Endocrine Buzzwords

Question 1

hypokalaemic metabolic alkalosis

Answer 1

Cushing’s syndrome

Question 1

Most important modifiable risk factor for thyroid eye disease?

Answer 1

Smoking Cessation

Question 2

Hashimoto’s thyroiditis

Answer 2

hypothyroidism + goitre + anti-TPO

Question 3

Proliferative retinopathy treatment

Answer 3

panretinal laser photocoagulation

Question 4

Flashes and floaters

Answer 4

vitreous/retinal detachment

Question 5

cotton wool spots

Answer 5

In diabetic retinopathy, cotton wool spots represent areas of retinal infarction

Question 6

complication of panretinal photocoagulation

Answer 6

A decrease in night vision

Question 7

any structural abnormality due to diabetes affecting the macula

Answer 7

Diabetic maculopathy

Question 8

what drug may result in a severe and permanent retinopathy

Answer 8

Hydroxychloroquine

Question 9

cape-like loss of pain and temperature sensation due to compression of the spinothalamic tract fibres decussating in the anterior white commissure of the spine

Answer 9

Syringomyelia

Question 10

first-line treatments for painful diabetic neuropathy

Answer 10

Duloxetine

Question 11

Erratic blood glucose control, bloating and vomiting

Answer 11

gastroparesis

Question 12

Addison’s disease management

Answer 12

hydrocortisone + fludrocortisone

Question 13

Diabetic ketoacidosis:

Answer 13

the IV insulin infusion should be started at 0.1 unit/kg/hour

Question 14

important complication of fluid resuscitation in DKA, especially in young patients

Answer 14

Cerebral Oedema

Question 15

high plasma osmolality and a low urine osmolality

Answer 15

Diabetes insipidus

Question 16

Water deprivation test:
urine osmolality after fluid deprivation: low
urine osmolality after desmopressin: low

Answer 16

nephrogenic DI

Question 17

Primary hyperaldosteronism management

Answer 17

spironolactone

Question 18

low T3/T4 and normal TSH with acute illness

Answer 18

Sick euthyroid syndrome

Question 19

contraindication to statin therapy

Answer 19

Pregnancy

Question 20

Whipple’s triad of symptoms of 1) hypoglycaemia with fasting or exercise, 2) reversal of symptoms with glucose, and 3) recorded low BMs at the time of symptom

Answer 20

insulinoma

Question 21

When is metformin contraindicated?

Answer 21

For type 2 diabetics requiring treatment, metformin is contraindicated in those with eGFR < 30

Question 22

Young woman, high BMI, headache and visual symptoms.

Answer 22

Think idiopathic intracranial hypertension

Question 23

A patient over 55 years with stage 2 hypertension and a QRisk score of >10%

Answer 23

requires a calcium channel blocker, atorvastatin and lifestyle advice as first-line therapy

Question 24

Difference between diahorrea and vomiting on ABG?

Answer 24

Diarrhoea can cause a normal anion gap acidosis whereas vomiting causes alkalosis The anion gap is calculated by: (sodium + potassium) - (bicarbonate + chloride). A normal anion gap is 10-18 mmol/L. In this case, the anion gap is 13 mmol/L.

Question 25

'unrecordable' blood sugar measurement with confusion and abdominal pain

Answer 25

DKA

Question 26

Diabetic ketoacidosis: once blood glucose is < 14 mmol/l

Answer 26

an infusion of 10% dextrose should be started at 125 mls/hr in addition to the saline regime

Question 27

HHS or DKA?

Answer 27

HHS has no acidosis/significant ketosis, the history is longer and the glucose is often significantly raised eg >30mmol/L

Question 28

hyperchloraemic, normal anion gap metabolic acidosis

Answer 28

Renal tubular acidosis