Endocrinology

Question 1

Physiological causes of hyperprolactinaemia

Answer 1

Pregnancy
Lactation
Stress
Exercise
Sleep
Post-ictal period
Chest wall surgery

Question 2

Pathological causes of hyperprolactinaemia

Answer 2

Drugs e.g. antipsychotics, SSRIs, antiemetics
Prolactinoma/other cerebral tumour
Ectopic prolactin synthesis

Question 3

Female-specific symptoms of hyperprolactinaemia

Answer 3

Oligomenorrhoea/amenorrhoea
Galactorrhoea (not pregnant or breastfeeding)
Vaginal dryness
Acne
Hirsutism

Question 4

Male-specific symptoms of hyperprolactinaemia

Answer 4

Erectile dysfunction
Decreased body + facial hair
Gynaecomastia

Question 5

General symptoms of hyperprolactinaemia

Answer 5

Low bone density
Reduced pituitary hormone production
Reduced libido
Headaches
Visual disturbances
Infertility

Question 6

Medical management of prolactinoma

Answer 6

Dopamine-agonist e.g. cabergoline –> inhibits release of prolactin

Question 7

Symptoms of hypocalcaemia

Answer 7

Tetany: muscle twitching, cramping, spasm
Perioral paraesthesia
Trousseau’s sign
Chvostek’s sign

Question 8

Trousseau’s sign

Answer 8

Carpal spasm if brachial artery occluded
Wrist flexion + fingers drawn together

Question 9

Chvostek’s sign

Answer 9

Tapping over parotid causes facial muscles to twitch

Question 10

ECG changes in hypocalcaemia

Answer 10

Prolonged QT interval
May see U waves

Question 11

ECG changes in hypokalaemia

Answer 11

Flattened T-waves

Question 12

ECG changes in hyperkalaemia

Answer 12

Tall, tented T waves

Question 13

ECG changes in hypercalcaemia

Answer 13

Shortened QT interval