Endocrinology

Question 1

What HbA1C is used to diagnose diabetes?

What is normal and what is pre-diabeteic.

In % and mmol/mol

Answer 1

DM: HbA1c > 6.5% / 48 mmol/mol

Normal: < 6.1% / 43mmol/mol

Impaired Glucose Tolerance: 6.1-6.5% / 43-48 mmol/mol

Question 2

Other than HbA1c, how else can DM be diagnosed?

Answer 2

Fasting BSL > 7 on two occasions (or once if Sx)

Random BSL or OGTT > 11 on two occasions

Question 3

What are the antibodies (or other tests) for T1DM?

Answer 3

Think of Guizz Cottin

GIIIZ C

G: anti-glutamic acid decarboxylase Ab (GAD antibodies)*

I: Islet cell Ab

I: insulinoma protein 2 antibodies (IA2A)*

I: Insulin antiboies (IAA)

Z: anti-Zn transporter Ab (ZnT8)

C: C-peptide*

Most commonly done

Question 4

What is the criteria for metabolic syndrome?

Answer 4

PHATS

P - Pressure > 135mmHg systolic, > 85 diastolic, or on Rx

H - HDL > 1 in males, > 1.3 in females, or on Rx

A - Abdominal obesity > 102cm in males, > 88cm in females

T - Triglycerides > 1.7 or on Rx

S - Sugar: fasting sugar >5.6 fasting or diagnosed diabetes

Question 5

At what eGFR can’t you use SGLT2i?

Answer 5

eGFR < 45

Question 6

PBS criteria for bisphosphonates

Answer 6

> 70 years old and T score < - 2.5

Minimal trauma fracture

> 7.5mg prednisolone for 3 months and T score < - 1.5

Question 7

PBS criteria for teriparatide

Answer 7

3,2,1

T score < - 3

2 minimial truma fractures

1 minimal trauma fracture in the last 12 months on another anti-resorptive

Question 8

Secondary hypertension screen

Answer 8

Confirm with ambulator blood pressure monitoring

Review drugs

UEC for renal function

Renal USS + dopplers for RAS

Hyperaldosteronism with ARR in the first instance (high aldosterone, low renin)

Cushings with late night salivary cortisol, 24 hour urinary cortisol, dexamethasone supression test

Hyper or hypothroidism with TFTs

Hyperparathyroidism with PTH

OSA - sleep study / STOP BANG

Coarctation of the aorta