Endocrine

Question 1

What are the 4 main types of Diabetes?

Answer 1

Type I, Type II, MODY, Gestational

Question 2

Diabetes Risk Factors

Answer 2

African-Caribbean, Family Hx, High BP, Overweight

Question 3

Diabetes Presentation

Answer 3

Frequency, Increased Thirst and Hunger, Blurry vision, Fatigue, Itchy skin, Slow healing

Question 4

Diabetes Investigations

Answer 4

Blood Glucose (2 hour post/Random = >11 / Fasting = >7), HBA1c (>48)

Question 5

Diabetes Treatment

Answer 5

Lifestyle, Insulin, Metformin, Gliclazide

Question 6

Who Gets Hyperthyroidism

Answer 6

Women, >60yrs

Question 7

Causes of Hyperthyroidism

Answer 7

Graves (most common), Adenoma, Abnormal secretion of TSH, Thyroiditis, Excessive iodine intake

Question 8

Hyperthyroidism Presentation

Answer 8

Irritability, Muscle weakness, Tachycardia, Hot, Diarrhoea, Weight loss, SOB, Amenorrhea, Tremors

Question 9

What do blood tests show in Hyperthyroidism?

Answer 9

Low TSH, Raised T3 and T4

Question 10

Hyperthyroidism Investigations

Answer 10

Bloods, Radioactive iodine uptake test, Imaging

Question 11

Hyperthyroidism Treatment

Answer 11

Anti-thyroid Medication (carbimazole), Diet (reduce iodine), Surgery, Radioiodine

Question 12

What are the 3 types of Hypothyroidism? Which is most Common?

Answer 12

Primary (gland itself), Secondary (pituitary), Tertiary (hypothalamus)

Primary is most common

Question 13

Hypothyroidism Risk Factors

Answer 13

Age, Family Hx, Type I Diabetes, Rheumatoid Arthritis

Question 14

Hypothyroidism Presentation

Answer 14

Fatigue, Cold, Constipation, Weight gain, SOB, Menorrhagia, Myxoedema, Bradycardia, Oedema

Question 15

What do blood tests show in Hypothyroidism?

Answer 15

Elevated TSH, Low T3 and T4

Question 16

Hypothyroidism Investigations

Answer 16

Bloods, Creatinine Kinase, LFTs, Cholesterol, Biopsy

Question 17

Hypothyroidism Treatment

Answer 17

Levothyroxine, Liothyronine

Question 18

What causes Goitre and which is most common?

Answer 18

Iodine Deficiency (most common), Congenital, Medication, Autoimmune, Grave’s Thyroiditis, Cancer

Question 19

How can Goitre Present?

Answer 19

With Hyper or Hypothyroidism Symptoms

Question 20

Goitre Investigations

Answer 20

TSH, Free T4, Thyroglobulin (anti-TG), USS, Radioisotope scan, Biopsy

Question 21

Goitre Treatment

Answer 21

Radioactive iodine (if too much T3/T4)

Lugol’s iodine or KI solution (for deficiency)

Thyroid supplements (if underactive)

Question 22

What are the causes of a Thyroid Nodule?

Answer 22

Iodine deficiency, Thyroiditis, Goitre, Cancer

Question 23

How would a Thyroid Nodule present if it was cancerous?

Answer 23

Large, Hard, Painful, Male, Family Hx

Question 24

Most common cause of Hypothyroidism?

Answer 24

Hashimoto’s Thyroiditis

Question 25

Where is a Thyroid Nodule often located?

Answer 25

Edge of Gland

Question 26

Thyroid Nodule Investigations

Answer 26

USS, FNA, Radioiodine scan, TSH, T3/T4, Anti-thyroid antibodies

Question 27

Thyroid Nodule Treatment

Answer 27

Watchful waiting, Levothyroxine, Surgery, Radioactive iodine, Anti-thyroid drugs, Alcohol ablation

Question 28

Who is most likely to get Cushing's Syndrome?

Answer 28

20-50yrs, Women

Question 29

Difference between Cushing's Disease and Cushing's Syndrome?

Answer 29

Cushing disease = pituitary gland tumour (more ACTH) Cushing syndrome = excess cortisol in the body, regardless of the cause

Question 30

Causes of Cushing's Syndrome? Which is most common?

Answer 30

Prolonged Corticosteroid Medication (most common), Pituitary tumour (70% of tumours), Adrenal, Ectopic

Question 31

What is Pseudo-Cushing's?

Answer 31

Elevated cortisol due to Contraceptive pill

Question 32

Cushing's Syndrome Presentation

Answer 32

Moon face, Abdo obesity, Fat pads, Stretch marks, High BP/Sugar, Psychological problems

Question 33

Cushing's Syndrome Investigations

Answer 33

Dexamethasone suppression test, Saliva cortisol level

Question 34

Cushing's Syndrome Treatment

Answer 34

Stop medication, Drugs to inhibit cortisol synthesis (ketoconazole), Surgery, Chemo/Radio

Question 35

What are the types of Hyperparathyroidism?

Answer 35

Primary = Too much PTH being made (adenoma - 80%) Secondary = Event triggering parathyroid glands (Vitamin D deficiency, CKD, Low calcium)

Question 36

Hyperparathyroidism Presentation

Answer 36

Kidney stones, Depression, Bone pain, Increased urination

Question 37

What do blood tests show in Hyperparathyroidism?`

Answer 37

High Blood Calcium and High PTH

Question 38

What does Cinacalcet do?

Answer 38

Decreases PTH

Question 39

Hyperparathyroidism Treatment

Answer 39

Monitoring, IV saline, Correct deficiencies, Surgery

Question 40

What is Addison's Disease

Answer 40

Adrenal glands do not produce enough cortisol and aldosterone

Question 41

What are the types of Adrenal Insufficiency?

Answer 41

Primary = Adrenal Glands Secondary = low ACTH/CRH (most common type)

Question 42

Addison's Disease Presentation

Answer 42

Abdo pain, Weakness, Weight loss, Darkening of Skin

Question 43

Addison's Disease Treatment

Answer 43

Lifelong Corticosteroids, High salt diet, IV fluids with dextrose, Fludrocortisone