Endocrinology

Question 1

Normal fasting glucose levels:

Answer 1

Normal - <=6 mmol/l - prediabetes - >=7mmol/l - DM

Question 2

Normal HbA1c levels:

Answer 2

Normal - <=41 mmol/l - prediabetes - >=48mmol/l - DM

Question 3

Mnemonic for diabetes drugs:

Answer 3

Gli-Sulfonylureas
Glitazo-lidinediones
SITagliptine- Sit chair 4 legs- DPP4
SGLT2-flozin between 2 teeth
GLP-1 GLuPtides

Question 4

Suspected acromegaly, IGF-1 raised, next step:

Answer 4

OGTT to confirm lack pf GH suppression

Question 5

Hypothermia and confusion, may present with eyes and legs oedema, reduced respiratory drive, pericardial effusions, anaemia, seizures, and other symptoms of hypothyroidism, diagnosis:

Answer 5

Myxoedema coma

Question 6

First line treatment for prolactinoma:

Answer 6

Dopamine agonists (cabergoline, bromocriptine)

Question 7

Which conditions can give falsely low HbA1c readings?

Answer 7

Sickle cell anaemia and other haemoglobinopathies, due the decreased lifespan of RBCs

Question 8

Which medication may result in suboptimal hypothyroidism treatment?

Answer 8

Iron / calcium carbonate tablets can reduce the absorption of levothyroxine, give them 4 hours apart

Question 9

DM2 drug that may cause weight gain and hypoglycaemic episodes:

Answer 9

Sulfonylureas

Question 10

Standard HbA1c target in type 2 diabetes mellitus:

Answer 10

48 mmol/mol.
53 mmol/mol if started on a second agent, or if receiving a medication that carries the risk of hypoglycaemia

Question 11

DM2 drug that increases risk of urinary tract infections:

Answer 11

SGLT-2 inhibitors

Question 12

Addison’s disease management:

Answer 12

Hydrocortisone + fludrocortisone

Question 13

Thyroid values in sick euthyroid syndrome:

Answer 13

Low T3/T4 and normal TSH with acute illness

Question 14

First-line treatment for symptomatic hypercalcaemia:

Answer 14

IV 0.9 saline, for dehydration

Question 15

Significant smoking history, weight loss, respiratory symptoms, and a mass on CXR, and hyponatraemia, diagnosis:

Answer 15

Small-cell lung cancer. SIADH is a common complication

Question 16

Indications for IV calcium gluconate, 10ml of 10% solution over 10 minutes

Answer 16

Carpopedal spasm, tetany, seizures or prolonged QT interval

Question 17

Drugs that can cause raised prolactin

Answer 17

Prochlorperazine, metocloPramide, domPeridone

Question 18

Increased secretion of adrenocorticotropic hormone (ACTH) from the anterior pituitary

Answer 18

Cushing’s disease

Question 19

electrolyte abnormality in Cushing’s syndrome:

Answer 19

Hypokalaemic metabolic alkalosis.
Increased cortisol acts like aldosterone, potassium depletion causes increased bicarbonate reabsorption.