Endocrine

Question 1

What is acromegaly?
3 signs?
Why might they keep walking into stuff?

Answer 1

Ant pit tumour secreting GH

Spade like hands, frontal bossing, macroglossia, headache, sweats, deepening voice, carpal tunnel, HTN

Bitemporal hemianopia

Question 2

2 key Ix for acromegaly

Answer 2

pit MRI

Serum IGF-1

Question 3

what finding on OGTT in acromegaly

Answer 3

Normal person - Growth hormone secretion suppressed by increase glucose

Does NOT happen in acromegaly - Still high GH

Question 4

Seen on FBC in hypoThy

Answer 4

macrocytic anaemia

Question 5

2 Drug Mx of hyperthyroid

Answer 5

carbimazole

propythiouracil

Question 6

2 specific signs for graves

Answer 6

exophthalmos
pretibial myxoedema
thyroid acropatchy

Question 7

difference between nephrogenic/cranial Diabetes Insipidus

Answer 7

Cranial - lack of ADH secretion
[Mx-Desmopressin]

Nephrogenic - lack of response to ADH

Question 8

How does water deprivation test diagnose DI

Answer 8

lack of water
The body should concentrate urine and decrease output

in DI - still large volumes with low osmolality

Question 9

Advice pose hypo in diabetic

Answer 9

regular finger prick monitoring
never miss meals
keep emergency glucose in pocket

Question 10

2 causes of hypo in non diabetic

Answer 10

liver failure
addisons
insulin secreting tumour
alcohol binge

Question 11

2 macrovascular comps of diabetes?

mico?

Answer 11

CV disease / stroke
MI
IHD
Peripheral vascular disease

Nephropathy, retinopathy, neuropathy

Question 12

Teen with high blood glucose

suspected DKA - what test for Dx

Answer 12

urine dipstick - ketonuria

Question 13

Key tests for addisons ?>

Electrolytes in crisis?

Answer 13

U+E, Synacthen test
HypoGly
HyperK
HypoNa -> Hypotensive

Question 14

Advice to person with addisons

Answer 14

Medical alert bracelet
carry emergency ampule of hydrocortison
need to change dose if sick

Question 15

3 Mx options for Prolactinoma

Answer 15

transphenoidal surgery
bromocriptine [D agonist]
radiotherapy

Question 16

primary HPT Ix

Answer 16

PTH high, phosphate low
DEXA scan,
Abdo XR 
CT/MRI
USS

Question 17

2 comps of parathyroid surgery

Answer 17

hypoPTH

Laryngeal nerve palsy