Endocrine

Question 1

Risk of over replacement of thyroxine

Answer 1

Osteoporosis

Question 2

HTN management in a diabetic

Answer 2

ACEi and ARBs are preferred at any age

(ARB if afro-caribbean origin)

Question 3

How is familial hypercholesterolaemia inherited?

Answer 3

Autosomal dominant

Question 4

Example of an SGLT2 inhibitor

Answer 4

Empagliflozin

Question 5

Side effect of SGLT2s

Answer 5

Frequent UTIs

Question 6

Example of GLP1

Answer 6

Exenatide
Liraglutide
Semaglutide (mounjaro)

Question 7

Diabetes management in a patient with established CVD

Answer 7

Up titrate metformin then add in SGLT2 regardless of control.

If metformin not tolerated then SGLT2 monotherapy would be the best option.

Question 8

Male infetility, low volume testes, sparse pubic hair, gynaecomastia, azoospermia

Answer 8

Kleinfelters (XXY)

Question 9

Kleinfelters hormone abnormalities

Answer 9

Raised FSH and LH
Low testosterone

Question 10

Diabetes diagnosis fasting BM

Answer 10

> 7

Question 11

Diabetes diagnosis random BM

Answer 11

> 11.1
(if symptomatic one occasion/ reading, if asymptomatic then need to repeat on a separate occasion)

Question 12

T1DM blood glucose targets
(waking and before meals)

Answer 12

5-7 on waking
4-7 before meals

Question 13

Renal threshold for stopping metformin

Answer 13

Cr >150 or eGFR <30

Question 14

Percentage reduction target in non-HDL on statin therapy

Answer 14

40% at 3 months

Question 15

Difference between Graves and de Quervains

Answer 15

de Quervains is often post viral and the goitre is tender

No treatment is required often

Question 16

Contraindications to pioglitazone

Answer 16

Bladder cancer

Question 17

How often should hba1c be measured in T1DM

Answer 17

Every 3-6 months

Question 18

Diagnostic test for Addisons

Answer 18

Short synacthen

Question 19

Patient presenting with hypotension, hyponatraemia, hyperkalaemia, hypoglycaemia

Answer 19

Addisons

Question 20

Pan hypopituitism following a large PPH

Answer 20

Sheehans syndrome

Question 21

Drugs that may cause gynaecomastia

Answer 21

Spironolactone
ACEi
Omeprazole
CCBs

Question 22

Pre-operative Hba1c target

Answer 22

<69

Question 23

At what age does screening for diabetic retinopathy begin

Answer 23

Aged 12 and over

Question 24

Hba1c target for pt on monotherapy

Answer 24

<48

Question 25

Hba1c target for pt on dual therapy

Answer 25

<53

Question 26

Hba1c threshold for adding a second anti-diabetic medication

Answer 26

58

Question 27

Additional vaccinations for children with diabetes

Answer 27

Annual flu and a once off pneumococcal

Question 28

Test for Cushings

Answer 28

Dexamethasone suppression

Question 29

Weight loss and new diabetes in an older patient is a red flag for what underlying condition

Answer 29

Pancreatic cancer

Question 30

Causes of hypervolaemic hyponatraemia

Answer 30

heart failure, profound hypothyroidism, liver and kidney failure

Question 31

Exenatide side effect

Answer 31

Pancreatitis | (NB it is a GLP1)

Question 32

Treatment of post partum thyroiditis

Answer 32

Usually all that is required is symptomatic relief with propranolol

Question 33

Initial insulin therapy recommended in refractory T2DM

Answer 33

Isophane (NPH) insulin (intermediate acting at bedtime or BD according to need)

Question 34

First line treatment of MODY

Answer 34

Gliclazide (no treatment may be needed if asymptomatic)

Question 35

Range for impaired fasting glucose

Answer 35

6.1- 6.9