endocrine disease

Question 1

agranulocytosis

Answer 1

side effect of antithyroid drugs
low WCC
inform patient of risk before treatment ie if they get a sore throat to go to the GP

Question 2

severe grave’s eye disease

Answer 2

indications that radioactive iodine therapy can make this worse

Question 3

subclinical hyperthyroidism

Answer 3

suppressed TSH (may also have other causes)
normal T3 & T4

low TSH: pituitary or hypothalamic insufficiency eg adenoma

Question 4

dexamethasone suppression tests

Answer 4

would expect cortisol to drop after dexamethasone. if not then:
48h low dose:
if failure to suppress, perform 48h high dose
if response now likely cause is at the pituitary level
if no response, ectopic ACTH suspected