Endocrine System

Question 1

Suggest 3 symptoms that can be associated with autonomic neuropathy

Answer 1

1. Impotence
2. Gastroparesis with diarrhoea and vomiting
3. Orthostatic symptoms

Question 2

Name a common local complication of the injection of insulin

Answer 2

Lipohypertrophy at the injection site

Question 3

What is Necrobioisis lipoidica

Answer 3

A rare shiny red/yellow rash seen in the lower legs of young-middle ages patients with diabetes

Question 4

Recall the WHO criteria for the diagnosis of diabetes

Answer 4

1. Fasting blood glucose >7.8 mol/l
2. 2hr glucose tolerance test > 11.1 mmol/l
   NB/ 2hr glucose >7.8 is classified as impaired glucose tolerance

Question 5

Which biomarker is used to discriminate between type 1 and type 2 diabetes?

Answer 5

C-peptide < 0.2 nmol/l

Question 6

Name a lipase inhibitor that can be used to reduce dietary fat absorption

Answer 6

Orlistat

Question 7

Name an appetite suppressant

Answer 7

Sibutramine

Question 8

Name a medication that may precipitate hyperthyroidism

Answer 8

Amiodarone

Question 9

Give 3 clinical signs specific to Grave’s disease

Answer 9

1. Exopthalmos
2. Pretibial myxoedema
3. Thyroid acropachy

Question 10

Suggest 5 medical conditions that can be managed with a long term course of steroids e.g. prednisolone

Answer 10

1. Rheumatoid arthritis
2. SLE
3. Chronic asthma
4. Pulmonary fibrosis
5. Transplantation

Question 11

Outline the medical treatment options for acromegaly

Answer 11

1. Somatostatin analogues e.g. octreotide

2. Dopamine agonists e.g. bromocriptine

Question 12

What type of visual field defect is associated with acromegaly?

Answer 12

Bitemporal hemianopia due to compression of the optic chasm by a pituitary macro adenoma

Question 13

Describe the vocal changes that are sometimes seen in patients with hypothyroidism

Answer 13

Hoarse/ deepened ‘ breaking’ voice

Question 14

What is the route of administration for insulin?

Answer 14

Subcutaneously