endocrine

Question 1

what is the biochem of addisons disease?

Answer 1

hyponateamic
hyperkalaemic
low glucose
low cortisol

*metabolic acidosis if acute

Question 2

what is the test for addisons?

Answer 2

short synacthen test

Question 3

what is the treatment of acute and long-term hypoadrenalism?

Answer 3

acute:

• steroids (hydrocortisone IV)
• fluids (saline)
• glucose

long-term:

• Glucocorticoids - prednisalone or hydrocortisone
• mineralcorticoids - fludrocortisone

Question 4

elderly females with an unquenchable thirst and an inappropriately normal or raised parathyroid hormone level.

Answer 4

primary hyperparathyroidism

associated with hypertension and MEN1

Features - ‘bones, stones, abdominal groans and psychic moans’
polydipsia, polyuria
peptic ulceration/constipation/pancreatitis
bone pain/fracture
renal stones
depression
hypertension

pepperpot skull is a characteristic X-ray finding of hyperparathyroidism