08/03

Question 1

What is the target blood sugar levels before meals in T1DM?

Answer 1

First thing in the morning 5-7

Before other meals 4-7

Question 2

What are key features of de Quervains thyroiditis?

Answer 2

Tender neck swelling
Decreased global uptake of iodine
Initial phase is hyperthyroid followed by hypothyroid state before returning to euthyroid

Question 3

What is the first line investigation for phaeochromocytoma?

Answer 3

24 hour urinary metanephrine collection

Question 4

What are features of phaeochromocytoma?

Answer 4

Episodic symptoms
Headaches
Fever 
Sweating
Palpitations 
Anxiety
HTN

Question 5

What is the management of phaeochromocytoma?

Answer 5

Surgery is definitive

First establish on alpha blocker followed by beta blocker

Question 6

What is the management of addisonian crises?

Answer 6

100mg IV or IM hydrocortisone
IV fluids- 1L normal saline with glucose if hypoglycaemic
Continue hydrocortisone 6hrly until pt stable
Then after 24hrs convert back to oral prednisolone and slowly reduce back to maintenance

Question 7

What is the first line investigation for thyroid nodules?

Answer 7

USS

Question 8

What is a key risk factor for graves diSease?

Answer 8

Smoking

Question 9

What can cause an abnormally low HbA1c?

Answer 9

Sickle cell disease due to decreased lifespan of RBC

Question 10

What can cause an abnormally high HbA1c?

Answer 10

Splenectomy as increased lifespan of RBC

Question 11

What causes patchy uptake on nuclear scintigraphy?

Answer 11

Toxic multinodular goitre

Question 12

What does increased TSH and normal T4 levels indicate in a patient with hypothyroidism?

Answer 12

Poor compliance to medication

Question 13

What are features of addisons disease?

Answer 13

Fatigue
Weakness
N&V
Weight loss
Hyperpigmentation
Loss of pubic hair in women
Hypoglycaemia
Hypotension
Hyponatraemia and hyperkalaemia

Question 14

What are complications of acromegaly?

Answer 14

HTN
Diabetes
Arrythmias
Cardiomyopathy