Corrections

Question 1

How can spider naevi be differentiated from telangiectasia?

Answer 1

By pressing on them and watching them fill.

Spider naevi –> fill from centre

Telangiectasia –> fill from edge

Question 2

What 4 paraneoplastic features are associated with squanous cell lung cancer?

Answer 2

1) PTH-rp secretion causing hypercalcaemia

2) clubbing

3) hypertrophic pulmonary osteoarthropathy (HPOA)

4) hypertrophic pulmonary osteoarthropathy (HPOA)

Question 3

What 4 paraneoplastic features are associated with small cell lung cancer?

Answer 3

1) SIADH

2) ACTH

3) Lambert-Eaton syndrome

Question 4

What type of pneumonia can cause a pleural empyema?

Answer 4

Klebsiella

Question 5

What GI symptoms can be seen in Addison’s?

Answer 5

Diarrhoea & nausea

Question 6

Name 2 corticosteroids that has very high glucocorticoid activity but minimal mineralocorticoid activity

Answer 6

Dexamethasone
Betamethasone

Question 7

What is the treatment of choice in a toxic multinodular goitre?

Answer 7

Radioactive iodine

Question 8

Gonadotrophin & testosterone levels in Klinefelter’s?

Answer 8

elevated gonadotrophin levels but low testosterone

Question 9

Most common cause of acromegaly?

Answer 9

Excess GH 2ary to pituitary adenoma

Question 10

Features of acromegaly?

Answer 10

1) coarse facial appearance, spade-like hands, increase in shoe size

2) large tongue, prognathism, interdental spaces

3) excessive sweating and oily skin: caused by sweat gland hypertrophy

4) features of pituitary tumour: hypopituitarism, headaches, bitemporal hemianopia

5) raised prolactin in 1/3 of cases → galactorrhoea

6) 6% of patients have MEN-1

Question 11

Complications of acromegaly?

Answer 11

1) HTN

2) diabetes

3) cardiomyopathy

4) colorectal cancer

Question 12

What is the purpose of checking TPO antibodies in patients who have subclinical hypothyroidism?

Answer 12

This can indicate patients who are more likely to progress to overt hypothyroidism.

Question 13

In TNM, what does a nuclear scintigraphy reveal?

Answer 13

Patchy uptake

Question 14

Features of Klinefelter’s?

Answer 14

• often taller than average
• lack of secondary sexual characteristics
• small, firm testes
• infertile
• gynaecomastia - increased incidence of breast cancer
• elevated gonadotrophin levels but low testosterone

Question 15

Karyotype of Klinefelter’s?

Answer 15

47, XXY

Question 16

In the mx of DKA, how much should treatment aim to reduce blood ketones by & glucose by/hour?

Answer 16

Ketones –> around 1mmol/hr

Glucose –> around 3mmol/hr.

Question 17

Kallman’s vs Klinefelter’s?

Answer 17

Kallmans –> hypogonadotrophic hypogonadism

Klinefelter’s –> hypergonadotrophic hypogonadism

Question 18

What mx of Grave’s disease may lead to the development / worsening of thyroid eye disease?

Answer 18

Radioiodine treatment

Question 19

What is a normal rise in urine osmolality following water deprivation test?

Answer 19

Urine osmolality >600mOsm/kg excludes diabetes insipidus.

Urine osmolality <400mOsm/kg and raised serum osmolality indicates an inability to concentrate urine & indicates diabetes insipidus.

Question 20

1st line mx of a prolactinoma (micro & macro)?

Answer 20

Dopamine agonist e.g. cabergoline