Treatment

Question 1

Addisons

Answer 1

replace lost steroids

?excision

Question 2

Addisonian Crisis

Answer 2

IV hydrocortisone 100mg

Fluid resuscitation if hypotensive.

IV glucose if hypoglycaemic

Consider fludrocortisone if there is adrenal disease

Question 3

Cushings

Answer 3

Trans-sphenoidal (through the nose) removal of a pituitary adenoma

can remove both adrenal glands and then give patient replacement steroids

reduce alcohol consumption (alcohol contains cortisol)

Question 4

Type 2 DM

Answer 4

low fat diet

metformin

if can’t take metformin take DPP-4 inhibitors (gliptins) or pioglitazone or sulphonylurea (gliclazide)

keep measuring HbA1c levels every 3-6 months

Question 5

Hyperthyroid

Answer 5

blood tests (thyroid function tests) to look for TSH and T3/T4

USS to look for masses

Question 6

Hypothyroid

Answer 6

Levothyroxine (hormone replacement)

regular TFTs

Question 7

tertiary hyperparathyroidism

Answer 7

parathyroidectomy

calcimimetics e.g. Cinacalcet

Question 8

Secondary hyperparathyroidism

Answer 8

Vit D and calcium supplements

Kidney transplant if CKD

calcimimetics e.g. Cinacalcet

Question 9

Primary hyperparathyroidism

Answer 9

parathyroidectomy and calcimimetics e.g. cincalcet

bisphosphonates to improve bone strength