Endocrine

Question 1

Difference between causeof T1 and T2 diabetes

Answer 1

T1 = Failure to produce insulin - destruction of B-cells in islets of Langerhans
T2 = Insulin resistance - Due to multiple causes

Question 2

Cause of T1

Answer 2

Autoimmune - Environmental factors acting on a genetically susceptible person

Question 3

Diagnostic glucose/HbA1c levels of diabetes

Answer 3

Random > 11
Fasting > 7
2 hrs post Glucose Tolerance Test (GTT) > 7
HbA1c > 48

Question 4

Symptoms of T1 Diabetes

Answer 4

Polyuria, Polydipsia, Lethargy, Weight Loss

Question 5

Treatment of T1

Answer 5

Insulin and Education

Question 6

Prevalence of T2 Diabetes in teh UK

Answer 6

3.5 Million

Question 7

Risk factors for T2

Answer 7

Obesity, Poor diet, Asian/Black, Metabolic Syndrome

Question 8

Components of Metabolic Syndrome

Answer 8

Hypertension, Hyperglycaemia, Obesity, Hypercholesterolaemia and High Triglycerides

Question 9

Treatment for T2

Answer 9

Lifestyle changes
1st line = Metformin
2nd line = Gliclazide

Question 10

Most common cause of Primary Hypothyroidism

Answer 10

Autoimmune - Hashimoto’s

Question 11

Causes of Secondary Hypothyroidism

Answer 11

Hypopituitarism or Hypothalamic disorders

Question 12

Symptoms of Hypothyroidism

Answer 12

Lethargy, Intolerance to cold, Hair Loss, Weight gain, Menorrhagia, Bradycardia, Hyporeflexia

Question 13

Investigations and Treatment of Hypothryroidism

Answer 13

TFT’s and Levothyroxine

Question 14

Is hyperthyroidism more common in men or women?

Answer 14

10x more common in women

Question 15

Leading cause of Hyperthyroidism

Answer 15

Graves - Autoantibodies stimulate the thyroid causing gland hypertrophy

Question 16

Other causes of hyperthyroidism

Answer 16

TSH secreting pituitary adenoma/ Thyroiditis

Question 17

Symptoms of Hyperthyroidism

Answer 17

Sweating, Tremor, Irritability, Weight Loss, Palpitations, Tachcardia, Exopthalmos

Question 18

What is a Thyroid Storm

Answer 18

Hyperthyroidism become a thyroid storm through an event such as sepsis, fever or dehydration and symptoms become much more severe and potentially life threatening.

Question 19

Investigations of Hyperthyroidism

Answer 19

TFT’s and serology of antibodies

Question 20

Treatment - Medical/Surgical

Answer 20

Medical = Block and replace - Carbimazole/Radioactive iodine and Thyroxine
Surgical = Thyroidectomy (If thyroid eye disease)

Question 21

Define Cushing Syndrome/Disease

Answer 21

Syndrome = Abnormalities due to chronic excess glucocorticoid production whatever the cause
Disease = Excess glucocorticoid production due to inappropriate ACTH secretion from the pituitary

Question 22

Symptoms of Cushings

Answer 22

Obese, Moon Face, Sweaty, Thin skin, Bruise easily

Question 23

Investigations of cushings

Answer 23

48hr Dexamethasone suppressions test - should suppress plasma levels of cortisol
Corticotrophin releasing hormone tests

Question 24

Treatment - Surgical and Medical

Answer 24

Medical - Ketoconazole

Surgical - Removal of pituitary/adrenal glands