Endocrine

Question 0

What are three alternative names for metabolic syndrome?

Answer 0

MetS
Syndrome X
Insulin resistance syndrome

Question 1

Name 3 known causes of DKA

Answer 1

Infection
Now cases of diabetes
Errors of insulin management

Question 2

What are the 4 main symptoms of metabolic syndrome?

Answer 2

Central obesity
Hypertension
Hyperglycaemia
Dyslipidaemia (high TG, low HDL)

Question 3

Name 4 causes of primary hypopituitarism

Answer 3

Pituitary tumour
Pituitary infarction
Granulomas - (sarcoidosis, TB, histocytosis)
Autoimmune

Question 4

Name 4 causes of secondary hypopituitarism

Answer 4

Hypothalamic Tumours
Irradiation/Chemotherapy
Trauma - pituitary stalk transection
Granulomas

Question 5

What is Conn’s syndrome and name 2 consequences

Answer 5

Adrenal tumour autonomously secretes aldosterone

-> hypertension (Na and H2O retention) and hypokalaemia (K+ excretion)

Question 6

What is the most common adrenal enzyme deficiency?

Answer 6

21-hydroxylase

Leads to decreased mineralo- and gluco-corticoids

Question 7

In Grave’s disease, what 4 things may there be stimulatory antibodies produced towards?

Answer 7

TSH receptor
Thyroglobulin
Thyroid peroxidase
IGF-receptor

Question 8

What are the signs of hyperthyroidism?

Answer 8

Weight loss, sweating, lid retraction, diarrhoea, tachycardia

Question 9

What are the signs of hypothyroidism?

Answer 9

Weight gain, expression, fatigue, constipation

Question 10

Why does Addison’s disease lead to pigmented skin?

Answer 10

There is an increase in ACTH secretion (in response to lack of cortisol) which is broken down to MSH (Melanocyte stimulating hormone)

Question 11

What is the syndrome of hypoprolactinaemia called and what is the most common cause?

Answer 11

Sheehan’s Syndrome - pituitary necrosis after post-partum hypotension (as pituitary grows during pregnancy so needs more blood supply)

Question 12

At what levels of 1) fasting glucose, 2) HbA1c and 3) random glucose is a diagnosis of diabetes made?

Answer 12

Fasting glucose >7.0 mmol/l
HbA1c > 6.5 %
Random glucose (75g oral) > 11.1 mmol/l

Question 13

What are the 3 disease mechanisms associated with the complications of diabetes?

Answer 13

Glycation of proteins (-> atheroma, inflammation)
Polyol pathway disruption (-> increased intracellular glucose -> swelling and impaired function and free radical damage)
Activation of PKC (-> VEGF, pro-inflammatory cytokines, endothelin)

Question 14

What causes neuropathy in diabetes?

Answer 14

Microvascular injury leads to axonal death and demyelination

Question 15

What causes diabetic nephropathy?

Answer 15

Thickened glomerular BM and reduced charge -> proteinuria

Question 16

What is hyperosmolar coma and what can trigger it in diabetes?

Answer 16

Extreme hyperglycaemia -> hyperosmolarity, dehydration altered mental status.
Triggered by infection, illness or lack of drinking

Question 17

How does the body try to compensate for DKA with the respiratory system?

Answer 17

Kussmaul’s breathing - increased rate and depth

Question 18

Give two pharmacological treatments for acromegaly

Answer 18

Somatostatin analogue - Octreotide

DA agonist - Bromocriptine

Question 19

What is Iluvien and what is it used to treat?

Answer 19

A long-acting steroid deposited into eye for 3 years giving out constant low dose steroid. Used to treat diabetic retinopathy

Question 20

What 2 drug treatments are used to treat hyperkalaemia in CKD?

Answer 20

Insulin + b-agonist - drives K into cells

Polystyrene sulphonate resin - binds K in GI tract