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  • Question 1 - A 67-year-old woman visits her GP with complaints of constipation that has been...

    Incorrect

    • A 67-year-old woman visits her GP with complaints of constipation that has been ongoing for a month. She requests medication to alleviate the symptoms. The patient reports feeling more fatigued than usual and has noticed recent weight gain. During the examination, the GP observes dry scaly skin. The patient's medical history indicates recent consultation with an endocrinologist.
      What would lead to elevated thyroid-stimulating hormone (TSH) levels and normal T4 in this case?

      Your Answer: Sick euthyroid syndrome

      Correct Answer: Poor compliance with thyroxine

      Explanation:

      Understanding Thyroid Disorders: Differentiating Poor Compliance with Thyroxine from Other Conditions

      Thyroid disorders can present with a variety of symptoms, making it important to differentiate between different conditions. In the case of poor compliance with thyroxine medication, a patient may present with signs of a low thyroid state, but blood results will show a high TSH and normal T4, indicating recent medication use.

      Primary hypothyroidism, on the other hand, would show a low T4 and high TSH, while thyrotoxicosis would reveal a low TSH and high T4, accompanied by symptoms such as tachycardia and tremors. Secondary hypothyroidism would present with low levels of both T4 and TSH, indicating a pituitary problem.

      Sick euthyroid syndrome, which often occurs in individuals with systemic illness, would show low levels of TSH, thyroxine, and T3, but the TSH level may still be within the normal range. Understanding these differences can help healthcare professionals make accurate diagnoses and provide appropriate treatment.

    • This question is part of the following fields:

      • Endocrinology
      27.9
      Seconds
  • Question 2 - At a routine occupational health check, a 30-year-old man is found to have...

    Correct

    • At a routine occupational health check, a 30-year-old man is found to have mild hypercalcaemia. He is anxious because the problem failed to resolve in his father, despite neck surgery. 24-hour urinary calcium excretion levels are low.
      Which of the following is the most likely diagnosis?

      Your Answer: Familial hypocalciuric hypercalcaemia (FHH)

      Explanation:

      Differentiating Hypercalcaemia Causes: A Comparison

      Hypercalcaemia can be caused by various conditions, including familial hypocalciuric hypercalcaemia (FHH), primary hyperparathyroidism, sarcoidosis, secondary hyperparathyroidism, and hypercalcaemia of malignancy. To differentiate these causes, 24-hour urinary calcium excretion levels are measured.

      In FHH, urinary calcium excretion levels are low, while in primary hyperparathyroidism, they are elevated. Sarcoidosis can also cause hypercalcaemia, but with elevated urinary calcium excretion levels. On the other hand, secondary hyperparathyroidism is associated with hypocalcaemia. Lastly, hypercalcaemia of malignancy is characterized by elevated urinary calcium excretion levels.

      Therefore, measuring 24-hour urinary calcium excretion levels is crucial in determining the underlying cause of hypercalcaemia.

    • This question is part of the following fields:

      • Endocrinology
      8.5
      Seconds
  • Question 3 - A 36-year-old woman visits her new GP for routine blood tests after recently...

    Incorrect

    • A 36-year-old woman visits her new GP for routine blood tests after recently moving locations. She mentions that her previous GP had told her she had a ‘thyroid problem’ and had prescribed medication, but she cannot recall any further details. Her blood test results are as follows:
      Investigation Result Normal value
      Thyroid-stimulating hormone (TSH) 18 mu/l 0.5–5.5 mu/l
      Free thyroxine (T4) 9.2 pmol/l 9–18 pmol/l
      What could be the possible cause of these biochemical results?

      Your Answer: Primary hypothyroidism

      Correct Answer: Poor compliance with thyroxine

      Explanation:

      Thyroid Function Tests: Understanding the Results

      Thyroid function tests are commonly used to diagnose and monitor thyroid disorders. The results of these tests can provide valuable information about the functioning of the thyroid gland. Here are some common thyroid function test results and what they may indicate:

      Poor Compliance with Thyroxine
      Patients who are not compliant with their thyroxine medication may only take it a few days before a routine blood test. This can result in normal thyroxine levels due to the supplementation, but the TSH levels may not have enough time to reach the normal range due to the required negative feedback.

      Sick Euthyroid Syndrome
      In this condition, all TSH, thyroxine, and T3 levels are low. However, the TSH level is often within the normal range. This condition is reversible upon recovery from the systemic illness.

