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MRCP Part 2 > Endo > Flashcards

Endo Flashcards

1
Q

Causes of thyrotoxicosis

A
  • Graves
  • toxic nodular goitre
  • acute phase of subacute (de Quervain’s) thyroiditis
  • acute phase of post-partum thyroiditis
  • acute phase of Hashimoto’s thyroiditis
  • amiodarone therapy
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2
Q

Management of papillary and follicular thyroid cancers

A

Total thyroidectomy
Followed by radioiodine I-131

Yearly thyroglobulin levels to detect recurrence

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3
Q

Follow up for gestational diabetes when glucose normal after birth?

A

Fasting blood glucose check at 6-13 weeks postpartum

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4
Q

Management of thyrotoxic storm:

A

Propylthiouracil (PTU) + corticosteroids + propranolol.

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5
Q

MEN I cancers

A

3Ps:

Parathyroid
Pituitary
Pancreas (insulinoma, gastrinoma)

Also adrenal + thyroid

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6
Q

MEN IIa cancers

A

Medullary thyroid

+ 2Ps:
Parathyroid
Phaeochromocytoma

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7
Q

MEN IIb cancers

A

Medullary thyroid

+ 1P:
Phaochromocytoma

Marfanoid
Neuromas

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8
Q

Genetics MEN I

A

‘MEN1 gene’

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9
Q

Genetics MEN IIa

A

RET oncogene

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10
Q

Genetics MEN IIb

A

RET oncogene

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11
Q

Canakinumab MOA

A

Inhibits interleukin-1B receptor binding

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12
Q

Canakinumab use

A

Acute gout where NSAIDs or colchicine are not tolerated or ineffective

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13
Q

pH indicating severe DKA

A

pH <7

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14
Q

Blood ketone, severe DKA

A

blood ketone >6 mmol/L

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15
Q

Bicarbonate level, severe DKA

A

Bicarbonate < 5 mmol/L

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16
Q

Normal anion gap

A

< 16 mmol/L

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17
Q

Potassium level indicating severe DKA

A

Potassium < 3.5 mmol/L on admission

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18
Q

Obs suggesting severe DKA

A

Tachycardia/bradycardia
Systolic BP < 90 mmHg
Sats <92% on air
GCS

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19
Q

Thiazolidinedione example

A

Pioglitazone

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20
Q

Anti-diabetic linked to bladder cancer

A

pioglitazone (Thiazolidinedione)

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21
Q

Thiazolinedione (pioglitazone) MOA

A

Insulin sensitizer

PPAR-gamma receptor agonist

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22
Q

Long-term management of diabetic gastroparesis

A

Domperidone, metoclopramide or erythromycin

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23
Q

Management of myxoedema coma

A 
IV thyroid replacement
IV fluid
IV corticosteroids (until coexisting adrenal insufficiency excluded)
Electrolyte replacement
Rewarming
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24
Q

Myxoedema coma presentation

A

Confusion
Hypothermia
Bradycardia
Profoundly hypothyroid

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25
Q

Marker for medullary thyroid cancer

A

Calcitonin

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26
Q

Sulfonylurea example

A

Gliclazide

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27
Q

Gliptin example (DPP-4 inhibitor)

A

Sitagliptin

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28
Q

Thiazolidinedione example

A

Pioglitazone

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29
Q

SGLT-2 inhibitor examples

A

Dapagliflozin,

Empagliflozin

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30
Q

GLP-1 mimetic examples

A

Exenatide,

Liraglutide

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31
Q

Pioglitazone (Thiazolidinedione) side effects

A 
Weight gain
Fluid retention
Liver impairment
Increased risk of fractures
Increased risk of bladder cancer
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32
Q

Management of hypertriglyceridaemia

A

Fibrates (fenofibrate)

Statins may be indicated if mixed hyperlipidaemia

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33
Q

Causes of primary hypothyroidism

A

Iodine deficiency

Iatrogenic (thyroidectomy, radioiodine, drugs)

