Endocrine

Question 1

What is the pattern of bone in Paget’s disease?

Answer 1

Lamellar bone

Question 2

What is the commonest cause of primary hyperparathyroidism?

Answer 2

Adenoma

Question 3

What are the cause of secondary hyperparathyroidism?

Answer 3

Renal insufficiency

Question 4

What are the laboratory results of hyperparathyroidism?

Answer 4

Hypercalcemia

Hypophosphatemia

Question 5

What is Cushing’s Syndrome?

Answer 5

Elevated serum cortisol

Question 6

What is the commonest cause of Cushing’s Syndrome?

Answer 6

Hypersecretion of ACTH from pituitary adenoma

= CUshing’s Disease

Question 7

How to investigate for CUshing’s Syndrome?

Answer 7

Overnight suppression dexamethasone test

Question 8

What is acromegaly

Answer 8

Elevated growth hormone

Question 9

What are the symptoms of acromegaly

Answer 9

Bitemporal hemianopia 
Enlargement of the skull 
Hands and feet 
Large tongue 
Skin tag

Question 10

Which diagnostic test is done for acromegaly?

Answer 10

IGF-1

Question 11

What is the treatment of prolactinoma

Answer 11

Dopamine agonist: cabergoline

Question 12

What is Diabetes insipidous?

Answer 12

dysfunction in ADH causing dilute urine

Question 13

What are the 2 types of diabetes insipidus?

Answer 13

Central DI

Nephrogenic DI

Question 14

What is central diabetes insipidus?

Answer 14

pituitary can’t make ADH because of past surgery, idiopathic, autoimmune, drugs…

Question 15

What is nephrogenic diabetes insipidus?

Answer 15

Collecting tubules dont respond to ADH

Question 16

How is diabetes insidious diagnosed?

Answer 16

Water deprivation test = don’t let them drink water –> still get dilute urine

Question 17

What is SIADH?

Answer 17

Too much ADH = too much water being reabsorbed into the body

Question 18

How is SIADH diagnosed?

Answer 18

Serum hyponatremia (<135)
Osmolality of blood low (<280)
High urine osmolality: urine more concentrated (>100)
High urine sodium (> 40)

Question 19

What are the causes of SIADH?

Answer 19

Stress
Malignancy (lung, pancreas, lymphoma)
CNS disease (inflammation, hemorrhage, tumour)
Respiratory (TB, abscess, pneumonia, empyema)
Drugs SE
Chemotherapy agents (vincristine, cyclophosphamide, vinblastine)

Question 20

What is the treatment of SIADH?

Answer 20

Fluid restrict

Hypertonic solution if hyponatremia severe

Question 21

What is important to monitor when giving Hypertonic solution in the context of low hyponatremia

Answer 21

Central pontine demyelination

Question 22

What is Addison’s Disease?

Answer 22

Low cortisol production

Question 23

Benefit of fish oil?

Answer 23

Lower triglycerides

Question 24

Problem of fish oils?

Answer 24

Disrupt glucose control in diabetic patient

Pro-Arhythmic effect in CAD patient

Question 25

What are the criteria of metabolic syndrome?

Answer 25

``` Waist Expansion Impaired Glucose Hypertension HDL low Trig High ```

Question 26

Hypoglycaemia treatment

Answer 26

D50W 50 mL (1 ampule) IV or 1 mg glucagon SC (if no IV available) ƒ- may need ongoing glucose infusion once BG > 90 mg/dL (5 mmol/L)

Question 27

In a patient with elevated LDL or any form hyperlipidemia what is important to rule out?

Answer 27

DM Hypothyroid Obstructive liver disease Chronic renal failure

Question 28

What is the optimal blood glucose range in a patient who is critically ill?

Answer 28

7.7-10

Question 29

How to calculate anion gap?

Answer 29

Na - (Cl + HCO3-)

Question 30

What is the key word in the symptoms of pheochromocytoma?

Answer 30

Paroxysmal

Question 31

How do you investigate for pheochromocytoma?

Answer 31

VMA and HVA in the urine collection test

Question 32

What is the treatment pheochromocytoma?

Answer 32

1. Stabalise with alpha-blocker (phenoxybenzamine) 2. Canse use beta blocker after 3. Surgery

Question 33

How to investigate for hyperaldosteronism?

Answer 33

K+: Hypokalemia | Aldosterone-to-plasma renin activity ratio: high

Question 34

Which organs are involved in MEN 1?

Answer 34

3 P's Pancreas Pituitary Parathyroid

Question 35

What organs are involved in MEN 2A?

Answer 35

2P's Parathyroid Pheochromocytoma Medullary thyroid cancer

Question 36

What organs are involved in MEN 2B?

Answer 36

1 P Pheochromocytoma Neuroma Medullary thyroid cancer

Question 37

Which gene is involved in MEN 2 cancers?

Answer 37

RET proto-oncogene

Question 38

What is the treatment of hyperkalaemia

Answer 38

1. Calcium glutinate | 2. Insulin / albuterol