Endocrinology

Question 1

Ix & mx pheocromocytoma

Answer 1

24hr urinary metanephrines

stabilise with a+b blockers –> surgery

Question 2

addison’s presentations & distinguish from 2ry adrenal insufficiency

Answer 2

lethargy, weakness, anorexia, N/V, wt loss, salt-craving
hyperpigmentation, hypotension, hypoglycaemia
hyponatraemia & hyperkalaemia

hyperpigmentation only in addison’s

Question 3

subclinical hyperthyroidism is associated with

Answer 3

AF, osteoporosis, dementia

Question 4

calcitonin a tumour marker of

Answer 4

medullary thyroid cancer

Question 5

cushing’s syndrome ABG

Answer 5

hypokalaemic metabolic alkalosis

Question 6

addison’s hydrocortisone mx

Answer 6

split with the majority given in the first half of the day

Question 7

… may lead to the development / worsening of thyroid eye disease in up to 15% of patients with Grave’s disease

Answer 7

Radioiodine treatment

Question 8

tx of crises
- thyroid storm
- addisonian
- neuroleptic malignant syndrome
- myasthenia gravis crisis

Answer 8

• IV hydrocortisone, propanolol, IV fluids
• hydrocortisone, fluids, glucose, antibiotics
• dantrolene, lorazepam
• plasmapheresis, IV immunoglobulin

Question 9

this is a non-selective alpha-blocker used for the management of hypertension associated with phaeochromocytoma and used prior to surgical removal

Answer 9

Phenoxybenzamine (then beta blockers)

Question 10

Check … in patients who have subclinical hypothyroidism as this can indicate patients who are more likely to progress to overt hypothyroidism

Answer 10

thyroid peroxidase antibodies

Question 11

Pepperpot skull is a characteristic X-ray finding of

Answer 11

hyperparathyroidism
(xs urination, abdo pain, tiredness)

Question 13

nuclear scintigraphy reveals
- patchy uptake
- Diffusely and increased activity with a decreased background
- Trace or absent uptake

Answer 13

• toxic multinodular goitre
• Grave’s
• inflammation/destruction of thyroid tissues