Endocrine

Question 1

Pheochromocytoma (rule of 10’s)

Answer 1

10% extra-abdominal
10% malignant
10% bilateral
10% in children
BUT 30% genetic/syndromic!

Question 2

Insulinoma (rule of 10’s)

Answer 2

10% are part of MEN1 syndrome
10% are multiple
10% are malignant
10% contain ectopic pancreatic tissue

Question 3

Symptoms of hyperthyroidism

Answer 3

(SWEATING)

 Sweating
Weight loss
Emotional lability
Appetite increased
Tremor/ tachycardia
Intolerance of heat/ Irregular menstruation/ Irritability
Nervousness
Goitre and GI problems (diarrhoea)

Question 4

Symptoms of hypothyroidism

Answer 4

Memory loss
Obesity
Malar flush/ Menorrhagia
Slowness (mentally and physically)
Skin and hair dryness
Onset gradual
Tiredness
Intolerance to cold
Raised BP
Energy levels fall
Depression/ Delayed relaxation of reflexes

Question 5

Causes of adrenal insufficiency

Answer 5

(ADDISON)

 Autoimmune (Addison’s disease)
Degenerative (amyloidosis)
Drugs (e.g. ketoconazole)
Infections (e.g. TB, HIV)
Secondary (hypopituitarism)
Others (adrenal bleeding)
Neoplasia

Question 6

thyroid carcinoma histological types

Answer 6

Please Feed My Alligator

In order from most to least common and least to most aggressive.

Papillary (80% of total)
Follicular (10%)
Medullary (5%)
Anaplastic (3%)

Question 7

steroids se

Answer 7

CUSHINGOID

Cataracts
Ulcers
Skin: striae, thinning, bruising
Hypertension/ Hirsutism/ Hyperglycemia
Infections
Necrosis, avascular necrosis of the femoral head
Glycosuria
Osteoporosis, obesity
Immunosuppression
Diabetes

Question 8

Diabetes Medication

Answer 8

BAGS

Biguanides
e.g. metformin – reduces insulin resistance, S/E GI upset, lactic acidosis
Alpha-glucosidase inhibitors
e.g. acarbose – inhibits carbohydrate digestion so reduces intestinal glucose reabsorption, S/E bloating, diarrhoea
Glitazones (thiazolidinediones)
e.g. pioglitazone, risoglitazone – insulin-sensitising agents causing transcription of Glut-1 receptors, S/E hepatotoxicity
Sulphonylureas
e.g. gliclazide, tolbutamine – stimulate insulin production from pancreatic beta-cells, S/E weight gain and hypoglycaemia

Question 9

Hypoglycemia causes

Answer 9

In the non-diabetic: EXPLAIN

EXogenous medication e.g. insulin, oral hypoglycaemics, alcohol, aspirin overdose, IGF-1
Pituitary insufficiency
Liver failure
Addison’s disease
Islet cell tumours (e.g. insulinoma)
Non-pancreatic neoplasm e.g. fibrosarcoma
Precipitating factors in a diabetic: MINE

Missing a meal
Insulin overdose (accidental)
Non-accidental overdose
Exercise (increased activity)