Endo

Question 1

What is Primary Hyperparathyroidism

Answer 1

One or more of the parathyroid glands become overreactive and secretes excess amounts of parathyroid hormone (PTH).
As a result, the blood calcium rises to a level that is higher than normal.

Question 2

Causes of Addison’s disease

Answer 2

TB (commonest cause worldwide)

Autoimmune (commonest in UK)

Question 3

Diabetes diagnosis

Answer 3

• Fasting > 7

- Random > 11.1

Question 4

Three disciriminatory signs of Cushing’s

Answer 4

Proximal myopathy
Purple striae
Easy bruising

Also make you suspect if young age:
HTN
DM
Osteoporosis

Question 5

First sign of diabetic nephropathy

Answer 5

Microalbuminuria

Question 6

Antibodies in T1DM

Answer 6

Anti-islet cell Ab (ICA)
Anti-GAD Ab (GAD)
Anti-insulun Ab (IAA)

Question 7

Why do you check TFTs when prolactin is high?

Answer 7

Because TRH stimulates prolactin release

Question 8

Management of Graves

Answer 8

Carbimazole (start with a big dose)
Propylthiouracil (PTU)
b blocker given as well

Then radio iodine treatment
More rare: thyroidectomy

Question 9

DI Investigations

Answer 9

1) Exclude DM by looking at glucose
2) Plasma osmolarity high with low urine osmolarity (Hypernatraemia present)
3) Water deprivation test –> Urine osmolarity will not rise
After desmopressin administration:
Osmolarity rises >50% Cranial DI
Osmolarity rises <45% Nephrogenic DI

Question 10

DI Management

Answer 10

Treat underlying cause
Cranial: Desmopressin daily
Nephrogenic: Sodium restriction, Thiazide diuretics

Question 11

Paget’s presentation

Answer 11

Bone pain
Fractures
Warmth over affected bone
Hearing loss

(Commonly affects one bone unlike osteoporosis (eg pelvis, femur, tibia)
Characteristic test High ALP)

Question 12

What is Paget’s

Answer 12

Disorder of bone turnover resulting in ‘pockets’ of disorganised bone metabolism, of unknown aetiology