Endocrine

Question 1

Hyperthyroidism

Answer 1

carbimazole
euthyroid after 2 months
gradually stop
radioiodine if euthyroid

Question 2

symptoms of hyperthyroid control

Answer 2

BETA BLOCKER

Question 3

2nd line to carbimazole

Answer 3

propylthiouracil

Question 4

block and replace

Answer 4

full dose of carbimazole and replace with levothyroxine

Question 5

hyperthyroid indications for surgery

Answer 5

• A large goitre, which is unlikely to remit after antithyroid medication

Question 6

indications for radioiodine

Answer 6

• Patient choice
• Persistent drug side effects
• Poor compliance with drug therapy
• Recurrent hyperthyroidism after drugs

Question 7

papillary and follicular thyroid cancer

Answer 7

o Total, or near total thyroidectomy
o If there is local nodal spread, or involvement of local structures, more extensive neck dissection is needed
o Most tumours take up iodine, so radioiodine therapy may be used

Question 8

medullary thyroid tumor

Answer 8

take out thyroid, node clearance

Question 9

anaplastic thyroid tumor

Answer 9

o Total thyroidectomy is ideal, but not usually possible

o External radiotherapy may give brief respite, and is sometimes used with partial excision

Question 10

prolactinoma

Answer 10

bromocriptine
or:
dopamine agonist
surgery
radiotherapy
can enlarge in pregnancy
treeatment to avoid long term oestrogen/testosterone deficency

Question 11

cushings

Answer 11

stop steroids

remove adenoma

Question 12

addisons

Answer 12

give steroids
10 mg in morning , 5mg in afternoon
do not stop suddenly

Question 13

conns

Answer 13

take adrenals out

give sprironolactone/amiloride before

Question 14

if calcium >3.5 + symptoms

Answer 14

IV fluids
bisphosphonates
diuretics if not working
steroids if refractory