Respiratory

Question 1

Define type 1 diabetes mellitus

Answer 1

A disease where the pancreas stops producing insulin.

Question 2

Presentation of T1DM

Answer 2

Often diabetic ketoacidosis
Polyuria
Ploydipsia
Weight loss
Recurrent infections

Question 3

Investigations in TIDM

Answer 3

FBC, UE, glucose
Blood cultures
HbA1c
Thyroid
Anti-TTG
Insulin antibodies

Question 4

Management of TIDM

Answer 4

Background and short acting insulin

Question 5

Hypoglycaemia management

Answer 5

2mg/kg bollus of 10% dextrose
5 mg/kg/hour infusion

Question 6

Triad of diabetic ketoacidosis

Answer 6

hyperglycaemia
Acidosis
Ketosis

Question 7

Presentation of diabetic ketoacidosis

Answer 7

Polyuria
Polydipsia
Nausea and vomiting
Weight loss
Acetone smell to breath
Dehydration
Altered consciousness
Symptoms of trigger - sepsis?

Question 8

Management of DKA

Answer 8

Correct dehydration over 48 hours
Fixed rate insulin infusion

Question 9

Define adrenal insufficiency

Answer 9

Adrenal glands do not produce enough steroid hormones - cortisol and aldosterone

Question 10

Features of adrenal insufficiency in babies

Answer 10

LEthargy
Vomiting
Poor feeding
Hypoglycaemia
Jaundice
Failure to thrive

Question 11

FEatures of adrenal insufficiency in children

Answer 11

Nausea and vomiting
Poor weight gain
Weight loss
Abdominal pain
Muscle cramps or weakness
Developmental delay
Bronze hyperpigmentation

Question 12

Investigations in adrenal insufficiency

Answer 12

UEs
Blood glucose
Short synacthen test
Cortisol
ACTH
Aldosterone
Renin

Question 13

Hormone levels in Addisons disease

Answer 13

Low cortisol
High ACTH
Low aldosterone
High renin

Question 14

Hormone levels in secondary adrenal insufficiency

Answer 14

Low cortisol
Low ACTH
Normal aldosterone
Normal renin

Question 15

Management of adrenal insufficiency

Answer 15

Hydrocortisone
Fludrocortisone
Monitor growth
Blood pressure
Glucose
Bone profile
Vit D
Sick day rules

Question 16

Define congenital adrenal hyperplasia

Answer 16

Congenital deficiency of 21-hydroxylase enzyme - causes underproduction of cortisol and aldosterone and over production of androgens

Question 17

Presentation of congenital adrenal hyperplasia

Answer 17

Ambiguous genitalia
Enlarge clitoris - high testosterone
Hyponatraemia
Hyperkalaemia
Hypoglycaemia
Poor feeding
Vomiting
Dehydration
Arrhythmias

Question 18

Phenotype of congenital adrenal hyperplasia

Answer 18

Female
Tall for age
Facial hair
Absent periods
Deep voice
Early puberty

Male
Tall for age
Deep voice
Large penis
Small testis
Early pubert

Hyperpigmentation

Question 19

Management of congenital adrenal hyperplasia

Answer 19

Cortisol replacement - hydrocortisone
Aldosterone replacement - fludrocortisone
Females - genital surgery

Question 20

Define growth hormone deficiency

Answer 20

Results from the disruption of the growth hormone axis at the hypothalamus or pituitary gland

Question 21

Presentation of growth hormone deficiency

Answer 21

Micropenis
Hypoglycaemia
Severe jaundice

Older
Poor growth
Short stature
Slow development
Delayed puberty

Question 22

Investigations in growth hormone deficiency

Answer 22

Growth hormone stimulation test - glucagon, insulin
Thyroid
MRI
Genetic
Xray

Question 23

Management of growth hormone deficiency

Answer 23

Sub cut growth hormone
Monitoring !

Question 24

Define congenital hypothyroidism

Answer 24

Child born with underactive thyroid gland - as a result of underdevelopment or faulty gland

Question 25

Presentation of congenital hypothyroidism

Answer 25

Heel prick test
Prolonged jaundice
Poor feeding
Constipation
Increased sleeping
Reduced activity
Slow growth and development

Question 26

MAnagement of congenital hypothyroidism

Answer 26

Levothyroxine