Diabetes & Endocrinology

Question 1

List some symptoms of diabetes

Answer 1

Lethargy
Thirst
Polyuria
Weight loss

Question 2

List some risk factors for diabetes

Answer 2

Family history of diabetes
Family history of autoimmune diseases
Pancreatitis

Obesity
High alcohol intake
Existing cardiovascular disease
Cardiovascular risk factors

Question 3

Describe restrictions on employment people with diabetes may face

Answer 3

Can’t be in the army, navy or air force with type 1 diabetes

People who operate heavy machinery/lorries etc may have to take time off

Question 4

The DVLA needs to be informed if you are diagnosed with diabetes or your medication changes (true/false)

Answer 4

True

Question 5

Why is diabetes knowledge important in pregnant women?

Answer 5

Uncontrolled diabetes in pregnancy can lead to miscarriage or congenital abnormalities

Question 6

What tests (and which results) would be one to diagnose diabetes?

Answer 6

1) Random blood glucose (>11.1 = diabetes)
2) OGTT (>11)
3) Fasting glucose (>7)
4) HbA1c (>48) - but iron deficiency anaemia can raise HbA1c

Question 7

How many tests are needed to confirm a diagnosis of diabetes?

Answer 7

1 test & symptoms OR 2 separate tests

Question 8

What does annual diabetes screening entail?

Answer 8

Weight/BMI check
BP
Foot screen
Eye screen
CVS examination
Injection sites - looking for lipohypertrophy
HbA1c
U&E
LFT
Lipid profile
ACR
\+/- TFT, coeliac screen

Question 9

Mechanism of action of statins

Answer 9

HMG CoA-reductase inhibitor

Question 10

Side effects of statins?

Answer 10

Muscle aches

Question 11

Mechanism of action of Metformin

Answer 11

Iguanide - improves insulin sensitivity (may work via AMP kinase or micro biome)

Question 12

Side effects of Metformin?

Answer 12

Diarrhoea - limited by taking with food

Question 13

Mechanism of action of Gliclazide

Answer 13

Sulphonylureas

Question 14

Side effects of sulphonylureas

Answer 14

Weight gain

Hypoglycaemia

Question 15

Mechanism of action of Liraglutide

Answer 15

GLP-1 agonist - act in stomach to reduce appetite and enhance insulin release

Question 16

Side effects of Liraglutide

Answer 16

Weight loss

Question 17

Mechanism of action of Dapagliflozin

Answer 17

SGLT2 antagonist - acts on transporter in kidney to increase glucose excretion

Question 18

Side effects of Dapagliflozin

Answer 18

UTI

Weight loss

Question 19

Mechanism of Lisinopril

Answer 19

ACE inhibitor

Question 20

Side effects of ACE inhibitors

Answer 20

Cough

Question 21

Mechanism of Amlodipine

Answer 21

Calcium channel antagonist

Question 22

Side effects of calcium channel antagonists

Answer 22

Ankle swelling

Question 23

Side effects of thiazide diuretics

Answer 23

Hypokalaemia

Question 24

List some symptoms of thyrotoxicosis

Answer 24

Weight loss
Heat intolerance
Palpitations
Increased appetite
Shortness of breath on exertion
Lethargy
Insomnia
Diarrhoea
Oligomenorrhoea
Exophthalmos
Thyroid eye disease
Proximal myopathy
Goitre

Question 25

What should you look for during a general examination in a patient with suspected thyroid disease?

Answer 25

Weight loss
Bulging eyes
Sweaty/warm
Agitated, can't sit still
Pressured speech

Question 26

What should you look for during a hand examination in a patient with suspected thyroid disease?

Answer 26

Nails - onycholysis
Sweaty/warm palms
Palmar erythema
Fine flapping tremor
Tachycardia, arrhythmia's

Question 27

What should you look for during a neck examination in a patient with suspected thyroid disease?

Answer 27

Goitre
Swollen lymph glands
Size and consistency of thyroid
Thyroid bruit (listen with stethoscope)

Question 28

What should you look for during a eye examination in a patient with suspected thyroid disease?

Answer 28

Proptosis
Lid lag
Swelling around eye
Eye movement - double vision/blurred vision