Autoimmune (Hashimoto’s, atrophic)

Thyroiditis (post-viral/DeQuervain, post-partum)

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34
Q

Carbimazole side effect

A

Neutropenia
Cholestasis
Rash

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35
Q

Test to diagnose thyroiditis

A

Thyroid scintigraphy - shows reduced uptake of iodine-131

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36
Q

Features of abetalipoproteinemia

A

Steatorrhoea + poor growth
Neurological dysfunciton
Visual impairment

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37
Q

Treatment of abetalipoproteinemia

A

Dietary fat restriction

High-dose Vitamin E

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38
Q

Deficiency in Abetalipoproteinemia

A

Apolipoprotein B-48 + B-100

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39
Q

QRISK2 score should not be used in:

A

> =85 years
Type 1 diabetics
eGFR <60 / albuminuria
FH of familial hyperlipidaemia

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40
Q

Offer statin primary prevention in T1DM if:

A 
Older than 40, 
or,
Had diabetes >10 years, 
or,
Have nephropathy, 
or, 
Have other CVD risk factors
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41
Q

Criteria for continuing GLP-1 mimetic

A

Only continue if HbA1c reduced by >=11 after 6 months

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42
Q

1st line drug in MODY

A

Sulfonyurea (eg glipizide)

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43
Q

1st line treatment for prolactinoma (even if very large!)

A

Dopamine agonist (cabergoline, bromocriptine)

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44
Q

Pseudo-hypoparathyroidism Type 1a AKA

A

Albright’s Hereditary Osteodystrophy

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45
Q

Initial insulin regime in type 1 diabetic - new diagnosis in adult

A

Basal-bolus using twice-daily insulin detemir

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46
Q

Findings in Gitelman’s syndrome (defective NaCl transporter)

A

Hypokalaemia
Normotensive
Low urinary calcium

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47
Q

T1DM glucose target, on waking

A

5-7mmol/L

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48
Q

T1DM glucose target, before meals

A

4-7mmol/L

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49
Q

T1DM glucose target, 90min after eating

A

5-9mmol/L

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50
Q

Type 1 RTA - location + defect

A

Distal tubule, inability to secrete H+ into urine

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51
Q

Causes of type 1 RTA (distal)

A

Idiopathic
Rheumatoid arthritis, SLE, Sjogren’s
Amphotericin B toxicity
NSAID nephropathy

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52
Q

Type 2 RTA (proximal) - defect

A

Decreased HCO3 reabsorption

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53
Q

Causes of type 2 RTA (proximal)

A

Idiopathic
Fanconi syndrome, Wilson’s disease, Cystinosis
Carbonic anhydrase inhibitors
Outdated tetracyclines

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54
Q

Type 3 RTA - caused by

A

carbonic anhydrase II deficiency

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55
Q

Type 4 RTA - location + defect

A

proximal tubule, decreased ammonium excretion

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56
Q

Type 4 RTA - caused by

A

hypoaldosteronism
diabetes
(NSAIDs)

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57
Q

Type 1 RTA - metabolic effect

A

Hyperchloraemia
Severe metabolic acidosis,
with Hypokalaemia

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58
Q

Type 2 RTA - metabolic effect

A

Hyperchloraemic metabolic acidosis,

Hypokalaemia

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59
Q

Type 4 RTA - metabolic effect

A

hyperchloraemic metabolic acidosis,

with hypERkalaemia

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60
Q

Type 3 RTA (mixed) - metabolic effect

A

Hyperchloraemic metabolic acidosis

Hypokalaemia

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61
Q

Primary hyperparathyroidism - definitive management

A

Total parathyroidectomy

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62
Q

Primary hyperparathyroidism - conservative management considered if:

A

> 50 yo
Calcium level less than 0.25 mmol/L over upper limit
No evidence of end-organ damage

