Endocrine

Question 1

What cells in the pancreas secrete insulin? And glucagon?

Answer 1

Insulin -beta

Glucagon - alpha

Question 2

Which immune cell mediates the AI response leading to T1DM?

Answer 2

T cell

Question 3

Name 2 conditions associated with T1DM

Answer 3

Thyroid disease, vitiligo

Question 4

Name 2 causes of DKA

Answer 4

Undiagnosed T1DM, interruption of insulin therapy, stress, intercurrent illness (surgery/infection)

Question 5

Name the type of breathing seen in DKA

Answer 5

Kussmaul

Question 6

What is the emergency treatment of DKA?

Answer 6

Fluids and insulin

Question 7

Above what level does a random glucose need to be to diagnose diabetes?

Answer 7

11.1 mmol/L

Question 8

Why is acidosis present in DKA but not HHS?

Answer 8

In HHS there is sufficient insulin to prevent excess ketone production

Question 9

Name 3 symptoms of hypoglycaemia

Answer 9

Sweating, anxiety, hunger, tremor, dizziness, confusion, irritability, drowsiness, seizure, coma

Question 10

How would you treat hypoglycaemia in an unconscious patient without IV access?

Answer 10

IM glucagon

Question 11

In which type of retinopathy do you have new blood vessel formation?

Answer 11

Proliferative

Question 12

Does thyroxin mostly circulate as T3 or T4?

Answer 12

T4

Question 13

What are the 2 specific eye signs found in grave’s disease?

Answer 13

Exopthalmos, opthalmoplegia (weakness or paralysis of extraocular muscles)

Question 14

What is the anti thyroid hormone medication called?

Answer 14

Carbimazole

Question 15

Where in the adrenals is cortisol produced?

Answer 15

Zona fasciculata

Question 16

If after a 48 hour low dose dexamethasone test, ACTH remains unchanged, do you scan pituitary or adrenals?

Answer 16

Pituitary - scan adrenals if it is depressed

Question 17

Which hormone is produced in excess in Conn’s syndrome?

Answer 17

Aldosterone

Question 18

Why is adrenal insufficiency secondary to hypothalamic pituitary disease do you have insufficient cortisol, but adequate aldosterone?

Answer 18

The RAAS system

Question 19

What are 2 drug treatments for Addision’s (long term) ?

Answer 19

Hydrocortisone and fludrocortisone

Question 20

Name 1 systemic disease that phaeochromocytoma is associated with.

Answer 20

Multiple endocrine neoplasia 2 (MEN 2)

Question 21

Pre-surgical treatment of phaeochromocytoma requires which 2 medications, in which order?

Answer 21

Alpha blockade (mirtazapine) THEN beta blockade (propanolol)

Question 22

What is the plasma and urine osmolality in diabetes insipidus? (high/low)?

Answer 22

High

Question 23

Through which route do you give desmopressin for DI?

Answer 23

Intranasally

Question 24

Which drug can be used in SIADH which promotes water excretion without loss of electrolytes?

Answer 24

Vaptans

Question 25

Which hormone counteracts the action of GHRH?

Answer 25

Somatostatin

Question 26

What is the commonest cause of acromegaly?

Answer 26

Somatotroph adenoma

Question 27

Name 2 signs of acromegaly?

Answer 27

Hypertension, impaired glucose tolerance

Question 28

Name 2 drugs used to treat acromegaly

Answer 28

Octreotide, bromocriptine/pegvisomant

Question 29

Which cells in the parathyroid secrete PTH?

Answer 29

Chief cells

Question 30

In primary hyperPTH is phosphate high or low?

Answer 30

Low

Question 31

Is the PTH level appropriate in secondary hyperPTH?

Answer 31

Yes

Question 32

Name two causes of hypocalcaemia

Answer 32

Biphosphate therapy, CKD, vit D deficiency, acute pancreatitis, hypoparathyroidism

Question 33

Which sign of hypocalcaemia is elicited by inflating a blood pressure cuff around the upper arm?

Answer 33

Trousseaus

Question 34

What is the emergency treatment of acute hyperkalaemia?

Answer 34

IV insulin and glucose, salbutamol nebs, IV calcium gluconate

Question 35

What are the ECG changes associated with hyperkalaemia?

Answer 35

Flat P, wide QRS, tall tented t waves

Question 36

Which hormone is excessively secreted in malignant carcinoid syndrome?

Answer 36

Serotonin

Question 37

Name 2 symptoms of hyperkalaemia

Answer 37

Diarrhoea, flushing of face and neck