Endocrine

Question 1

Grave’s disease:

Answer 1

• Goitre, exophthalmos, pretibial myxoedema
• TSH receptor antibodies

Question 2

Pheochromocytoma:

Answer 2

• Tumour of adrenal glands that causes increased adrenaline
• First line = 24hr metanephrine collection

Question 3

Addison’s disease:

Answer 3

• Primary adrenal insufficiency, therefore decreased cortisol
• First line (in GP) = 8-9am cortisol
• Gold standard = ACTH stimulation test (Synacthen test)

Question 4

Cushing’s syndrome:

Answer 4

• Increased cortisol
• Overnight dexamethasone suppression test
• (Or 24hr urinary free cortisol)

Question 5

Acromegaly:

Answer 5

• Increased growth hormone production
• First-line = serum insulin-like growth factor 1
• Then if deranged, do OGTT

Question 6

Conn’s syndrome:

Answer 6

• Increased aldosterone
• First-line: renin:aldosterone ratio
• Also bloods will who hypernatremia and hypokalaemia