Endocrinology

Question 1

PTH level in primary hyperparathyroid?

what is calcium and phosphate?

Answer 1

PTH can be normal / high

calcium is high
phosphate is low

Question 2

causes of primary Hyperparathryoidism?

Answer 2

pituitary adenoma

bilateral hyperplasia
multiple adenoma

Question 3

management of acute DKA?

what should insulin be?

Answer 3

fixed rate insulin

continue long acting
hold short acting

Question 4

intravenous infusion rate of insulin for DKA includes?

Answer 4

0.1 unit/kg/hour of insulin
aim is to reduce ketones

Question 5

when should you add dextrose infusion

Answer 5

once glucose <14mmol

start 10% dextrose infusion rate of 125ml / hour

Question 6

primary hyperaldosteronism

how to differentiate between bilateral hyperplasia and conns?

Answer 6

Adrenal venous sampling

Question 7

T2DM
mx

if triple therapy fails?

Answer 7

switch a drug to either
GLP-1 mimetic

insulin

Question 8

2nd line T2DM

Answer 8

if not able to get under 58 mmol
7.5%

dual therapy

metformin

metformin + DPP-4 inhibitor
metformin + pioglitazone
metformin + sulfonylurea
metformin + SGLT-2 inhibitor

Question 9

example of a Dpp-4 inhibitor?

Answer 9

act on incretin system
DPP-4 usually breaks down GLP-1

Sitagliptin is an example

Question 10

pioglitazone MOA and example
negative s/e

Answer 10

thiazolidinedione

improves insulin sensitivity

weight gain
worsen HF

Question 11

Sulfonyureas

Answer 11

cause release of insulin from beta pancreatic cells

Glipizide

Question 12

SGLT2 inhibitors?

Answer 12

dapagliflozin

Question 13

most common cause of malignancy thyroid?

Answer 13

papillary carcinoma

Question 14

First line in thryoid nodules?

Answer 14

ultrasonograohy

Question 15

High-dose dexamethasone suppression test with a pituitary adenoma
affects on cortisol?
on acth?

Answer 15

cortisol not suppressed
ACTH suppressed

Question 16

an HBA1c of what is considered diagnostic if patient also has symptoms?

Answer 16

HBa1c of 48mmol >

6.5%

Question 17

Random glucose test diagnostic of T2DM?

Answer 17

11.1

Question 18

fasting glucose?

Answer 18

7.0 mmol/l

Question 19

what is pre diabetes?

Answer 19

42-47
6.0-6.4%

Question 20

OGTT impaired fasting glucose?

Answer 20

OGTT 2-hour value greater than or equal to 7.8 mmol/l but less than 11.1 mmol/l

Question 21

Diffusely reduced uptake of radioactive iodine-131

is shown in what?

Answer 21

subacute de quervein thyroiditis

Question 22

High-dose dexamethasone suppression test with an ectopic source of ACTH

Answer 22

not suppressed
not suppressed

Question 23

tender goitre and hyperthyroid signs

Answer 23

subacute (De Quervain’s) thyroiditis

Graves is not tendeer

Question 24

is the single most important blood test to assess a patient’s response to treatment with levothyroxine for Hashimoto’s thyroiditis.

Answer 24

TSH

Question 25

what is klinefelters?

Answer 25

47 XXY
primary hypogonadism

testicular failure

Question 26

neoplastic lesions in the pituitary gland
parathyroid gland
pancreas

Answer 26

multiple endocrine neoplasia type 1

all p’s

Question 27

multiple endocrine neoplasia 2?
2a

Answer 27

2p’s

parathyroid
phaeochromocytoma

Question 28

men type 2b?

Answer 28

medullary thyroid cancer
1P
phaechromocytome

marfanoid

Question 29

prednisolone / glucocorticoids can cause?

Answer 29

neutrophilia

Question 30

what is the difference between impaired fasting glucose

impaired glucose tolerance

Answer 30

impaired fasting is on a fasting plasma

6.1- 6.9

Impaired glucose tolerance is on an OGTT

7.8-11

Question 31

congenital androgen insensitivity syndrome

Answer 31

phenotype is female - female genitalia

genotype is male

Question 32

diabetic neuropathy

GI

Answer 32

Gastroparesis
GORD
chronic diarrhoea

Question 33

what is the pathophysiology of gastroparesis?

Answer 33

sensory loss from diabetes
autonomic
neuropathy

Question 34

what is the trademarks of gastroparesis?

Answer 34

delayed gastric emptying (due to autonomic dysfunction = erratic BM)

bloating
nausea
early satiety
vomiting

Question 35

why does cushing cause hypokalaemia metabolic alkalosis?

Answer 35

excess of cortisol production
= sodium and water retention
=htn

and hypokalaemia

Question 36

hypoglycaemia mx?

Answer 36

oral glucose 10-20
quick-acting carbohydrate

intravenous 20% glucose solution

Question 37

modifiable risk factor for development of thyroid eye disease?

Answer 37

smoking

Question 38

thyroid eye disease presenting with change

Answer 38

Any change in vision with thyroid eye disease requires urgent review by a specialist

Question 39

Mx DKA

Answer 39

1st line isotonic saline - fluid !!!

fixed rate insulin
when glucose <14 add 10% dextrose

check and manage potassium 1u/kg/day

Question 40

which class of antidiabetics are good for weight loss>?

Answer 40

Dpp-4 inhibitors

GLP1 mimetics (obvi)

Question 41

Primary hyperaldosteronism management?

Answer 41

spironolactone

Question 42

thiazides cause which electrolyte abnormality?

Answer 42

hypercalcaemia

Question 43

T1DM how often should you monitor as a minimum?

Answer 43

4 times before bed and every meal

Question 44

Blood glucose targets
T1DM

on waking

Answer 44

5-7 mmol

Question 45

Blood glucose targets
T1DM
after meals?

Answer 45

4-7 mmol/l

Question 46

regime of choice for t1dm?

Answer 46

twice-daily insulin detemir
Once-daily insulin glargine or insulin detemir