Endo 3

Question 1

5 y/o T1DM. 12 hr hx vomitting and abdominal pain.

Urin dipstick positive for ketones.

Treated with IV fluids, insulin. post three hours boy has a seizure. what is the underlying pathophysiology of the seizure?

Answer 1

Patient has DKA

• abdo pain
• nausea
• vomiting
• elevated ketones

Cerebral Oedema
- important complication of fluid resuscitation in DKA.

Question 2

mode of inheritance of MODY

Answer 2

autosomal dominant

maturity onset diabetes of the young
- characterised by development of T2DM in patients < 25 y/o

Question 3

40 y/o female with Grave’s disease

• erythematous, oedematous lesions above lateral malleoli
  What is this known as?
• recently diagnosed with anti-TSH receptor antibody positive autoimmune disease

Answer 3

Pre-tibial myxoedema

Question 4

what might you test to distinguish between T1DM and other types of diabetes?

Answer 4

C-peptide

C-peptide will be low in patients with T1DM

Question 5

genetic condition characterised by neoplasia of the thyroid (medullary cell carcinoma), parathyroid (parathyroid adenoma) and adrenal glands (phaeochromocytoma).

Answer 5

Multiple endocrine neoplasia (MEN) type 2

Question 6

42 y/o female

• investigated for symptoms of irritability
• altered bowel habit
• smooth enlargement of thyroid gland
• decreased TSH levels

indicative of:

Answer 6

Grave’s disease

Question 7

which condition is characterised by the following:

1) severe hyperglycaemia
2) dehydration and renal failure
3) mild/absent ketonuria

Answer 7

hyperosmolar hyperglycaemic state (HHS)

Question 8

which condition leads to an under-estimate of her blood sugar levels?

Answer 8

hereditary spherocytosis

• affects RBC
• anaemia
• jaundice
• splenomegaly

Question 9

first line treatment for patients with pituitary tumour causing acromegaly:

Answer 9

trans-sphenoidal surgery

Question 10

42 y/o male

• TATT
• tanned
• palmar creases and buccal mucosa show pigmentation

underlying condition:

Answer 10

Addison’s disease

- autoimmune destruction of the adrenal glands

Question 11

Describe Cushing’s triad

Answer 11

• irregular respirations
• bradycardia
• systolic hypertension

from raised ICP

Question 12

A 62-year-old woman presents with polyuria and lethargy. Her HbA1c is 50 mmol/mol (6.7%)

what does patient have?

Answer 12

• diabetes mellitus
• HbA1c of greater than or equal to 48 mol/mol
• is diagnostic of DM in symptomatic patient

Question 13

66 y/o admitted to ED with acute confusion.

• overweight
• non pitting oedema in eyes and legs
• dry skin
• coarse hair

Obs

• 50 bpm
• 90/60 mmHg
• RR 10
• temp 30
• O2 90%

most likely diagnosis

Answer 13

myxoedema coma

- fatal complication of longstanding underrated hypothyroidism