Endocrine

Question 1

MEN Type 1

Answer 1

MEN-I
parathyroid (95%): hyperparathyroidism due to parathyroid hyperplasia
pituitary (70%)
pancreas (50%, e.g. Insulinoma, gastrinoma)
also: adrenal and thyroid

Question 2

Zollinger-Ellison syndrome

Answer 2

Excessive gastrin, usually from a gastrin secreting tumour usually of the duodenum or pancreas.
Around 30% occur as part of MEN type I syndrome

Features
multiple gastroduodenal ulcers
diarrhoea
malabsorption

Diagnosis
fasting gastrin levels: the single best screen test
secretin stimulation test

Question 3

Addison’s Disease

Answer 3

Primary adrenal insufficiency
Low sodium AND high potassium
Hypoglycaemia and metabolic acidosis

Dx: short ACTH test
Tx: hydro and fludro, more during illness.

BEWARE ADDISONIAN CRISIS