Endocrine

Question 1

Mineralocorticoid SEs (5)

Answer 1

HTN, hypernatraemia, hypokalaemia, hypocalcaemia, water retention

Question 2

Glucocorticoid SEs (4)

Answer 2

Diabetes, osteoporosis, psychiatric reaction, muscle wasting

Question 3

Which type are most steroids that we use?

Answer 3

Glucocorticoid

Question 4

Main side-effects of steroids (7)

Answer 4

Insomnia, GI disturbances, increased risk of infections, psychiatric reactions, impaired wound healing, adrenal suppression (prolonged use), growth retardation in children

Question 5

Why do we need to avoid abrupt withdrawal of steroids

Answer 5

Risk of acute adrenal insufficiency

Question 6

Target HbA1C

Answer 6

48 if on diet-controlled/metformin/pregnancy

53 if on other antidiabetic drugs

Question 7

What should you glucose be in T1DM in order to be able to drive

Answer 7

at least 5 mmol/L

Question 8

Which insulin regimen is 1st line

Answer 8

Multiple daily basal bolus ijection regimen

Question 9

Examples of long-acting insulins

Answer 9

Determir, Glargine, Degludec

Question 10

Example of intermediate insulin

Answer 10

Isophane

Question 11

Which anti-diabetic class is associated with hypoglycaemia & weight gain

Answer 11

Sulphonylureas

Question 12

Which anti-diabetic class is associated with DKA

Answer 12

Na-glucose co-transporters

Question 13

When can semaglutide/dulaglutide/liraglutide be initiated?

Answer 13

Only if triple therapy fails

and patient is obese, BMI >35

Question 14

Which combination you should avoid in triple therapy for T2DM

Answer 14

Dapagliflozin + pioglitazone

Question 15

What is the first line if Metformin is contraindicated/not tolerated

Answer 15

Suphonylureas

Question 16

If insulin is initiated in T2DM, what changes should you make to previous treatment regimens?

Answer 16

Stop everything except metformin

Question 17

Which non-diabetic treatment should be given to pregnant women with diabetes?

Answer 17

Folic acid 5mg

Question 18

Which diabetic medications are safe in pregnancy?

Answer 18

Metformin and insulin

Question 19

Which side-effect is common for DPP4s and GLP-1s?

Answer 19

Acute pancreatitis

Question 20

Management of hypoglycaemia

Answer 20

10-20g of oral glucose 1st line

Glucagon injection if oral route inaccessible

IV 20% Glucagon infusion if no imporvement

Question 21

Which bisphosphonate is administered IV?

Answer 21

Zolendronic acid

Question 22

Dose of Alendronic acid

Answer 22

10mg daily or 70mg weekly

Question 23

What do you need to ensure/address before starting bisphosphonate treatment?

Answer 23

Correct deficiencies, especially Ca and vit D

Question 24

HRT treatment for women with and without uterus

Answer 24

With uterus - oestrogen + cyclical/continuous progesterone

Without uterus - oestrogen only

Question 25

Effects on cancer risks for progesterone

Answer 25

Increased risk of breast cancer Reduced risk of endometrial cancer

Question 26

HRT risks and side-effects (4)

Answer 26

VTE, stroke, PE, breast & endometrial cancer

Question 27

Stop requirements for HRT and contraceptives (7)

Answer 27

``` Severe chest pain Severe breathlessness Severe abdominal pain Suspected VTE Neurological reactions BP >160 Hepatitis/jaundice ```

Question 28

Treatment options for heavy periods (3)

Answer 28

IUD with levonorgestrel CoC Tranexamic acid

Question 29

1st line for Hyperthyroidism

Answer 29

Carbimazole