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63
Q

Cinacalcet (calcium mimetic) is used in

A

Primary hyperparathyroidism, to reduce calcium levels

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64
Q

Glucagonoma features

A

Diabetes
VTE
Necrolytic migratory erythema

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65
Q

Management of prolactinoma

A

1st line: dopamine agonist (cabergoline, bromocriptine)

2nd line: surgery

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66
Q

Contraindication to pioglitazone

A

Congestive cardiac failure

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67
Q

Sulfonylurea (eg gliclazide) MOA

A

Increases glucose-independent insulin release

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68
Q

GLP-1 agonist MOA

A

Binds GLP-1 receptor on beta cells to increase glucose-dependent insulin secretion

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69
Q

DPP4 inhibitors (sitagliptin) MOA

A

Inhibit breakdown of GLP-1 to increase glucose-dependent insulin secretion

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70
Q

Metformin MOA

A

Biguanide: Insulin sensitizer

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71
Q

Thiazolidinediones (pioglitazone) MOA

A

Insulin sensitizer

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72
Q

SGLT-1 inhibitor MOA

A

Inhibit glucose reabsorption in kidney

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73
Q

Acromegaly - sources of raised GH

A
  • Pituitary adenoma 95%

- Ectopic GHRH/GH (pancreatic tumour)

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74
Q

Acromegaly features

A

Facial features + large hands, feet, jaw, tongue

Sweating (gland hypertrophy)

Tumour: bitemporal hemianopia, hypopituitarism, raised prolactin

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75
Q

Acromegaly genetics

A

MEN-1 in 6%

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76
Q

Acromegaly complications

A

HTN
Diabetes
Cardiomyopathy
Colorectal cancer

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77
Q

Deficiency in congenital adrenal hyperplasia

A

21-hydroxylase deficiency (90%)

11-beta hydroxylase deficiency (5%)

17-hydroxylase deficiency (very rare)

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78
Q

Inheritance pattern of congenital adrenal hyperplasia

A

Autosomal recessive

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79
Q

Diagnosis of congenital adrenal hyperplasia

A

Raised 17-OH progesterone

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80
Q

Features of 21-hydroxylase mutation (Classic Congenital Adrenal Hyperplasia)

A
  • Virilisation
  • Salt wasting
  • Hypovolemia/shock
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81
Q

Features of CAH - 11-beta hydroxylase mutation

A
  • Hypertension

- Virilisation

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82
Q

Features of CAH - 17-alpha hydroxylase mutation

A
  • Hypertension

- No virilisation

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83
Q

Insulin stress test cushings vs pseudo-cushings

A

Cushings: limited rise in cortisol

Pseudo-cushings: normal rise in cortisol

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84
Q

Tests to confirm Cushings syndrome/pseudo-cushings is present

A
  • Overnight dexamethasone suppression test

- 24hr urinary free cortisol

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85
Q

Kallman syndrome

A

Hypogonadotrophic hypogonadism

Failure of migration of GnRH-releasing neurons and olfactory neurons

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86
Q

Hormone levels in Kallmann’s syndrome

A
  • Low GnRH
  • Low gonadotrophs (LH, FHS)
  • Low sex hormones (estrogen, progesterone, testosterone)
  • Other pituitary hormones normal
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87
Q

Kallmann’s syndrome - inheritance pattern

A

X-linked recessive

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88
Q

Kallmann’s syndrome - features

A 
Delayed puberty
Low sex hormones
Small testes
Anosmia
Tall
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89
Q

Commonest thyroid cancer

A

Papillary - 70%

90
Q

Thyroid cancer which may cause pressure symptoms

A

Anaplastic

91
Q

2nd commonest thyroid cancer

A

Follicular 20%

92
Q

Which thyroid cancer is associated with MEN II

93
Q

Which cells involved in medullary thyroid cancer

A

Parafollicular (c) cells

94
Q

T2DM HbA1c target - lifestyle changes alone

A

48 mmol/mol (6.5%)

95
Q

T2DM HbA1c target - on metformin only

A

48 mmol/mol (6.5%)

