Semester 2- Endocrinology

Question 1

What is a prolactinoma?

Answer 1

A pituitary tumour secreting prolactin

Question 2

How in a prolactinoma treated?

Answer 2

Tablets of a dopamine agonist

Question 3

What are the symptoms of a prolactinoma?

Answer 3

Galactorrhoea (milky discharge from breast) and disruption of periods and fertility problems in women

Question 4

What hormone is there an excess of in acromegaly?

Answer 4

Growth hormone

Question 5

What are signs of acromegaly?

Answer 5

Gigantism, large hands and feet, a lowered jaw

Question 6

How is acromegaly treated?

Answer 6

Surgical removal of tumour and dopamine agonists

Question 7

What investigation can be used to diagnose acromegaly?

Answer 7

Oral glucose tolerance test

Question 8

What is Cushing’s disease?

Answer 8

ACTH secreting pituitary tumour

Question 9

What are clinical signs of Cushing’s disease?

Answer 9

Increased abdominal fat gain, moon face, purple striae on abdomen, red face, buffalo hump

Question 10

How is Cushing’s disease treated?

Answer 10

Surgical removal of pituitary tumour

Question 11

What causes diabetes insipidus?

Answer 11

Lack of ADH from either pituitary or kidney disease

Question 12

What are the symptoms of diabetes insipidus?

Answer 12

Large quantities of pale urine and excessive thirst, also hypernatraemia

Question 13

How is diabetes insipidus treated?

Answer 13

Give fluids and synthetic vasopressin (desmopressin)

Question 14

What is pituitary apoplexy?

Answer 14

A sudden vascular event in the pituitary tumour (a bleed or infarction)

Question 15

How does a pituitary apoplexy present?

Answer 15

Sudden onset headache, double vision, cranial nerve palsy, visual field loss

Question 16

What is Addison’s disease?

Answer 16

Low levels of cortisol

Question 17

What is the main cause of Addison’s disease?

Answer 17

Autoimmune destruction of the adrenal cortex

Question 18

What are signs of Addison’s disease?

Answer 18

Weight loss, hyperpigmentation, nausea and abdominal pain

Question 19

How is Addison’s disease treated and managed?

Answer 19

On life long replacements of glucocorticoids and mineralocorticoids (hydrocortisone, prednisolone, fludrocortisone)

Question 20

How is a life-threatening Addisonian crisis treated?

Answer 20

Hydrate the patient with fluids and give IV hydrocortisone

Question 21

What is Cushing’s syndrome?

Answer 21

An umbrella term for increased cortisol levels

Question 22

What are the 3 causes of Cushing’s syndrome?

Answer 22

Pituitary tumour, adrenal cortex tumour, small cell tumours in lungs releasing cortisol

Question 23

How is Cushing’s syndrome diagnosed?

Answer 23

Dexamethasone tolerance test

Question 24

How is adrenal Cushing’s treated?

Answer 24

Laparoscopic adrenectomy

Question 25

What is steroid induced-hypoadrenalism?

Answer 25

Suppression of ACTH from long term steroid use

Question 26

What is something to look out for after abrupt withdrawal of steroid treatment?

Answer 26

Hypo-adrenal crisis

Question 27

What is hyperaldosteronism?

Answer 27

When the adrenal gland is producing excess aldosterone

Question 28

Why does an increase in aldosterone levels increase blood pressure?

Answer 28

Aldosterone increases sodium and water reabsorption so blood volume increases

Question 29

Why does an increase in aldosterone levels sometimes lead to hypokalaemia?

Answer 29

Aldosterone increases potassium secretion

Question 30

If a baby is born with ambiguous genitalia what this be a sign of?

Answer 30

Congenital adrenal hyperplasia

Question 31

How does congenital adrenal hyperplasia present?

Answer 31

High potassium, low sodium, hypoglycaemia and hypotension

Question 32

What is a phaeochromocytoma?

Answer 32

A tumour of the adrenal medulla

Question 33

What is a paraglioma?

Answer 33

An extra-adrenal tumour

Question 34

What would levels of TSH and thyroid hormones be like in hypothyroidism?

Answer 34

High TSH levels and low levels of T3 and T4

Question 35

What can cause hypothyroidism?

Answer 35

Autoimmune, radioactive therapy, iodine deficiency, postpartum thyroiditis and certain medications

Question 36

What are common symptoms associated with hypothyroidism?

Answer 36

Tiredness, depression, weight gain, constipation, dry skin and hair, cold intolerance

Question 37

What can hypothyroidism in children lead to?

Answer 37

Cretinism

Question 38

What are some clinical signs of hypothyroidism?

Answer 38

Bradycardia, slow reflexes and carpal tunnel syndrome

Question 39

What is the treatment for hypothyroidism?

Answer 39

Thyroxine replacement therapy (levothyroxine)

Question 40

Once on treatment for hypothyroidism how long should it take for blood results to return to normal?

Answer 40

Around 2 months

Question 41

What would levels of TSH and thyroid hormones be like in hyperthyroidism?

Answer 41

Low levels of TSH and high levels of thyroid hormones

Question 42

What are symptoms of hyperthyroidism?

Answer 42

Weight loss, irritability, palpitations, tremor, diarrhoea, sweating

Question 43

What are clinical signs of hyperthyroidism?

Answer 43

Tachycardia, hypertension, atrial fibrillation, warm peripheries

Question 44

What specific clinical signs indicate Graves’ disease?

Answer 44

Graves ophthalmology (wide open eyes) and pre-tibial myxoedema

Question 45

What is used to treat hyperthyroidism?

Answer 45

Carbimazole. Beta blockers can be used to control symptoms

Question 46

What are some red flag symptoms of thyroid cancer?

Answer 46

Rapid enlargement of lump in neck, hoarse voice, difficulty swallowing and family history of thyroid cancer

Question 47

How would you treat hypoglycaemia?

Answer 47

Lucozade IM glucagon IV 20% glucose