Endocrinology

Question 1

How to you diagnose diabetes mellitus in a symptomatic patient?

Answer 1

1 Blood Test of:
Fasting plasma glucose >7.1mmol/L
Random glucose

Question 2

When is HbA1c not diagnostic of diabetes?

Answer 2

Pregnancy, children, T1DM

Question 3

How do you diagnose diabetes mellitus in an asymptomatic patient?

Answer 3

2 Blood Test’s of:
Fasting plasma glucose >7.1mmol/L
Random glucose

Question 4

What are first and second line treatments for diabetes mellitus?

Answer 4

1st Line: Metformin

- If 16 weeks later HbA1c is still >53mmol/L then add Glicazide (a sulfonylurea) as second line

Question 5

What is the hallmark feature of pre-proliferative diabetic retinopathy?

Answer 5

Cotton wool spots

Question 6

What is the hallmark feature of proliferative diabetic retinopathy?

Answer 6

Neovascularisation

Question 7

What is the steps for neuropathic pain for a patient with diabetes?

Answer 7

Paracetamol
TCA
Duloxetine 
Gabapentin
Opioids

Question 8

What is the definition of hypoglycemia?

Answer 8

Glucose

Question 9

How do you treat a patient with hypoglycemia in conscious or unconscious patients?

Answer 9

Give sugary food (2 teaspoons sugar 10-20g)

If Px is unconcscious then give IV glucose 20% (80ml)

Question 10

In DKA what is done first, fluid resuscitation or insulin administration?

Answer 10

Fluids!

Question 11

Low T4, High TSH is a pattern of what thyroid disease?

Answer 11

Hypothyroidism

Question 12

What is the most common cause of hyperthyroidism?

Answer 12

Graves disease (2/3 of cases)

Question 13

A patient has a painful lump in their thyroid, hyperthyroidism and a raised ESR, what is the most likely diagnosis?

Answer 13

De Quervains hyperthyroid

Question 14

What advice must be given regarding carbimazole in pregnancy?

Answer 14

Contra-indicated in the first trimester of pregnancy

Question 15

What are the three main causes of Goitre?

Answer 15

Graves
Iodine deficiency
Hashimoto’s thyroiditis

Question 16

Stones, bones, abdominal moans and psychic groans is a common description of?

Answer 16

Primary hyperparathyroidism

Question 17

What is the main cause of primary hyperparathyroidism?

Answer 17

Adeoma of the parathyroid (80%)

Question 18

What is the difference between osteomalacia and ricketts?

Answer 18

Osteomalacia: In adults
Ricketts: In children
Both are due to low vitamin D, there is just a different name for before and after the epiphesial plates close

Question 19

What is produced by the zona glomerulosa of the adrenal gland?

Answer 19

Mineralocorticoid

Aldosterone

Question 20

What is produced by the zona fasciculata?

Answer 20

Glucocorticoid

Cortisol

Question 21

What is produced by the zona reticularis?

Answer 21

Androgens

Question 22

If you suspect a gland may be overactive, what is the best way to investigate it?

Answer 22

Try suppressing the gland

- E.g. dexamethosone suppression test for cushings

Question 23

Hypertension, hypokalaemia and alkalosis is suggestive of what disorder?

Answer 23

Conn’s syndrome- Hyperaldosteronism

Aldosterone promotes loss of potassium, and the potassium takes H+ out with it

Question 24

Lean, tanned, tired and tearful with unexplained abdo pain and vomiting is classical of which endocrine syndrome?

Answer 24

Addisons disease

Question 25

Tachycardia, sweating, headache, palpitations, tremor, hypertension, what do you suspect?

Answer 25

Phaeochromocytoma

Question 26

What drug most commonly causes gynaecomastia?

Answer 26

Spironolactone

Question 27

Polyuria, polydipsia, dehydration are key signs of?

Answer 27

Diabetes insipidus

Question 28

What test do you do to diagnose diabetes insipidus?

Answer 28

Fluid deprivation test with desmopression (DDVAP)