Passmed Endo

Question 1

Which imaging is ideal for thyorid nodules?

Answer 1

Ultrasound

Question 2

Which combo of diabetic drugs is best for T2DM?

Answer 2

Mefrromin
SGLT2 inhibitor
GLIP-1, especially for BMI over 35

Question 3

How is Conn’s managed?

Answer 3

With spironolactone

Question 4

What is the first line choice for diabetic retinoapthy?

Answer 4

Amitripyline

Question 5

When is amitryptiline contraindicated for diabetic neuropathy?

Answer 5

Risk factor fr acute urinary retention like BPH

-> OFFER PREGALBALIN

Question 6

What test distinguishes between T1DM and T2DM?

Answer 6

C-peptide

Question 7

What is a consequence of secondary hyperparathyoridism?

Answer 7

Tertiary hyperparathyoridism

Question 8

What are the features of primary hyperparathyoridism?

Answer 8

Calcium must be high
PTH may be normal

Typically cases by parathyroid ADENOMA

Question 9

What is a key risk with HHS?

Answer 9

Thrombolysis because the low fluid status puts the patient at a highly coagulate state

Question 10

Which medications increase risk of gynaecomastia?

Answer 10

GnRH agonists
Digoxin
Cimetidine
Cannabis
Oestrogen

Question 11

How to manage diabetic foot?

Answer 11

education about foot care and a diabetic foot clinic appointment must be organised

Question 12

Which lung cancer causes hypercalcaemia?

Answer 12

Squamous cell air coma due to secretion of PTHrp
->there will be high calcium and low /normalPTH

Question 13

What causes all thyorid functions to be low apart from TSH?

Answer 13

Typically sick euthyroid syndorme

Question 14

Which diabetic drug is linked to bladder cancer?

Answer 14

Thiazolidinediones

Question 15

What should patients with insulin have with them for emergency?

Answer 15

Glucagon kit
-> insulin can be stored in the fridge

Question 16

What is target BP for T2DM?

Answer 16

Clinic= 140.90
Home= 135/85

Question 17

What does fasting glucose between 6.1 -7.0 indicate?

Answer 17

Impaired fasting glucose
-> they should be offered oral glucose tolerance test

Question 18

What does fasting glucose less than 7 AND what is the required oral glucose value?

Answer 18

Impaired glucose tolerance must have oral glucose tolerance between 7.8 and 11.1

Question 19

What is first line drug for black T2DM with hypertension?

Answer 19

Angiotensin II receptor lower

Question 20

What drug should be considered in BMI over 25 and T1DM?

Answer 20

Metformin

Question 21

WHAT IS SITAGLIPTIN?

Answer 21

DPP-4 inhibitor which reduces breakdown of GLP-1

Question 22

WHAT IS a risk with Haemodialysis?

Answer 22

Gynaecomastia

Question 23

What causes both cortisol and ACTH to not be suppressed?

Answer 23

Adrenal adenoma

Question 24

How to taper steroid treatment?

Answer 24

Slowly reduce weekly if taking:
40mg of prednisolone daily for more than one week or 3 weeks or recently received repeated courses

Question 25

How is thyroid storm treated?

Answer 25

Thyrotoxic storm is treated with beta blockers, propylthiouracil and hydrocortisone

Question 26

What steroid is used in thyorid storm?

Answer 26

Prednisolone

Question 27

What is glimeride?

Answer 27

A sulphponylurea

Question 28

What to give for TD2M drugs?

Answer 28

metformin + DPP-4 inhibitor + sulfonylurea metformin + pioglitazone + sulfonylurea metformin + (pioglitazone or sulfonylurea or DPP-4 inhibitor) + SGLT-2 if certain NICE criteria are met insulin-based treatment

Question 29

What medication is given for impaired fasting glucose?

Answer 29

None-lifestyle measures

Question 30

What is the risk with the use of thyorxine overuse?

Answer 30

Osteoporosis

Question 31

What is first line when Metformin is not best?

Answer 31

DPP-4 inhibitor

Question 32

What is the hierarchy for non Metformin drugs

Answer 32

DPP-4 Sulphonylurea SGLT2 inhibitor

Question 33

How to calculate serum osmolality?

Answer 33

(2 x Na) + glucose + urea

Question 34

What to obtain for asymptomatic diabetes test?

Answer 34

Repeat the same test performed initially

Question 35

What does severe illness cause in thyorid pathology?

