Diagnosis and management of medullary thyroid cancer?
- Neck ultrasound + fine needle aspiration + Calcitonin measurement
- Total thyroidectomy with level 6 lymph node dissection +/- adjunct immunotherapy
Phaeochromocytoma diagnosis and management?
- Plasma metanephrines or urinary catecholamines
- Surgical resection after pre-operative blood control medication
What condition may be associated with Hirschprung’s disease?
MEN 2 A and B
What is the most common affected gland in Tuberculosis?
Adrenal gland (Hyperkalaemia + hyperpigmentation)
What effect does excess thyroxine have on oestrogenisation?
Decreases oestrogenisation (amenorrhoea + osteoporosis)
What are the conditions caused by extreme hypothyroidism (myxoedema)?
Cardiomegaly (+heart failure with pericardial effusions, bradycardia, altered mental state)
What are the best diagnostic tests for recurrent hypoglycaemia?
Insulin, glucose and C-peptide levels DURING THE ATTACK
What is the HbA1c target for diabetic women who wish to conceive?
<6%
What test is used to diagnose Conn’s syndrome if aldosterone:renin ratio is unequivocal?
Saline suppression test
In familial hypertriglyceridaemia, what levels are elevated despite normal LDL levels?
VLDL levels
At what triglyceride levels does acute pancreatitis occur?
> 11mmol/L
Which HLA type is associated with multiple autoimmune conditions including diabetes mellitus?
HLA-DR3
What condition is associated with HIV-medication that leads to lipodystrophy?
Redistribution of arm and face subcutaneous fat to visceral and abdominal fat + high triglycerides and low HDL cholesterol
What type of bone loss occurs in osteoporosis?
TRABECULAR bone loss (not cortical)
What is the recommended treatment for pregnancy in the 2nd or 3rd trimester with Grave’s disease?
Low dose carbimazole to keep T3 and T4 in third upper of normal range
What is the mechanism of melatonin synthesis?
Increased serotonin N-acetyltransferase
What histological finding is characteristic of Paget’s disease?
Multinucleated osteoclasts on bone biopsy
What defines adrenal failure?
Inability of plasma cortisol to rise in response to ACTH. High ACTH = primary adrenal failure
What is the gold standard test to diagnose adrenal failure?
Short corticotropin test
If the short corticotropin test is unavailable, what should be measured?
Morning ACTH and cortisol levels
