endo DPD

Question 1

Causes of amenorrhoea/ oligomenorrhoea

Answer 1

Pregnancy
Hypothalamus: excessive exercise, low BMI
Pituitary: hyperprolactinaemia
hypogonadism (low LH/FSH)
Thyroid: hyper/hypo
Ovaries: PCOS, ovarian failure

Question 2

PCOS and ovarian failure investigations

Answer 2

PCOS: clinical/biochemical high androgen
Ovarian failure: high FSH, low androgens
(Do USS for both too)

Question 3

Hypokalaemia presentations

Answer 3

Weakness
Fatigue
Arrythmia

Question 4

Causes of hypoK+

Answer 4

GI - vomiting
Diuretics
Primary aldosteronism (bilateral hyperplasia or Conn’s) - check aldosterone:renin ratio

Question 5

Hyponatraemia hypovolaemic causes

i.e. decrease of fluid in body
Low urine Na+

Answer 5

Diarrhoea
Vomiting
Diuretics

Question 6

Hyponatraemia euvolaemia causes

Answer 6

Hypothyroidism
- (check TFTs)
Adrenal insufficiency
- (do short syncACTH test)
SIADH
- (plasma and urine osm)

Question 7

Hyponatraemia hypervolaemic causes

i.e. fluid overload in body so dilutes Na+
Low urine Na+

Answer 7

Heart failure
Cirrhosis
Nephrotic syndrome

Question 8

Causes of high urine osm

Answer 8

Dehydration
HHS (due to glucose)
T2DM
SIADH

Question 9

Causes of low urine osm

Answer 9

Diabetes insipidus

Question 10

Anion gap equation

Answer 10

Na+ + K+ - Cl- - HCO3-

Question 11

2(Na+K) + urea + glucose =

Answer 11

plasma osmolality

Question 12

Treatment of hyperK+

Answer 12

IV 50% glucose
50% insulin
Calcium glucuronate
Nebulised salbutamol
Sodium bicarbonate

Question 13

Septic arthritis diagnostic investigation

Answer 13

Joint aspiration

Broad spec antibiotics when confirmed

Question 14

Botulinum toxin (from IV heroin use) will disrupt NMJ stimulation = wound botulism. Signs and symptoms…

Answer 14

Bilateral ptosis
Diplopia (bilateral 6th)
Slurred speech
Dysphasia
Skin abscesses

Question 15

Osteoporosis bone biochemistry results

Answer 15

Ca2+
Phosphate
PTH
ALP

All normal

Question 16

Cushing’s disease definition and biochemical findings

Answer 16

Pituitary tumour producing excess ACTH:
High ACTH
High cortisol

Question 17

Cushing’s syndrome definition and biochemical findings

Answer 17

1. Adrenal tumour
   Low ACTH in adrenal tumours
   High cortisol
2. Ectopic ACTH produced i.e. from lung tumour
   High ACTH
   High cortisol