      Thyrotoxicosis
      Thyrotoxicosis is characterized by low TSH and high T4 levels.

      Primary Hypothyroidism
      Primary hypothyroidism results in low T4 levels and subsequent high TSH levels due to negative feedback.

      Secondary Hypothyroidism
      In secondary hypothyroidism, both TSH and T4 levels are low. This condition occurs due to the failure of the anterior pituitary to secrete TSH despite adequate thyrotropin-releasing hormone (TRH) levels. TRH is elevated, but TSH, T3, and T4 are low, and TSH fails to rise even after a TRH stimulation test.

      Understanding the results of thyroid function tests can help healthcare providers diagnose and manage thyroid disorders effectively.

    • This question is part of the following fields:

      • Endocrinology
      15.5
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  • Question 4 - A 25-year-old veterinary student is being evaluated for possible Addison's disease due to...

    Correct

    • A 25-year-old veterinary student is being evaluated for possible Addison's disease due to symptoms of weight loss, hypotension, and fatigue. As part of the diagnostic process, the patient undergoes testing to measure cortisol levels before and after receiving synthetic adrenocorticotropic hormone (ACTH) injection (short-synacthen test). What is a true statement regarding cortisol in this scenario?

      Your Answer: It has a peak hormonal concentration in the morning

      Explanation:

      Misconceptions about Cortisol: Clarifying the Facts

      Cortisol is a hormone that has been the subject of many misconceptions. Here are some clarifications to set the record straight:

      1. Peak Hormonal Concentration: Cortisol has a diurnal variation and peaks in the morning upon waking up. Its lowest level is around midnight.

      2. Protein or Steroid: Cortisol is a steroid hormone, not a protein.

      3. Blood Glucose: Cortisol increases blood glucose levels via various pathways, contrary to the belief that it lowers blood glucose.

      4. Anabolic or Catabolic: Cortisol is a catabolic hormone that causes a breakdown of larger molecules to smaller molecules.

      5. Stimulated by Renin or ACTH: Cortisol is stimulated by adrenocorticotropic hormone (ACTH) released from the anterior pituitary, not renin.

      By understanding the true nature of cortisol, we can better appreciate its role in our bodies and how it affects our health.

    • This question is part of the following fields:

      • Endocrinology
      29.5
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  • Question 5 - A 35-year-old male is scheduled for his annual diabetic review. During the examination,...

    Correct

    • A 35-year-old male is scheduled for his annual diabetic review. During the examination, it is noted that his body mass index has increased to 31.5 kg/m2. How do you calculate body mass index?

      Your Answer: Weight/(Height)2

      Explanation:

      BMI is a calculation of weight over height squared and is used to determine if someone is underweight, normal weight, overweight, or obese. A BMI above 30 indicates obesity and is associated with increased risks for various health issues and surgical complications.

    • This question is part of the following fields:

      • Endocrinology
      13.5
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  • Question 6 - A 50-year-old woman from the UK presents with lethargy, and dizziness when she...

    Correct

    • A 50-year-old woman from the UK presents with lethargy, and dizziness when she gets out of bed in the mornings and stands from sitting. She has noticed that her appetite has been reduced for the last month but has not noticed any weight loss. On examination you notice that she has an area of hypopigmented skin on her back, but hyperpigmented skin around her mouth, and you suspect a diagnosis of Addison’s disease.
      What is the most common cause of Addison’s disease in the UK?

      Your Answer: Autoimmune destruction

      Explanation:

      Addison’s disease is most commonly caused by autoimmune destruction in the UK, accounting for up to 80% of cases. Therefore, it is crucial to screen individuals with Addison’s for other autoimmune conditions like thyroid diseases and diabetes. Congenital adrenal hyperplasia is a rare cause of Addison’s that typically presents in childhood with symptoms such as failure to thrive and grow. While tuberculosis is the most common cause of Addison’s worldwide, it is not the primary cause in the UK. Adrenal haemorrhage, which can result from severe bacterial infections like meningococcal, can also lead to Addison’s disease in a condition known as Waterhouse-Friderichsen syndrome. Finally, metastatic cancer is a rare but significant cause of addisonism.

    • This question is part of the following fields:

      • Endocrinology
      23.5
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  • Question 7 - A 55-year-old woman visits her GP with concerns about her susceptibility to osteoporosis....