96
Q

T2DM HbA1c target - on a drug which may cause hypoglycaemia

A

53 mmol/mol (7.0%)

97
Q

Which diabetes drugs may cause hypoglycaemia

A

Sulfonylurea (gliclazide)

Insulin

98
Q

T2DM on 1 drug - if HbA1c rises to this level, should add a second drug

A

58 mmol/mol (7.5%)

99
Q

T2DM on metformin and HbA1c rises to >58

A

Add gliptin / sulfonylurea / pioglitazone / SGLT-2 inhibitor

100
Q

T2DM on metformin and 1 other drug and HbA1c >58

A

Triple therapy

Or consider insulin

101
Q

Criteria for adding GLP-1 mimetic (exenatide)

A

Triple therapy not effetive/not tolerated and:

BMI >= 35
or <35 but cant use insulin due to occupation/weight loss beneficial for other comorbidities

102
Q

Criteria for continuing GLP-1 mimetic after 6 months

A

HbA1c reduction of at least 11 mmol/mol

and

Lost at least 3% of initial body weight

103
Q

Statin for primary prevention - indications

A

10yr CVD QRISK2) >= 10%

T1DM

CKD with eGFR <60

104
Q

Statin for primary prevention - titration

A

If non-HDL not fallen by >= 40%, consider uptitrating to 80mg

105
Q

Statin for secondary prevention - indications

A

Known IHD
Cerebrovascular disease
Peripheral arterial disease

106
Q

SIADH - 1st line management

A

Fluid restriction

107
Q

SIADH - management if resistant to fluid restriction

A

Demeclocycline

108
Q

Demeclocycline MOA

A

Inhibits effect of ADH on renal tubules

109
Q

Orlistat MOA

A

Inhibits pancreatic lipase

110
Q

Orlistat criteria for starting

A

BMI >= 30
or
BMI >=28 with risk factors

And 3 months of dietary + lifestyle measures have failed

111
Q

Orlistat criteria for continued use

A

Weight loss of 5% at 3 months

May only be used for <1 year

112
Q

Criteria for weight loss surgery

A

Failure of non-surgical measures
BMI >40, or BMI 35-40 with other disease
Commits to long-term followup

113
Q

Anti-thyroid drugs in pregnancy

A

Propylthiouracil in first trimester (SE hepatotoxicity)

Switch to carbimazole at start of second trimester (SE congenital abnormality)

114
Q

Management of Addisonian crisis

A

Hydrocortisone 100mg IM/IV
- 6hrly until stable
IV fluids
PO steroids after 24hrs

115
Q

Thyroid nodule, TSH is low - next investigation?

A

Thyroid uptake scan

  • If cold/iso nodule -> FNA
  • Hot nodule - no FNA
116
Q

Thyroid nodule, TSH is normal/elevated - next investigation?

A

Thyroid USS

- FNA if suspicious ft on US

117
Q

JBDS DKA criteria

A

glucose > 11 mmol/l (or known DM)

pH < 7.3

bicarbonate < 15 mmol/l

ketones >3, or dipstick ++

118
Q

(JBDS) DKA - potassium replacement if K >5.5

119
Q

(JBDS) DKA - potassium replacement if K 3.5 - 5.5

120
Q

(JBDS) DKA - potassium replacement if K <3.5

A

Senior review

121
Q

Screening for other disease, in known acromegaly

A

Regular colonoscopy, starting aged 40

122
Q

Acromegaly 1st line management

A

Trans-sphenoidal surgery

123
Q

Acromegaly 2nd line management

A

Best: Somatostatin analogue (octreotide) - inhibits GH release

Pegvisomant - GH receptor antagonist

Dopamine agonist (bromocriptine)

124
Q

Drug causes of hypercalcaemia

A

Thiazides
Calcium-containing antacids
Lithium

125
Q

Hypothyroidism monitoring in pregnancy

A

TSH each trimester, and 6-8 weeks post-partum

126
Q

Thyroxine dose in pregnancy

A

Increase by 25-50% by weeks 4-6 of pregnancy.

