Endocrine

Question 1

Treat ment for thyroid storm

Answer 1

Analgesia
Fluid
Cool - avoid ASA/NSAID (displace thyroid hormone) 
Propranolol 30-60mg (atenolol of Copd) 
Caribmazole 40-60mg tds 
Hydrocortisone 100-200mg tds 
Propothiouracil 250-500mg qid 
Lugols iodide 5-10drops NGT qid

Question 2

Effects of laryngeal nerve injury

Answer 2

Superior laryngeal
Uni -minimal effects
Bilat - hoarseness , tiring of voice

Recur laryngeal
Uni hoarseness
Bilateral Acute stridor ,RDS
Bilat chronic aphonia

Vagus
Uni hoarseness
Bilat aphonia

Question 3

Classes of BMI

Answer 3

> 24 overweight
30 obese
40 extreme obesity

Question 4

Diabetic autonomic neuropathy

Answer 4

Hypertension
Orthostatic hypotension

Lack of HR variation ( > 10bpm on deep inspiration)
Resting tachy
Reduced HR response to atropine and propranolol

Painless MI

Lack of sweating

Early satiety

Neurogenic bladder
Impotence

Question 5

Diabetes blood tests

Answer 5

Hba1c - normal 6.5
Poorly controlled > 8.5
Only proceed if with urgent if hba1c > 10

Fasting HGT - > 7
Glucose tolerance > 11.1

Question 6

Metabolic syndrome

Answer 6

1) waist circumference >88cm fem , 102 cm in male
2) trig >1.7
3) HDL men <1.0 female <1.2
4) BP >130 or > 85
5) fasting gluc >5.6

Diag : 3 of 5 ( if on rx for one component- counts as positive)

Question 7

OSA

Answer 7

Mild <2
Mod 3-5
Severe >5

Question 8

Steroid replacement

Answer 8

20mg /day for 3 weeks for last 6months

5mg prednisone = 20 hydro cort = 0.75 dex = 5 prednisolone