    Correct

    • A 55-year-old woman visits her GP with concerns about her susceptibility to osteoporosis. She underwent a hysterectomy and oophorectomy due to uterine fibroids five years ago, which resulted in mild hot flashes that have since subsided. The patient is anxious about the possibility of fractures after her mother broke her hip at the age of 72. She inquires about osteoporosis medications. Her BMI is 17.3 kg/m2, and her T score is <−2.5. She was on Depo-Provera from the age of 39 to 45, during which time she experienced amenorrhea. The physical examination, including breast examination, is normal. What would you suggest to her?

      Your Answer: Bisphosphonate

      Explanation:

      Treatment for Osteoporosis in a High-Risk Patient

      Osteoporosis is a condition characterized by low bone density and increased risk of fractures. This condition is more common in women, especially those with a low body mass index (BMI), a positive family history, and those who have undergone oophorectomy. In this case, the patient has multiple risk factors for osteoporosis, but she no longer experiences menopausal symptoms.

      To diagnose severe osteoporosis, a T score of <−2.5 SD is required, along with one or more fragility fractures. In this patient's case, the most appropriate therapy would be a bisphosphonate. This medication helps to increase bone density and reduce the risk of fractures. It is important to note that bisphosphonates have potential side effects, such as gastrointestinal upset and osteonecrosis of the jaw, but the benefits generally outweigh the risks. In summary, this patient’s high-risk factors for osteoporosis make her a candidate for treatment with a bisphosphonate. It is important to discuss the potential benefits and risks of this medication with the patient before starting treatment.

    • This question is part of the following fields:

      • Endocrinology
      34.2
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  • Question 8 - A 65-year-old man with a history of diabetes mellitus complains of a swollen...

    Correct

    • A 65-year-old man with a history of diabetes mellitus complains of a swollen right ankle joint that is not painful. Upon examination, radiographs reveal a joint that has been destroyed and contains a significant number of loose bodies. What is the most likely diagnosis?

      Your Answer: Charcot's joint

      Explanation:

      Charcot’s Joint: A Destructive Process Affecting Weight-Bearing Joints

      Charcot’s joint is a condition that primarily affects the weight-bearing joints in the extremities, including the feet, ankles, knees, and hips. It is a destructive process that can often be mistaken for an infection in these areas. The condition is characterized by a decreased sensation in the affected area and peripheral neuropathy. It is most commonly associated with diabetes mellitus, leprosy, and tabes dorsalis.

      Charcot’s joint is a serious condition that can lead to significant disability if left untreated. It is important to recognize the symptoms and seek medical attention promptly. Treatment typically involves immobilization of the affected joint and management of the underlying condition. With proper care, it is possible to prevent further damage and preserve joint function.

    • This question is part of the following fields:

      • Endocrinology
      20.8
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  • Question 9 - A 38-year-old woman presents with a 6-month history of excessive sweating, palpitations, and...

    Incorrect

    • A 38-year-old woman presents with a 6-month history of excessive sweating, palpitations, and weight loss. She now complains of a headache. On examination, her blood pressure is 230/130 mmHg, with a postural drop to 180/110 mmHg. She has a bounding pulse of 115 bpm, a tremor, and appears pale. The rest of the examination is unremarkable. Which hormone is most likely responsible for her symptoms and signs?

      Your Answer: Thyroxine

      Correct Answer: Catecholamines

      Explanation:

      Explanation of Hormones and their Role in Hypertension

      The patient’s symptoms suggest a rare tumour called phaeochromocytoma, which secretes catecholamines and causes malignant hypertension. Excess cortisol production in Cushing’s syndrome can also cause hypertension, but it does not explain the patient’s symptoms. Renin abnormalities can lead to hypertension, but it is not the cause of the patient’s symptoms. Hyperaldosteronism can also cause hypertension, but it does not explain the patient’s symptoms. Although hyperthyroidism can explain most of the patient’s symptoms, it is less likely to cause severe hypertension or headaches. Therefore, the patient’s symptoms are most likely due to the secretion of catecholamines from the phaeochromocytoma tumour.

    • This question is part of the following fields:

      • Endocrinology
      43.4
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  • Question 10 - A 32-year-old woman reports to her community midwife with complaints of failure to...

    Incorrect

    • A 32-year-old woman reports to her community midwife with complaints of failure to lactate, lethargy, dizziness upon standing, and weight loss after a difficult childbirth complicated by placental abruption. What blood test results are expected?

