Metabolic and Endocrine disturbances

Question 1

Hyperkalaemia

Answer 1

Cardiac arrhythmias ECG: tall ‘t’ waves

Question 2

Hypokalaemia

Answer 2

Muscle weakness, tetany

ECG: small ‘t’ waves, prominent U wave

Question 3

Hypocalcaemia

Answer 3

Carpopedal spasm, perioral anaesthesia Positive Trousseau’s, Chvostek’s sign

Question 4

Hypercalcaemia

Answer 4

Many vague symptoms:
Abdominal pain, constipation, vomiting Depression
Anorexia (malignancy)
Confusion (especially elderly people) Bone pain (malignancy)
↑ incidence renal stones
ECG: reduced Q–T interval

Question 5

Vitamin K deficiency

Answer 5

Prolonged bleeding

Question 6

Vitamin C deficiency

Answer 6

Malnourished, bleeding gums (scurvy)

Question 7

Vitamin D deficiency

Answer 7

Bowed legs (rickets)

Question 8

Vitamin B1 deficiency

Answer 8

Nystagmus, othamolplegia, ataxia

Question 9

Nicotinic Acid deficiency

Answer 9

Diarrhoea, dementia, dermatitis

Question 10

Vitamin B12 deficiency

Answer 10

Sore red tongue

Peripheral neuropathy

Question 11

Hyperthyroidism

Answer 11

Heat intolerance, weight loss, diarrhoea, anxiety

Question 12

Hypothyroidism

Answer 12

Cold intolerance, weight gain, depression, constipation, dementia, depression

Question 13

Acromegaly

Answer 13

Change in facial appearance, visual problems

Question 14

Cushing’s syndrome

Answer 14

Weight gain, menstrual problems, depression

Question 15

What would you see on examining a patient with Addison’s disease?

Answer 15

Buccal/palmar crease hyperpigmentation,

postural hypotension

Question 16

What would you see on examining a patient with Cushing’s disease?

Answer 16

‘Moon-shaped’ face, centripetal obesity,
proximal myopathy, purple striae,
hypertension, diabetes mellitus

Question 17

What would you see on examining a patient with Acromegaly?

Answer 17

Macroglossia, spade-like hands and feet

Question 18

What would you see on examining a patient with Hypothyroidism?

Answer 18

Bradycardia, dry thin hair, goitre, loss of
outer third of eyebrow, slowly relaxing
reflexes

Question 19

What would you see on examining a patient with Hyperthyroidism?

Answer 19

Tachycardia, goitre, atrial fibrillation, lid lag