Endocrinology

Question 1

Addisons clinical findings

Answer 1

Hyperkalaemia
Hyponatraemia
Hypotension
Hypoglycaemia

Question 2

Hyperaldosteronism Na/ K

Answer 2

Hypernatraemia

Hypokalaemia

Question 3

What is cushings Disease?

Answer 3

ACTH producing pituitary adenoma >bilateral adrenal hyperplasia

Question 4

ACTH dependent causes of Cushings syndrome

Answer 4

Cushings disease, ectopic from SCLC, carcinoid

Question 5

Cushing’s syndrome clinical findings

Answer 5

Hypertension
Hypernatraemia
Hypokalaemia
Hyperglycaemia
Metabolic acidosis
ACTH > pigmentation

Question 6

ACTH-independent causes of Cushing’s syndrome

Answer 6

Adrenal adenoma/cancer
Adrenal nodular hyperplasia
Steroids
Carney complex
McCune–Albright syndrome

Question 7

Dexamethasone suppression test uses

Answer 7

For Cushing’s syndrome.
If ACTH dependent - dexamethasone suppresses ACTH > low cortisol.
Ectopic ACTH - needs high dose suppression.

ACTH independent (no feedback) so no suppression.

Question 8

Addison’s Test

Answer 8

Short ACTH stimulation test -Synacthen
Do plasma cortisol before and 1⁄2h after tetracosactide (Synacthen®) 250μg IM. Addison’s is excluded if 30min cortisol >550nmol/L.

Question 9

Addison’s disease adrenal autoantibodies

Answer 9

anti-21-hydroxylase