endocrine disorders

Question 1

Addison’s disease electrolytes

Answer 1

hyperkalaemia, hyponatraemia, hypoglycaemia

hypotension, hyperpigmentation, lethargy

Question 2

Conn’s syndrome electrolytes

Answer 2

hypokalaemia, hypertension, alkalosis, no similar family history, raised aldosterone

Question 3

biochem presentation of vitamin b12 deficiency

Answer 3

low Hb, high MCV, normal platelets

Question 4

what is SIADH

Answer 4

large amounts of ADH
> the water dilutes the sodium in the blood > hyponatraemia
> euvolaemic hyponatramia

Question 5

what does ADH do

Answer 5

stimulates water reabsorption from collecting ducts

Question 6

impact of SIADH on kidneys

Answer 6

high urine osmolality

high urine sodium

Question 7

presentation of SIADH

Answer 7

headache 
fatigue 
muscle aches and cramps
confusion 
sever hyponatraemia> seizures

Question 8

causes of SIADH

Answer 8

infection (atypical pneumonia)
head injury > subarachnoid haemorrhage
medications (thiazide diuretics, carbamazepine)
small cell lung cancer

Question 9

management of SIADH

Answer 9

treat the cause
correct sodium slowly
fluid resus
tolvaptan (ADH receptor blockers)

Question 10

presentation of hashimotos thyroidits

Answer 10

goitre
TSH high
T3, T4 low

Question 11

presentation of a thyroid storm

Answer 11

rare

severe presentation of hyperthyroidism- pyrexia, tachycardia, delirium

Question 12

de quervain’s thyroiditis

Answer 12

presentatioin of a viral infection with fever, neck pain and tenderness, dyshpagia and features of hyperthyroidis,

Question 13

treatment of de quervain’s thyroiditis

Answer 13

NSAIDs for pain and inflammation

BB for symptom relief

Question 14

most common cause of acromegaly

Answer 14

pituitary adenoma

Question 15

bitemporal hemianopia

Answer 15

loss of vision on the outer half of both eyes due to pituitary tumour compressing on optic chasm

Question 16

presentation of acromegaly

Answer 16

headaches, visual field defects
overgrowth of tissues: promients facial features, nose, tongue, jaw
large hands and feet
arthritis 
hypertrophic heart 
hypertension
diabetes

Question 17

presentation of big non functioning pituitary adenoma

Answer 17

compression on optic chiasm

compression on other structures (cranial nerves 3,4,6)

Question 18

drugs causing increased prolactin

Answer 18

dopamine antagonists (metoclopramide)
antipsychotics
antidepressants
osestrogen
cocain

Question 19

female presentation of raised prolactin

Answer 19

early 
galactorrhoea
menstrual irregularity 
infertility
amenorrhoea

Question 20

male presentation of raised prolactin

Answer 20

late presentation 
galactorrhoea 
menstrual irregularity 
visual field abnormality
anterior pituitary malfunction

Question 21

prolactin investigations

Answer 21

serum prolactin concentration
MRI pituitary 
visual field 
PFT
TFT

Question 22

prolactinoma treatment

Answer 22

dopamine agonists: cabergoline, bromocriptine, quinagolide

Question 23

treatment of acromegaly

Answer 23

surgery
radiotherapy
medical: somatostatin analogues: sandostatin
dopamine agonists

Question 24

management of a thyroid storm

Answer 24

supportive care 
anti-arrhythmic medication
betablockers 
propylthiouracil
radio-iodine

Question 25

pathophysiology of pheochromocytoma

Answer 25

tumour of the chromaffin cells that secretes unregulated amounts of adrenaline

Question 26

type of hormone is adrenaline

Answer 26

catecholamine

Question 27

associated condition with pheochromocytoma

Answer 27

MEN2

Question 28

diagnosis of pheochromocytoma

Answer 28

24 hour urine catecholamines

plasma free metanephrines

Question 29

presentation of pheochromocytoma

Answer 29

symptoms fluctuate throughout the day
anxiety 
headaches
sweating 
hypertension 
palpitations, tachycardia, afib

Question 30

management of pheochromocytoma

Answer 30

alpha blockers- phenoxybenzamine
bb
adrenalectomy