Endocrinology

Question 1

Describe a hypercalcaemic crisis

Answer 1

Intermittent confusion
Non-specific abdominal pain
Constipation
urine/chest infection may accompany

Question 2

What is the order of the three aspects of the optic chain?

Answer 2

Optic nerve
Optic chiasm
Optic tract

Question 3

What will a lesion in the optic chiasm cause?

Answer 3

Bitemporal hemianopia

Question 4

What will a lesion in the optic tract cause?

Answer 4

Homonymous hemianopia

Question 5

What will a lesion in the optic nerve cause?

Answer 5

Unilateral loss of vision

Question 6

Ketoconazole is used to treat what condition?

Answer 6

Cushing’s.

Question 7

What may be a cause of High TSH, normal T4?

Answer 7

Patient not being compliant with medication - taken Thyroxine before consultation - TSH has not had time adjust.

Question 8

What are the treatment choices for mineralocorticoid deficiency Vs. glucocorticoid deficiency?

Answer 8

Mineralocorticoid deficiency = fludrocortisone

Glucocorticoid deficiency = hydrocortisone

Question 9

What is the most common ECG presentation in a pulmonary embolism?

Answer 9

Sinus tachycardia

Question 10

What is the most common cause of Cushing’s syndrome?

Answer 10

Glucocorticoids NOT adenoma.

Question 11

How does the oral dexamethasone suppression test work?

Answer 11

Patient takes dexamethasone at night and 9am cortisol is measured the next day. ACTH should be low if normal (<50nmol/L). Dexamethasone will inhibit ACTH.

Question 12

What will urine osmolarity be like in SIADH?

Answer 12

High.

Question 13

What impact does insulin have on potassium levels?

Answer 13

Insulin will lower potassium levels. Must give KCL with Insulin.

Question 14

What is key about carcinoid tumours?

Answer 14

Metastatic spread of primary carcinoid tumours. Breakdown of serotonin (5HT) products. Heart disease in 50-60% carcinoid syndrome.

Question 15

What is the role of alpha-interferon in carcinoid tumours?

Answer 15

Reduce size of tumours.

Question 16

Which antibody is specific for Grave’s disease?

Answer 16

Anti-TSH antibodies.

Question 17

Which hyperthyroid medication may cause agranulocytosis as a side effect?

Answer 17

Carbimazole.

Question 18

Name one side effect of Propylthiouracil.

Answer 18

Nephritis.

Question 19

What is the most likely cause of SIADH?

Answer 19

Small cell lung carcinoma.

Question 20

How do we treat hypercalcaemia?

Answer 20

Bisphosphanates

Question 21

Which test is used for phaeochromocytomas?

Answer 21

MIBG scan.

Question 22

What will calcium look like in chronic renal failure?

Answer 22

Low calcium.

Question 23

What can cause chronic renal failure and anaemia?

Answer 23

Myeloma.

Question 24

Which systems does Goodpasture’s syndrome impact?

Answer 24

Lung and renal involvement.

Question 25

Increase in urea, creatinine and potassium could point toward what?

Answer 25

Acute kidney injury.

Question 26

Do we treat hyperkalaemia or hypokalaemia with dialysis?

Answer 26

Hyperkalaemia.

Question 27

Name a medication that we can treat hyperkalaemia with.

Answer 27

Calcium Gluconate.

Question 28

What do we use Vancomycin to treat?

Answer 28

MRSA.

Question 29

What type of bacteria are staphylococcus aureus and streptococcus pyogenes?

Answer 29

Gram positive cocci.

Question 30

What type of bacteria is Neisseria Meningitidis.

Answer 30

Gram negative cocci.

Question 31

Name a medication we can use to treat malaria.

Answer 31

Artesunate.

Question 32

What is the first line treatment for sepsis?

Answer 32

Ceftriaxone.

Question 33

What is the most common complication of bacterial meningitis?

Answer 33

Sensorineural deafness.

Question 34

What must we exclude before diagnosing essential hypertension?

Answer 34

Conn's and phaeochromocytoma.

Question 35

Which skin condition can be seen in hypothyroidism?

Answer 35

Vitiligo also separately - menorrhagia.

Question 36

What do TSH and T4 levels look like in primary hypothyroidism?

Answer 36

High TSH, low T4.

Question 37

Which is the most common cause of primary hypothyroidism?

Answer 37

Hashimoto's disease.

Question 38

What is Conn's syndrome?

Answer 38

High aldosterone.

Question 39

If aldosterone and renin are both high, which differential diagnosis does this point toward?

Answer 39

Renal artery stenosis. In Conn's syndrome, aldosterone will be high but not renin; aldosterone is high alone not as a result of increased renin production.

Question 40

What is the first step in managing phaeochromocytomas?

Answer 40

alpha blockers

Question 41

In which grade hypertension is papilloedema seen?

Answer 41

Grade 4

Question 42

Describe grade 3 hypertension

Answer 42

Cotton wool spots, flame-shaped haemorrhages.

Question 43

What is Methotrexate?

Answer 43

Folic acid antagonist.

Question 44

Describe the transferrin levels in Iron deficiency anaemia.

Answer 44

High transferrin.

Question 45

What is the first step in management of hyponatraemia?

Answer 45

Fluid restriction.

Question 46

When do we give saline?

Answer 46

Hypovolaemia - not euvolaemia nor hypervolaemia.

Question 47

Which test do we perform to diagnose Cushing's?

Answer 47

High dose dexamethasone test.

Question 48

How do we treat hyperkalaemia?

Answer 48

Calcium gluconate first, then insulin.

Question 49

What is a treatment for Paracetamol overdose?

Answer 49

N-acetylcysteine

Question 50

Which is the drug treatment of choice for opiate overdose?

Answer 50

Naloxone.

Question 51

Which is the first line test for Cushing's?

Answer 51

Low dose dexamethasone test.

Question 52

Which is the most common cause of hypothyroidism?

Answer 52

Hashimoto's disease

Question 53

Which sign is specific for Grave's disease?

Answer 53

Exopthalmos NOT goitre. Goitre is non specific for any over productive thyroid.

Question 54

What is the first line management for hypercalcaemia?

Answer 54

IV fluids - assess patient's confusion status.