Return to normal dose after delivery

127
Q

Features of APS type 1 (MEDAC - multiple endocrine deficiency autoimmune candidiasis)

A

Need 2 out of 3:

  • Addison’s
  • Primary hypoparathyroidism
  • Chronic mucocutaneous candidiasis
128
Q

Features of APS type 2 (Schmidt’s syndrome)

A

Addison’s plus either:

  • T1DM
  • Autoimmune thyroid disease
129
Q

APS type 1 genetic mutation

A

AIRE1 gene on chromosome 21

130
Q

APS type 2 HLA linkage

A

HLA DR3/DR4

131
Q

Primary hyperparathyroidism monitoring

A

Regular renal function, bone profile + DEXA scan

132
Q

Type 2 DM + anti-GAD

A

LADA

Latent Autoimmune Diabetes of Adulthood

133
Q

Liddle’s syndrome inheritence

134
Q

Liddle’s syndrome pathophysiology

A

Dysfunctional sodium channels in distal tubules -> increased sodium reabsorption

135
Q

Liddle’s syndrome presentation

A

Hypertension
Metabolic alkalosis
Hypokalaemia
Low renin, low aldosterone

Teenager with symptomatic HTN

136
Q

Liddle’s syndrome treatment

A

Amiloride or triamterene

137
Q

Simone Broome criteria for familial hypercholesterolaemia - Definite FH

A

TC/LDL-C over threshold, plus:
Tendon xanthoma in patient/1st/2nd degree relative
Or
DNA evidence of FH

138
Q

Simone Broome criteria - TC and LDL-C threshold in child <16

A

TC >6.7 mmol/L or LDL-C >4.0 mmol/L

139
Q

Simone Broome criteria for familial hypercholesterolaemia - Possible FH

A

TC/LDL-C over threshold, plus:
MI <50 in 2nd degree relative,
MI <60 in 1st degree relative, or,
FH of raised cholesterol

140
Q

Simone Broome criteria - TC and LDL-C threshold in adult

A

TC >7.5 mmol/L or LDL-C >4.9 mmol/L

141
Q

Familial hypercholesterolaemia management

A

Referral specialist lipid clinic
High-dose statin
Screen first-degree relatives, by age of 10 (50% chance)

142
Q

Calculated serum osmolarity

A

2Na + 2K + glucose + urea

143
Q

Normal osmolar gap

144
Q

Osmolar gap

A

Measured osmolarity - calculated osmolarity

145
Q

Treatment options for Graves’ disease

A

ATD titration (Carbimazole)

Block-and-replace (Carbimazole + thyroxine)

RAIA (radioactive ionine ablation)

Surgery

146
Q

Definitive treatment options for Graves’ disease

A

RAIA and surgery

147
Q

Contraindications to RAIA in Graves’

A

Pregnancy/trying to get pregnant
Age <16y
Thyroid eye disease

148
Q

Thiamine

A

Vitamin B1

149
Q

Rotterdam criteria for PCOS

A

At least 2 of:
- Clinical/biochemical evidence of hyperandrogenism

  • Oligo- or anovulation
  • Polycystic ovaries on US
150
Q

Management of infertility in PCOS

A

Weight loss
Clomifene (+/- metformin)
Gonadotrophins

151
Q

Management of hirsutism in PCOS

A

COCP (co-cyprindiol has anti-androgen action)
Topical eflornithine
Spironolactone/finasteride/flutamide

