FINALS ENDO

Question 1

Graves management

Answer 1

Medical - 12-18 months of carbimazole/PTU and beta blockers for symptom control
Radioiodine
Surgical - thyroidectomy

Question 2

Graves investigation

Answer 2

TSH receptor

Question 3

What do you give if someone is hyperthyroid but also wanting to get pregnant?

Answer 3

PTU is preferred in pregnancy

Question 4

when is radioiodine therapy contraindicated

Answer 4

Pregnancy
Significant eye disease
Job

Question 5

Surgery thyroidectomy risks

Answer 5

Risk of GA
Risk of hypoparathyroidism
Recurrent laryngeal

Answer 6

Tiredness - low testosterone
Fertility problem - hypogonadism
Eye problems -

Answer 7

macroprolactin = prolactin + antibodies; these are not active prolactin

Question 8

What inhibits prolactin?

Answer 8

Dopamine

Question 9

First line treatment for
a prolactinoma

Answer 9

Cabergoline 250mcg - dopamine agonist

Question 10

When would you prefer surgery over dopamine agonist for hyperprolactinemia?

Answer 10

If someone is exhibiting signs of lack of impulse control

Question 11

in malignancy, what happens to PTH

Answer 11

PTH gets supressed due to excess calcium

Question 12

Primary hyperparathyroidism immediate management

Answer 12

3L IV fluids - to avoid
Wait a few days before deciding whether to use bisophosphanates or not

But this is problematic because if they go onto have surgery, and become hypocalcemic, they can’t mobilise any calcium

Question 13

Management of

Answer 13

Parathyroidectomy
Cinacalcet - brings down PTH levels
Bisophophonate

Question 14

Intitial investigation in addisons

Answer 14

Blood cortisol and ACTH

Question 15

Addison’s management

Answer 15

Crisis:
IV fluids
IV hydrocortisone

longer term:
pred, fludrocortisone, steroid card, IM hydrocortisone at home, sick day rules)