      Your Answer: Increased cortisol; decreased aldosterone

      Correct Answer: Decreased cortisol; normal aldosterone

      Explanation:

      Interpreting Cortisol and Aldosterone Levels in Sheehan’s Syndrome

      Sheehan’s syndrome is a condition that results in hypopituitarism, causing reduced adrenocorticotropic hormone (ACTH) production and secondary adrenal insufficiency. This can lead to postural hypotension and reduced cortisol levels, while aldosterone levels remain normal as they are not dependent on pituitary function.

      An increased cortisol level with decreased aldosterone would be an unusual result and does not fit the clinical picture of hypocortisolism. Similarly, an increased cortisol level with increased aldosterone may occur in rare cases of adrenal adenoma but does not fit the clinical picture of Sheehan’s syndrome.

      A decreased cortisol level with decreased aldosterone would be true in primary adrenal insufficiency, which is not the case in Sheehan’s syndrome. Finally, a decreased cortisol level with increased aldosterone would also be an unusual result as aldosterone levels are not affected in Sheehan’s syndrome.

      Therefore, when interpreting cortisol and aldosterone levels in a patient with Sheehan’s syndrome, a decreased cortisol level with normal aldosterone is expected.

    • This question is part of the following fields:

      • Endocrinology
      31.6
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  • Question 11 - A 46-year-old man with type 1 diabetes for 20 years presents with an...

    Incorrect

    • A 46-year-old man with type 1 diabetes for 20 years presents with an ulcer on his right foot. The ulcer is located on the outer aspect of his right big toe and measures 2 cm in diameter. Despite having palpable peripheral pulses, he experiences peripheral neuropathy to the mid shins. The ulcer has an erythematosus margin and is covered by slough. What is the most probable infective organism?

      Your Answer: Streptococcus pyogenes

      Correct Answer: Staphylococcus aureus

      Explanation:

      Diabetic foot ulcers can be categorized into neuropathic and ischemic. Infections in diabetic feet are serious and can range from superficial to deep infections and gangrene. Diabetics are more susceptible to foot ulceration due to neuropathy, vascular insufficiency, and reduced neutrophil function. Local signs of wound infection include friable granulation tissue, yellow or grey moist tissue, purulent discharge, and an unpleasant odor. Methicillin-resistant Staphylococcus aureus (MRSA) is more common in previously hospitalized or antibiotic-treated patients. Deep swab and tissue samples should be sent for culture and broad-spectrum antibiotics started if infection is suspected. Urgent surgical intervention is indicated for a large area of infected sloughy tissue, localised fluctuance and expression of pus, crepitus in the soft tissues on radiological examination, and purplish discoloration of the skin. Antibiotic treatment should be tailored according to the clinical response, culture results, and sensitivity. If osteomyelitis is present, surgical resection should be considered, and antibiotics continued for four to six weeks.

    • This question is part of the following fields:

      • Endocrinology
      36
      Seconds
  • Question 12 - A mother brings her 9-month-old baby to clinic for a check-up. His prior...

    Correct

    • A mother brings her 9-month-old baby to clinic for a check-up. His prior medical history has been unremarkable and his immunisations are up-to-date. The mother is concerned about his growth. After you determine that the baby has grown appropriately since the last visit and is unchanged from the 50th centile, you provide the mother with advice regarding growth.
      What signalling pathway does growth hormone (GH) use?

      Your Answer: A tyrosine kinase receptor that uses the JAK/STAT pathway

      Explanation:

      Comparison of Second Messenger Systems and Receptor Types in Hormonal Signaling

      Hormones utilize various signaling pathways to transmit their messages to target cells. One important aspect of hormonal signaling is the use of second messengers, which relay the hormone signal from the cell surface to the intracellular environment. Here, we compare and contrast the second messenger systems and receptor types used by different hormones.

      Growth hormone (GH) and prolactin both use the tyrosine kinase receptor, followed by activation of Janus kinase (JAK), signal transduction, and activation of transcription (STAT). In contrast, platelet-derived growth factor (PDGF), fibroblast growth factor (FGF), insulin-like growth factor 1 (IGF-1), and insulin use the MAP kinase or RAS system. Aldosterone uses steroid receptors, while GH uses the tyrosine kinase receptor.