152
Q

Screening for gestational diabetes - with any risk factors

A

OGTT at 24-28 weeks

153
Q

Screening for gestational diabetes - previous gestational diabetes

A

OGTT as soon as possible after booking + at 24-28weeks

154
Q

Diagnostic threshold for gestation diabetes - fasting glucose

A

> = 5.6 mmol/L

155
Q

Diagnostic threshold for gestation diabetes - 2-hour glucose

A

> = 7.8 mmol/L

156
Q

Gestational diabetes, fasting glucose >= 7 at time of diagnosis

A

Start insulin

157
Q

Gestational diabetes - glucose targets not met with 1-2 weeks of diet/exercise

A

Start metformin

158
Q

Gestational diabetes - glucose targets not met with diet/exercise/metformin

A

Start insulin

159
Q

Gestational diabetes - plasma glucose 6 - 6.9 with evidence of macrosomia/hydramnios

A

Offer insulin

160
Q

Pre-existing diabetes and pregnant

A

Weight loss if BMI >27

Stop PO hypoglycemics, apart from metformin, start insulin

Folic acid 5mg up to 12wk

Aspirin 75mg 12wk-delivery

161
Q

Blood sugar target diabetes in pregnancy - Fasting

A

5.3 mmol/l

162
Q

Blood sugar target diabetes in pregnancy - 1 hour after meal

A

7.8 mmol/l

163
Q

Blood sugar target diabetes in pregnancy - 2 hour after meal

A

6.4 mmol/l

164
Q

Type 1 (distal) RTA complications

A

Renal stones, nephrocalcinsis

165
Q

Features of primary hyperaldosteronism

A

Hypertension
Hypokalaemia
Alkalsosis
Raised aldosterone: renin ratio

166
Q

Management of bilateral adrenal hyperplasia

A

Spironolactone

167
Q

Management of adrenal adenoma

168
Q

Investigation of hyperaldosteronism

A

High-resolution CT abdomen + Adrenal Vein Sampling

169
Q

DVLA: Diabetics on insulin can hold an HGV licence as long as

A
  • No severe hypo in last 12m
  • Have hypo awareness
  • 3-month evidence of regular glucose monitoring
  • Understand risks of hypose
  • No debarring complications
170
Q

DVLA: Diabetics on insulin can drive a car as long as

A
  • Have hypo awareness
  • No more than 1 hypo requiring assistance in last 12m
  • No visual impairment
171
Q

Causes of Addisonian crisis

A

Sepsis/surgery triggering acute exacerbation of existing insufficiency

Adrenal haemorrhage (Waterhouse-Friderichsen syndrome in meningitis)

Steroid withdrawal

172
Q

Causes of raised prolactin

A 
prolactinoma
pregnancy
oestrogens
stress, exercise, sleep
acromegaly
PCOS
primary hypothyroidism
173
Q

Drug causes of raised prolactin (dopamine-blockers)

A

Metoclopramide, domperidone
Haloperidol
Phenothiazines (prochlorperazine)
Rare: SSRIs, opioids

174
Q

Subacute ‘De Quervains’ Thyroiditis on thyroid scintigraphy

A

Globally reduced uptake of iodine-131

Transient increase in hormone release, not over-production

175
Q

Management of subacute/De Quervains Thyroiditis initial phase

A

Propranolol for symptoms
NSAIDs for thyroid pain
Steroids if severe

176
Q

SIADH criteria

A

Na <135
Serum osmolality <271
Urine osmolality >100
Euvolemic

177
Q

Management of congenital adrenal hyperplasia

A

Reverse circadian rhythm steroids

178
Q

Features of hyperosmolar hyperglycaemic state

A

High osmolality + high glucose (>30)
Dehydration, unwell
No significant ketonaemia/acidosis

179
Q

Indications for radioiodine therapy

A

Differentiated thyroid cancer
Toxic multinodular goitre
Refractory Graves disease

180
Q

Test for adult growth hormone deficiency

A

Insulin tolerance test - demonstrates low peak GH levels in response to hypoglycaemia

