JB-Endocrine

Question 1

Most common cause of hypothyroidism

Answer 1

Hashimoto’s (may cause transient hyperthyroid in acute phase)

Question 2

Painful goitre, raised ESR and hyperthyroidism -> dx

Answer 2

Subacute thyroiditis (De Quervain’s)

Hyperthyroidism (painful goitre) -> euthyroid -> hypo (weeks - months) -> normal

NSAIDs for pain

Question 3

What scan could be used for subacute thyroiditis and results

Answer 3

Thyroid scintgraphy: globally reduced uptake of iodine 131

Question 4

Ab seen in hashimoto’s

Answer 4

TPO (anti-thyroid peroxidase)

[anti Tg (thyroglbulin)]

Question 5

Ab seen in Graves

Answer 5

TSH receptor antibodies

(Anti-TPO also possible)

Question 6

DKA insulin rate

Answer 6

0.1 units per kg per hour

Question 7

Dose changes in addisions when patient is unwell

Answer 7

Double hydro, same fludrocortisone

Question 8

Medical treatment of prolactinoma (2)

Answer 8

Bromocriptine

Cabergoline

Dopamine agonists

Question 9

Key measurement in prognosis in HHS

Answer 9

Seum osmolarity

Question 10

What type of drug is amiloride and key SE

Answer 10

ENaC blocker (same cell as alodesterone)
Potassium sparing

Question 11

Treatment of thyroid storm

Answer 11

BB (CCB if CI)
Anti thyroid drugs (propothyrouricil)
Steroid cover (dex)
?lugols iodine

Question 12

Treatment of myxoedema coma

Answer 12

Iv T4
Iv hydrocortisone until not AI proven