endocrinology

Question 1

what accounts for 60-80% of hyperthyroidism cases?

Answer 1

Graves disease (thyroid receptor antibodies)

Question 2

graves disease can cause what to the eyes?

Answer 2

Exopthalmous

Question 3

hyperthyroid drug treatment?

Answer 3

Symptoms - Propranolol (non selective)

1st line = Carbimazole (agranulocytosis)

Question 4

TFT of secondary hypothyroidism?

Answer 4

Low free hormones and TSH

Question 5

peak flow worse in mornings is…

Answer 5

diurnal variability (>20% difference)

Question 6

samter’s triad

Answer 6

asthma, nasal polyps, aspirin sensitivity

Question 7

asthma diagnosis?

Answer 7

> 15% improvement in PEFR after reliever or inhaled steroids

Question 8

which pathogen cause desaturation on exertion?

Answer 8

Pneumocystis jiroveci

Question 9

what should yu be careful with when taking rifmapicin?

Answer 9

oral contraception and warfarin

P450 inducer!!

Question 10

anti-TPO antibody =

Answer 10

hashimoto’s thyroiditis

Question 11

first line test for acromegaly?

Answer 11

serum IGF-1

Question 12

treatment of thyroid storm?

Answer 12

propylthiourcil, hydrocortisone, beta blockers

Question 13

features of SIADH?

Answer 13

euvolaemic hyponatraemia with low serum osmolality

high urine osmolality

high urine sodium

Question 14

first line treatment for SIADH?

Answer 14

fluid restriction

Question 15

most common cause of cortisol excess?

Answer 15

exogenous steroid use (NOT ACTH secreting tumour)

Question 16

posterior pituitary hormones?

Answer 16

Oxytocin

ADH

Question 17

what is osmolality?

Answer 17

concentration of solution expressed as total number of solute particles per kilogram

Question 18

test for diabetes insipidus?

Answer 18

water deprivation test - measure osmolality (urine will maintain low osmolality while plasma osmolality will increase)
then given ADH and urine will concentrate, or not, if kidney problem

Question 19

features of SIADH?

Answer 19

low plasma sodium
low plasma osmolality
high urine sodium
high urine osmolality

treat underlying cause + fluid restriction

Question 20

describe Addisons?

Answer 20

adrenal insufficiency
hyperpigmentation
postural hypotension
depression

Question 21

investigation for addison’s?

Answer 21

Synacthen test

Question 22

treatment for Addison’s?

Answer 22

Hydrocortisone
+
Fludrocortisone (if primary cause)

Question 23

describe Addisonian Crisis

Answer 23

hypotension + Coma
Bloods = low sodium and high potassium

causes = acute stress e.g. infection, trauma