181
Q

Test for GH deficiency when ITT contraindicated

A

Arginine-GHRH stimulation test

182
Q

CI to ITT

A

IHD

Previous seizures

183
Q

Risk of rapid correction of HYPOnatraemia

A

Central pontine myelinolysis

184
Q

Hyponatramia correction - aim in 24hr period

A

Raised Na levels by 4-6mmol/l in 24 hours

185
Q

Visible features of pseudo-hypoparathyroidism type 1a

A

Short 4th and 5th metacarpals

Obesity

186
Q

Biochemical findings in pseudo-hypoparathyroidism type 1a

A

High PTH, with low calcium, and high phosphate

187
Q

Imaging for phaeochromocytoma

A

MIBG (metaiodobenzylguanidine) scan

188
Q

24h urinary HIAA - screens for what

A

Carcinoid syndrome

189
Q

Pentagastrin stimulation test - for which cancer

A

Medullary thyroid cancer

190
Q

Definition of Stage 1 hypertension

A

Clinic BP > 140/90
and
ABPM daytime average/HBPM average > 135/85

191
Q

Definition of Stage 2 hypertension

A

Clinic BP > 160/100
and
ABPM daytime average/HBPM average > 150/95

192
Q

Definition of Severe hypertension

A

Clinic systolic BP >180 or diastolic BP >120

193
Q

Treat Stage 1 hypertension if:

A

<80 years old with any of:

Target organ damage,
Established CD
Renal disease
QRISK >10%

194
Q

Management of diabetes in cystic fibrosis

A

High calorie diet with insulin

195
Q

Features of carcinoid syndrome

A 
Diarrhoea
Facial flushing
Bronchospasm
Hypotensions
Right heart valvular stenosis
196
Q

Prolactin level seen in prolactinoma

A

> 5000 mU/L

197
Q

Prolactin level seen in non-prolactin secreting pituitary tumour

A

600 - 3000 mU/L

198
Q

Ferritin levels seen in haemochromatosis

A

> 500 ug/L

199
Q

1st line management of hyperphosphataemia in CKD

A

Start with dietary phosphate restriction, add in phosphate binder (calcium acetate) if needed

200
Q

Target BP in diabetics/CKD

A

Aim BP < 130/80 with ACEi

201
Q

Management of hyperphosphataemia in CKD, when calcium is raised

A

Non-calcium phosphate binder (Sevelamer)

202
Q

Features of Bartter syndrome

A

Hypokalamic alkalosis
Normotensive
Muscle weakness/lethargy (due to low K)

203
Q

Verner-Morrison syndrome (VMS)

A

Uncontrollable watery diarrhoea causing hypokalaemia and dehydration

204
Q

Best screening test for acromegaly

205
Q

Test for growth hormone deficiency

A

Insulin tolerance test

206
Q

1st line management of solitary toxic thyroid nodule

A

Radioactive iodine therapy

207
Q

Solitary toxic thyroid nodule - Indications for partial thyroidectomy

A

Thoracic obstruction

CI to radioiodine (planned pregnancy, young children)

208
Q

T score representing osteopenia

A

-1.5 to -2.5

209
Q

T score representing osteoporosis

A

Below -2.5

210
Q

Feature of pseudohypoparathyroidism

A

High PTH
Low calcium, high phosphate
Short 5th digit

211
Q

Initial management of nephrogenic diabetes insipidus (after stopping lithium)

A

Thiazide diuretic (Hydrochlorothiazide)

212
Q

2nd line management of nephrogenic diabetes insipidus

A

Add amiloride or NSAID (indomethacin)

213
Q

Treatment of cranial diabetes insipidus

A

Desmopressin

214
Q

Alternate test for acromegaly

A

Glucose tolerance test, with growth hormone measurement (failure to suppress GH)

215
Q

C282Y or H63D mutations in

A

Haemochromatosis

216
Q

H1069Q mutation is seen in

A

Wilsons disease

217
Q

C282Y or H63D mutations in

A

Haemochromatosis

218
Q

H1069Q mutation in

219
Q

Diagnostic test for phaeochromocytoma

A

24hr urinary metanephrines

220
Q

Use for calcitonin

A

Hypercalcaemia

with rehydration +/- bisphosphonates

MRCP Part 2 (15 decks)

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