Endocrinology

Question 1

Causes of raise prolactin

Answer 1

pregnancy
prolactinoma
physiological
polycystic ovarian syndrome
primary hypothyroidism
phenothiazines, metoclopramide, domperidone

Question 2

Specific test in suspected Addison’s

Answer 2

Short Synacthen test/short ACTH test (ACTH analogue)

Insulin tolerance test - if cortisol increases >550nmol/L addions is excluded

Question 3

Specific test in suspected Acromegaly

Answer 3

Oral Glucose Tolerance Test

Question 4

Pathophysiology of clubbing

Answer 4

This describes an increase in the soft tissue around the end of the fingers and toes. The swelling is painless and usually bilateral, unless a localised vascular abnormality exists. There is no change to the underlying bone. The nail base eventually becomes convex and extends halfway up the nail.

Clubbing is thought to result from changes to the volume of interstitial fluid and increased blood flow to the area but the exact pathophysiology remains unknown.

Question 5

What is acropachy?

Answer 5

Thyroid acropachy describes clubbing in association with Graves’ disease with additional swelling of the fingers and periosteal new bone formation.

Question 6

Specific test in suspected Cushings

Answer 6

Dexamethasone suppression test