question 3

What is metabolic syndrome?

Answer 3

Obesity + hypertension + diabetes

Question 4

What is the main cause of acromegaly?

Answer 4

mACROadenoma

Question 5

Which type of hypersensitivity is Grave’s disease?

Answer 5

Type 2

Question 6

Where does lymph from the thyroid gland drain to?

Answer 6

Superior + inferior deep cervical nodes

Question 7

4 hormones that increase blood glucose?

Answer 7

Glucagon
Adrenaline
Growth Hormone
Cortisol

Question 8

LH acts on which cells to produce what?

Answer 8

Theca cells to produce ANDROGENS

Question 9

FSH acts on which cells to produce what?

Answer 9

Granulosa cells to produce aromataze enzymes (convert androgens to oestrogen)

Question 10

Hypertension targets for diabetics?

Answer 10

135/85

Question 11

Hypertension targets for most patients?

Answer 11

140/90

Question 12

What is Klinefelter’s syndrome a cause of?

Answer 12

Primary hypogonadism

Question 13

What is Kallman’s syndrome is part of which group of conditions?

Answer 13

Hypogonadotrophic hypogonadism

Question 14

In primary hypogonadism, is LH/testosterone high or low?

Answer 14

LH high

Testosterone low

Question 15

In Kallman’s syndrome, is LH/testosterone high or low?

Answer 15

LH low

Testosterone low

Question 16

What is Carney Complex?

Answer 16

Mutation in PPKAR1A

Unregulated cAMP and proliferation

Question 17

Symptoms of Carney Complex?

Answer 17

PPNAD–> Cushings
Acromegaly
Thyroid carcinoma

Question 18

What inhibits the release of GH?

Answer 18

Somatostatin

Question 19

How do you confirm a normal menstrual cycle?

Answer 19

Mid-luteal serum progesterone test

Question 20

Symptoms of hypopituitarism?

Answer 20

Infertility, obesity, gynaecomastia, loss of hair, reduced growth, dry skin/hair, oligo/amenorrhoea

Question 21

Symptoms and treatment of Congenital Adrenal Hyperplasia?

Answer 21

Hirsutism, menstrual disturbance, infertility

Low dose glucocorticoid

Question 22

WHO Group 1 Ovarian Disorders

Answer 22

Hypothalamic/Pituitary FAILURE

Question 23

WHO Group 2 Ovarian Disorders

Answer 23

Hypothalamic/Pituitary DYSFUNCTION (e.g. PCOS)

Question 24

WHO Group 3 Ovarian Disorders

Answer 24

Ovarian failure

Question 25

3 ways of ovarian induction?

Answer 25

FSH/LH injections GnRH injections Laproscopic ovarian diathermy (drilling)

Question 26

3 complications of ovarian induction?

Answer 26

Ovarian hyperstimulation Multiple pregnancies Possible increase in ovarian cancer

Question 27

Nerve supply to the thyroid?

Answer 27

Recurrent laryngeal nerve

Question 28

What is produced in the adrenal glomerulus?

Answer 28

Mineralocorticoids (e.g. aldosterone)

Question 29

What is produced in the adrenal fasciculata?

Answer 29

Glucocorticoids (e.g. cortisol)

Question 30

What is produced in the adrenal reticularis?

Answer 30

Androgens

Question 31

What is produced in the adrenal medulla?

Answer 31

Catecholamines

Question 32

Presentation of Transcription Factor MODY?

Answer 32

Adolescent with progressive hyperglycaemia

Question 33

Investigation for Transcription Factor MODY?

Answer 33

BG, C-peptide levels (raised)

Question 34

Treatment for Transcription Factor MODY?

Answer 34

Diet, GLICLAZIDE

Question 35

Amine hormone receptors?

Answer 35

G-protein coupled

Question 36

Insulin (peptide) receptor?

Answer 36

Receptor tyrosine kinase

Question 37

GH + prolactin receptor?

Answer 37

Cytokine receptor

Question 38

Steroid hormone receptor?

Answer 38

Class 1 nuclear receptor (in cytoplasm- moves into nucleus when active)

Question 39

Lipid hormone receptor?

Answer 39

Class 2 nuclear receptor (in nucleus already)

Question 40

Glucose enters pancreatic cells via GLUT2 and produce ATP- what next?

Answer 40

ATP inhibits K+ channels DEPOLARISATION Open Ca2+ channels Vesicles secrete insulin

Question 41

Insulin binds where on the tyrosine kinase receptor?

Answer 41

Alpha subunit

Question 42

Which cells produce thyroid hormones?

Answer 42

Follicular cells

Question 43

TPO antibodies?

Answer 43

Hashimoto's

Question 44

Myxoedema coma

Answer 44

Due to severe hypothyroidism | T2 resp failure, bradycardia, T wave inversion

Question 45

Thyroid storm

Answer 45

Due to severe hyperthyroidism | Hyperthermia, resp + cardiac failure

Question 46

Thyroid storm treatment

Answer 46

Iodine | Glucocorticoids

Question 47

Most common thyroid cancer + mode of spread?

Answer 47

Papillary (lympathatic)

Question 48

What is follicular cancer associated with?

Answer 48

Iodine deficiency

Question 49

Diagnosis criteria for DKA?

Answer 49

Ketonaemia >3mmol/l High BG > 11mmol/l Low bicarb <15mmol/l

Question 50

Kussmaul breathing + N+V?

Answer 50

DKA

Question 51

Treatment of DKA?

Answer 51

IV fluids IV insulin + 10% dextrose Potassium Thromboembolism prophylaxis

Question 52

3 features of hyperglycaemic hyperosmolar state?

Answer 52

Hyperglycaemia Hyperosmolar Hypovolaemia

Question 53

MEN1

Answer 53

parathyroid, pituitary, pancreas

Question 54

MEN2

Answer 54

parathyroid, medullary thyroid, phaechromocytoma

Question 55

Treatment of hypercalcaemia?

Answer 55

Fluids Loop diuretics Bisphosphonates