Answer 35

Sick euthyroid syndorme with normal TSH and low thyorid INR and T3

Question 36

Which drugs cause galactorrhoea?

Answer 36

Chlorpromazine Haloperidol Phenothiazine’s SSRIs and opioids

Question 37

Which medication causes hypercalcaemia?

Answer 37

Thiazide diuretic which increase renal reabsorption of calcium Calcium contiianng antacids Overdosing on Vitmain D

Question 38

What can mimic Cushing;s disease?

Answer 38

Excess alcohol Depression HIV infection

Question 39

What is medullary cancer assoicated with? p

Answer 39

Haechromocyotma

Question 40

S

Question 41

In patients with hyperglycaemic hyperosmolar state what does increased confusion and polydipsia indicate?

Answer 41

Cerebral oedema which should be managed with mannitol and hypertonic saline

Question 42

What is subliminal hyperthyroidism?

Answer 42

decreased TSH level with normal free T4 levels

Question 43

What is subclinical hypothyroidism?

Answer 43

Subclinical hypothyroidism is characterised by elevated TSH levels with normal free T4 levels

Question 44

What to consider with normal HbA1c but high fasting glucose?

Answer 44

Steroid induced hyperglycaemia, which should be treated with Sulphonylurea like gliclazide b

Question 45

Which treatment of heat failure causes diabetes?

Answer 45

Thiazide diuretics which pair glucose tolerance by reducing insulin secretion Beta blockers by inhibiting insuin secretion and promoting resistance

Question 46

What is Von Gierke’s disease?

Answer 46

Glycogen Storage Disease Type 1 (von Gierke's disease): The inability to perform gluconeogenesis can lead to hypoglycemia and secondary hyperglycemia

Question 47

What is pomp’s disease?

Answer 47

Glycogen Storage Disease Type 2 (Pompe disease): It affects the heart and skeletal muscles more than it causes diabetes, but can present with variable symptoms

Question 48

What does high TSH level with normal T4 indicate with hypothyroidism on medication?

Answer 48

Poor medicaiton compliance

Question 49

What causes high calcium with CKD?

Answer 49

Tertiary hyperparathyroidism

Question 50

What causes high LH and low testosterone with lack of secondary male characteristics?

Answer 50

Klinefelter syndrome

Question 51

What is the criteria for diagnosing diabetes?

Answer 51

HbA1c over 48 is enough

Question 52

When is SGLT2 inhibitor mono therapy indicated?

Answer 52

For CVD with T2DM

Question 53

What is the DVLA criteria for diabetes?

Answer 53

there has not been any severe hypoglycaemic event in the previous 12 months the driver has full hypoglycaemic awareness the driver must show adequate control of the condition by regular blood glucose monitoring*, at least twice daily and at times relevant to driving the driver must demonstrate an understanding of the risks of hypoglycaemia here are no other debarring complications of diabetes

Question 54

What is associated with MALT lymphoma?

Answer 54

Hashimoto’s thyroiditis

Question 55

What is a risk factor for Grave;s?

Answer 55

Smoking Genetics Age 30-60

Question 56

What causes high calcium and low PTH?

Answer 56

Malignancy

Question 57

What is the dialysis indication?

Answer 57

Acidosis BELOW 7.2 Electrolyte severely raised of K= I Oedema pulmonary, indicated by bilateral shadowing Uraemia

Question 58

What is the fasting glucose level for diabetes diagnosis

Answer 58

Glucose over 7

Question 59

How many readings do sympaotmaic patients need for diabetes diagnosis?

Answer 59

Only one

Question 60

What diabetic drug causes intense genital pain and oedema?

Answer 60

SGLT2 inhibitors linked to Fournier’s gangrene, with necrotising fasciitis of genitalia and/or perineal presenting as intense genital pain with oedema over the region

Question 61

What is the most important idicator of treatment response to thyorid hormone replacement therapy?

Answer 61

TSH level -> goal of treatment is to maintain TSH level in normal reference

Question 62

What does low C-peptide level indicate?

Answer 62

T1DM

Question 63

What is the hit shold for diagnosis of impaired fasting glucose?

Answer 63

6.2 to 7

Question 64

What can cause neutorphilia?

Answer 64

Steroids

Question 65

What is onycholysis?

Answer 65

Nail lifting from nail bedassoicated with Ypresrthyoridism

Question 66

What is a specific sign of Graves’ disease?

Answer 66

ACRopachy with hyperthyoirdism

Question 67

What is high in