Endocrinology

Question 1

What is the normal preprandial blood sugar range?

Answer 1

4 to 5.9 mmol/L OR
72 to 100 mg/dL

Question 2

What is the normal postprandial blood sugar range?

Answer 2

< 7.8 mmol/L OR
<140 mg/dL

Question 3

TFT low TSH, high T4
Dx and Mx?

Answer 3

Thyrotoxic

Management
• β- blocker: propranolol, atenolol for symptoms
• Carbimazole: inhibit synthesis of thyroid hormone
o Not for thyroiditis
o Can give short term before radioactive I or surgery
o Long- term (12-18months) to induce remission
o SE: agranulocytosis, hepatitis, aplastic anemia, SLE- like
• 131I: radioactive- need 3-4 months to work, TFT monitoring
o If on carbimazole, stop >4 days before and >3 after
o Avoid pregnancy for 4 months
o Risk of thyroid malignancy
• Surgery: partial or total thyroidectomy. Risk damage to PT, RLN

Question 4

TFT: high TSH, low T4
Dx and Mx?

Answer 4

Hypothyroidism

Management
• <65: lexothyroxine 100mcg. Check TFT after 4-6wksàyearly
• Elderly/ with heart disease: levothryoxin 25mg then increase
every 4-6 weeks (+ propranolol bc can provoke angina)
• Overcorrection = AF and osteoporosis
• Need for life time

Question 5

What drug increases risk of hypothyroidism

Answer 5

Amiodarone