Endocrinology

Question 1

Features of Graves NOT seen in any other causes of hyperthyroidism (distinguishing features of Grave’s)

Answer 1

Exophthalmos (bulging eyes)
Pretibial myxoedema
Thyroid acropatchy (clubbing, soft tissue swelling of hands and feet, periosteal new bone formation)

Question 2

How do you treat multi-nodular goitre?

Answer 2

Radioactive iodine

Question 3

What are the key electrolyte changes caused by Primary Aldosteronism?

Answer 3

Low Na and high K

Also HTN

Question 4

What are the adverse effects of radioiodine therapy?

Answer 4

Hypothyroidism
Thyroid eye disease

*NOTE: Is an anti-thyroid drug (ATD) used in its who relapse or are resistant to ATD therapy

Question 5

What is the 1st line therapy for Grave’s disease?

Answer 5

Carbimazole

Question 6

What is a major complication of carbimazole treatment?

Answer 6

Agranulocytosis

*NOTE: to avoid this, can try ‘block-and-replace’ method. Start carbimazolethen add thyroxine when euthyroid.

Question 7

What is the Px of Zollinger-Ellison?

Answer 7

Epigastric pain + diarrhoea

Multiple gasproduodenal ulcers cause this.
Malabsorption

1/3 of pts have multiple endocrine neoplasia type 1 (MEN1).

Question 8

What is Zollinger-Ellison syndrome?

Answer 8

A condition characterised by excessive levels of gastrin, usually from a gastrin-secreting tumour of the duodenum or pancreas.

30% hae MEN type 1

Question 9

How do you diagnose Zollinger-Ellison syndrome?

Answer 9

• Fasting gastrin levels (best)

- Secretin stimulation test