Endocrinology

Question 1

Adverse effects of SGLT-2 inhibtiors(Glifozins)

Answer 1

urinary and genital infection (secondary to glycosuria). Fournier’s gangrene has also been reported
normoglycaemic ketoacidosis
increased risk of lower-limb amputation: feet should be closely monitored

Question 2

when is 3% hypertonic saline given in hyponatraemia

Answer 2

<120 serum sodium

Question 3

Kallman vs Kleinfelter

Answer 3

• both cause pubertal delay
• key feature of kallman- cleft palate and anosmia- failure of gnrh -secreting neurons to migrate to the hypothalamus and thereby secreting GNRH for LH and FSH release from ant pituitary
• kallman is hypogonadtrophic hypogonadism- low LH, Low FSH, Low testosterone
• kleinfelter is hypergonadotrophic hypogonadism- high LH, high FSH, low Testosterone

Question 4

Prevents PCS-K9 mediated LDL receptor degradation- what drug and what is its use

Answer 4

evolocumab, cholesterol lowering when statins are CI’ed

Question 5

hashimotos thyroiditis is associated with this lymphomA

Answer 5

MALT LYMPHOMA

Question 6

dense fibrous thyroid- painless hard nodule associated with retroperitoneal fibrosis

Answer 6

Riedel’s thyroiditis

Question 7

Diagnostic thresholds for gestational diabetes

Answer 7

fasting glucose is >= 5.6 mmol/l

2-hour glucose is >= 7.8 mmol/l

Question 8

mangement plan for gestational diabetes

Answer 8

if fasting <7- diet /exercise- if not maintaining- start metformin
If >7- need to be on insulin, can give insulin and metformin if tolerating.

Question 9

raised hb with someone who has uterine fibroids - reason

Answer 9

polycythaemia secondary to uterine fibroids

Question 10

Carbamazepine, SSRIs, Tricyclics, sulfonylureas- what do they cause

Answer 10

SIADH

Question 11

hypernatraemia, raised serum osmolarity, decreased urine osmolarity- what condition

Answer 11

Diabetes insipidus

Question 12

LIDLE minded people get hypertension, but GENTLEMEN would not develop hypertension

Answer 12

Liddle- AD condition associated with hypertension

Gitelman- defect in thizide sensitive Na Cl channel in the DCT- causes hypomagnesemia and metabolic alkalosis.

Question 13

management of graves in pregnancy

Answer 13

1st trimester- Propylthiouracil(Carbim- congenital abnormalities)
2nd trimester- Carbimazole

Question 14

raised insulin , low C-peptide(breakdown of endogenous Insulin)

Answer 14

Insulin abuse

Question 15

raised insulin, raised C-peptide

Answer 15

Insulinoma

Question 16

gene most likely to be responsible for MODY

Answer 16

HNF-1 alpha