Endo/Diabetes

Question 1

What causes thyroid eye disease

Answer 1

Grave’s

Question 2

Tx of thyroid eye disease

Answer 2

Methylprednisolone
Ciclosporin (if severe)

Question 3

Most common causes of Cushing’s syndrome

Answer 3

Most often iatrogenic secondary to exogenous steroids

Pituitary adenoma
Adrenal adenoma
Ectopic ACTH syndrome

Question 4

Cushing’s TX

Answer 4

First line for pituitary tumour = transphenoidal hypophysectomy

If surgery fails: cabergoline

Question 5

Ix of OSA

Answer 5

Epsworth sleepiness scale
Sleep habit questionnaire
Polysomnography

Question 6

Acromegaly Tx

Answer 6

First choice = transphenoidal surgery to debulk
Octreotide

Yearly IGF1, Prolactin, visual fields assessment

Question 7

Ix of Addison’s

Answer 7

9am cortisol should be taken – a level < 100 is indicative of adrenal insufficiency, > 400 suggests adrenal sufficiency and levels between 100-400 are a grey area and would need a short synacthen test

Short synacthen test should rise >500-550 after 30 minutes – less than that is suggestive of adrenal insufficiency.