METABOLIC

Question 1

What are the long term complications of subclinical hyperthyroidism?

Answer 1

AF
Osteoporosis
Dementia ?

Question 2

When are platelet transfusions indicated?

Answer 2

When platelet count <30x10^9 and clinically significant bleeding

Question 3

What are adverse effects of thiazolidinediones e.g. glitazones)

Answer 3

Weight gain
Liver impairment
Fluid retention (CI in HF)
Increased risk of fractures
Increased risk of bladder cancer

Question 4

When can aspirin be continued in AKI?

Answer 4

When its at a cardioprotective dose of 75mg as this will not negatively impact renal function

Question 5

What are the key drugs to stop in AKI?

Answer 5

CANADA
Contract media
ACEi
NSAIDS
Amingolycosides
Diuretics
ARBs

Question 6

What value of fasting glucose is impaired fasting glucose?

Answer 6

6.1-6.9

Question 7

What value of fasting glucose is impaired glucose tolerance?

Answer 7

<7.9mmol/l and OGTT 2 hour value 7.8-11.1

Question 8

Diagnostic criteria for DM type 2?

Answer 8

If the patient is symptomatic:
fasting glucose>=7.0 mmol/l
random glucose>=11.1 mmol/l (or after 75g oral glucose tolerance test)

If the patient is asymptomatic the above criteria apply but must be demonstrated on two separate occasions.

If HbA1c >=48mmol/mol

Question 9

Thyroid function test results in sick euthyroid syndrome?

Answer 9

Decreased serum T3 levels
Possibly low T4 levels
Normal or occasionally reduced TSh levels

Question 10

Triad for HUS?

Answer 10

AKI
Microangiopathic haemolytic anaemia
Thrombocytopenia

Question 11

What is typical HUS?

Answer 11

When HUS is secondary to shiga toxin-producing E.Coli 0157:H7
Can also be caused by pneumococcal infection or HIV

Question 12

Prognosis of minimal change disease?

Answer 12

1/3 have just one episode
1/3 have infrequent relapses
1/3 have frequent relapses which stop before adulthood

Question 13

What does an isolated rise in GGT with macrocytic anaemia suggest?

Answer 13

Alcoholism

Question 14

Acute haemolytic transfusion reaction symptoms

Answer 14

Shortly after blood transfusion (mins-hours)…
Fever
Abdominal pain
Hypotension

Question 15

Blood gas findings in renal tubular acidosis?

Answer 15

Hypercloraemia metabolic acidosis (normal anion gap)

Question 16

Drug causes of acute interstitial nephritis?

Answer 16

Penicillin
Rifampicin
NSAIDs
Allopurinol
Furosemide

Question 17

Features of acute interstitial nephritis

Answer 17

Fever, rash, arthralgia
Mild renal impairment
Hypertension
Eosinophilia
White cell casts and sterile pyuria

Question 18

Commonest cause of addisons disease in the UK?

Answer 18

Autoimmunity

Question 19

Why is it important to correct hypomagnasaemia before correcting a potassium deficiency?

Answer 19

As hypomagnasemia prevents potassium absorption

Question 20

What makes up MEN 1 syndrome?

Answer 20

Hyperparathyroidism
Pituitary
Pancreas e.g. Insulinoma or gastrinoma

Question 21

What makes up MEN 2A syndrome?

Answer 21

Medullary thyroid cancer
Hyperparathyroidism
Phaeochromocytoma

Question 22

What makes up MEN 2b syndrome?

Answer 22

Medullary thyroid cancer
Phaeochromocytoma
Marfanoid body habits
Neuromas

Question 23

What is the most common cause of Hypopituitarism?

Answer 23

Non-secretory pituitary macroadenoma

Question 24

what causes multiple endocrine neoplasias?

Answer 24

Autosomal dominant disorders
MEN1 - MEN1 gene
Men 2A and 2B - RET oncogene