Peer Mentoring

Question 1

What is pagets disease?

Answer 1

Increased osteoblast activity

Question 2

What presents with deafness and bone pain?

Answer 2

Pagets disease

Question 3

What are the hormone changes in primary, secondary and tertiary hyperparathyroidism?

Answer 3

Primary = high PTH, high Ca (low phosphate)
Secondary = high PTH, low/normal Ca (high phosphate)
Tertiary = high PTH, normal/high Ca (low phosphate - secondary to corrected secondary hyperparathyroidism)

Question 4

Give an example fo a dopamine agonist

Answer 4

Carbergoline

Question 5

What type of drug is phenoxybenzamine?

Answer 5

Alpha blocker

Question 6

What drugs for hyperthyroidism are given during each trimester of pregnancy?

Answer 6

1st = PTU
2/3rd = Carbomazole

Question 7

How is hypercalcaemia managed?

Answer 7

Fluids + diuretics

Question 8

What is the electrolyte abnormality in addisons?

Answer 8

Hyponatraemia, hyperkalaemia, hypoglycaemia

Question 9

What disease are parathyroid tumours, pituitary tumours and pancreatic tumours associated with?

Answer 9

MEN 1 (3P’s)

Question 10

Which type of MEN presents with marfanoid body features?

Answer 10

MEN 2B

Question 11

What is the classic disease associated with MEN 2A?

Answer 11

Medullary thyroid carcinoma

Question 12

How is the different between Cushings disease and syndrome identified?

Answer 12

High dose dexamethasone suppression test

Disease = excess ACTH production at the pituitary

Syndrome = excess ACTH from another source

Question 13

How is Cushings disease diagnosed?

Answer 13

Low dose dexamethasone suppression test

steroid so should suppress ACTH production

Question 14

What should the insulin regime be for T1DM?

Answer 14

2x basal (long acting) insulin
Rapid acting insulin before meals (3x/day)

Question 15

What is the HbA1c aim for T1DM?

Answer 15

<48mmol/L

Question 16

What are the 2 types of MODY and what is the treatment for each?

Answer 16

Glucokinase mutations (Reassurance) 
Transcription factor mutations (sulphonylureas - glicazide)

Question 17

How is MODY diagnosed?

Answer 17

C-peptide measurement

Autoantibodies (not present in MODY unlike T1DM)

Question 18

Is metformin safe during pregnancy?

Answer 18

Yes

Question 19

Who gets HHS?

Answer 19

Elderly with multiple co-morbidities

Question 20

How does HHS present?

Answer 20

Hyperglycaemia without significant ketoacidosis (high osmolarity)

Question 21

During which trimester does gestational diabetes present?

Answer 21

Last trimester

Question 22

How is acromegaly diagnosed?

Answer 22

Glucose tolerance test (as glucose inhibits GH - measure after 0, 30, 60, 90, 120 mins - normal/rises = acromegaly)

Question 23

How is acromegaly treated?

Answer 23

Somatostatin analogue (octreotide) - suppresses GH