MT1

Question 1

List three symptoms patients with new-onset diabetes mellitus might present with.

Answer 1

Thirst (polydipsia)
Polyuria / nocturia (can only count once)
Recurrent infections
Fatigue
Unintentional weight loss

Question 2

List two microvascular complications of diabetes, and describe the screening methods used to detect each one at an early stage.

Answer 2

Retinopathy – retinal photography / fundoscopy
Nephropathy – urine albumin excretion
Neuropathy – sensation in feet (pin-prick / pain or monofilament)

Question 3

Eating less than usual , they. Omit insulin treatment. What acute complication of diabetes are they at risk of developing?

Answer 3

Diabetic ketoacidosis

Hypoglycaemia

Question 4

Which blood test would give the most info about average glycaemic control

Answer 4

HbA1c

Question 5

2 way in which we acquire vitamin D?

Answer 5

Skin and diet

Question 6

Where is vitamin D activated?

Answer 6

Liver and kidney

Question 7

Which organs in which vitamin D acts to regulate calcium concentrations?

Answer 7

Intestine, bone and kidneys

Question 8

What is the most common imaging technique used to provide information about the functional status of the thyroid gland?

Answer 8

Isotope scan (pertechnetate scan)

Question 9

What is the most common structural imaging technique used to image the thyroid gland for a patient presenting with a thyroid nodule?

Answer 9

Ultrasound

Question 10

List effective routes of testosterone administration that are commonly used in adult clinical practice.

Answer 10

Testosterone gel
Intramuscular testosterone
Testosterone implants, buccal testosterone, testosterone patches

Question 11

Consequences of male hypogonadism?

Answer 11

Loss of libido
Erectile dysfunction
Low energy levels/fatigue
Reduced muscle strength 
Osteopaenia, osteoporosis
Infertility
Delayed puberty

Question 12

Primary and secondary hypogonadism hormone concentrations?

Answer 12

Primary: High LH and FSH and low testosterone

Secondary: LH and FSH low and low testosterone

Question 13

LH/FSH and testosterone are what type of hormones?

Answer 13

LH and FSH are peptide

Testosterone steroid

Question 14

Complications of bariatric surgery?

Answer 14

Nutrient deficiencies, dumping syndrome, weight re-gain, hypoglycaemia

Question 15

Drug for obesity?

Answer 15

Orlistat, a lipase inhibitor which reduces absorption of dietary fat

Question 16

Metabolic syndrome, risk of developing these diseases?

Answer 16

Type 2 diabetes, coronary heart disease, PCOS, non alcoholic fatty liver disease, bowel/endometrial cancer

Question 17

A patient with central obesity requires which tests and investigations?

Answer 17

Blood pressure
Glucose tolerance test
Fasted lipid profile
HbA1c
Screening

Question 18

Having primary hypothyroidism and coeliac could mean

Answer 18

Automimmune polyendocrine syndrome

Question 19

Cause of addisons?

Answer 19

Autoimmune

Question 20

For addisons, life-long replacement therapy?

Answer 20

Hydrocortisone and fludrocortisone

Question 21

Low plasma glucose, fatigue, lost weight, abdominal pain and vomiting. May have addisons, what will electrolytes sodium and potassium look like?

Answer 21

High potassium and low sodium

Question 22

Single blood tests for addisons?

Answer 22

9am plasma cortisol

Question 23

Long term health risks of thyrotoxicosis?

Answer 23

Osteoporosis, myopathy, hihj output heart failure, thyroid storm, atrial fibrillation, hypertension

Question 24

How to investigate hyperthyroidism?

Answer 24

Thyroid autoantibody titre
Thyroid isotope scan
Thyroid uptake scan

Question 25

Causes of thyrotoxicosis?

Answer 25

Graves, toxic multinodular goitre, thyroiditis, drug induced, iatrogenic thyroid adenomal

Question 26

Thyroidectomy for Graves, results in tingling in fingers and lips, with muscle cramps. ECG abdormal with long Q-T interval what treatment shoudl you give immediately and by what route?

Answer 26

Intravenous calcium