      Inositol trisphosphate (IP3) works as a second messenger for hypothalamic hormones such as gonadotropin-releasing hormone (GnRH), growth hormone-releasing hormone (GHRH), thyrotropin-releasing hormone (TRH), and pituitary hormones such as antidiuretic hormone (ADH) and oxytocin.

      Cyclic guanosine monophosphate (cGMP) is a second messenger that activates protein kinases and mediates endothelium-derived relaxing factor (EDRF), atrial natriuretic peptide (ANP), and nitric oxide.

      Cyclic adenosine monophosphate (cAMP) is a second messenger of follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), human chorionic gonadotropin (hCG), and several other hormones, but not GH.

      In summary, different hormones use distinct second messenger systems and receptor types to transmit their signals, highlighting the complexity and diversity of hormonal signaling pathways.

    • This question is part of the following fields:

      • Endocrinology
      82.9
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  • Question 13 - What is the accurate description of growth hormone (GH) and its role in...

    Correct

    • What is the accurate description of growth hormone (GH) and its role in normal growth?

      Your Answer: It stimulates cartilage and bone growth via somatomedin C

      Explanation:

      Functions and Characteristics of Growth Hormone

      Growth hormone (GH) plays a crucial role in stimulating cartilage and bone growth through the production of somatomedin C, also known as insulin-like growth factor 1 (IGF-1). While GH has direct effects throughout the body, its receptors have a limited distribution outside the central nervous system (CNS). GH is secreted in a pulsatile manner, with its concentration peaking during sleep. The synthesis of GH is stimulated by the action of somatostatin, which inhibits its release and is sometimes referred to as ‘growth hormone-inhibiting hormone’. In addition to its other actions, GH has a proinsulin-like effect, which is in contrast to its anti-insulin-like effects, such as promoting gluconeogenesis.

    • This question is part of the following fields:

      • Endocrinology
      41.5
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  • Question 14 - Which type of tumor is typically linked to a paraneoplastic syndrome? ...

    Correct

    • Which type of tumor is typically linked to a paraneoplastic syndrome?

      Your Answer: Bronchial carcinoma

      Explanation:

      Paraneoplastic Syndromes

      Paraneoplastic syndromes are commonly linked to certain types of cancer, such as bronchial carcinoma, pancreatic carcinoma, breast carcinoma, and renal cell carcinoma. These syndromes are characterized by clinical effects that are associated with the presence of a neoplasm, but are not directly related to the infiltration of the primary tumor or its metastases. Paraneoplastic syndromes may or may not be caused by hormone secretion.

      One example of a paraneoplastic syndrome is Cushing’s syndrome, which can occur in association with small cell bronchial carcinoma due to the secretion of ectopic ACTH. Another example is hypercalcemia, which can occur in the absence of bony metastases and may be caused by the secretion of a PTH-related peptide. Other paraneoplastic syndromes include myopathy and cerebellar ataxia.

      In summary, paraneoplastic syndromes are a group of clinical effects that are associated with the presence of a neoplasm but are not directly related to the tumor itself. These syndromes can be caused by hormone secretion or other factors and can occur in a variety of cancer types.

    • This question is part of the following fields:

      • Endocrinology
      36.7
      Seconds
  • Question 15 - A 42-year-old obese woman, with a history of type II diabetes mellitus, complains...

    Incorrect

    • A 42-year-old obese woman, with a history of type II diabetes mellitus, complains of weight gain during the past 3 years, despite her adherence to a balanced diet. She has diffuse skeletal pain. She is not married and does not have a sexual partner. Her family history is unremarkable. Her blood pressure is 160/105 mmHg. Her face is plethoric and round and she has hypertrichosis of the upper lip (hirsutism). There are purple striae on the abdomen and thigh, and mild wasting of the upper and lower limb muscles. Her full blood count shows a slight increase in the polymorphonuclear leukocyte count, without a left shift. Her haemoglobin is 180 (115–155 g/l).
      Which of the following changes in serum calcium, phosphate and parathyroid hormone concentrations would you expect to find in this patient?

      Your Answer: Calcium - decreased; phosphate - increased; parathyroid hormone - increased

      Correct Answer: Calcium - decreased; phosphate - decreased; parathyroid hormone - increased

      Explanation:

      Interpreting Calcium, Phosphate, and Parathyroid Hormone Levels in a Patient with Prolonged Hypercortisolism

      A patient presents with diffuse bone pain and laboratory results show decreased calcium and phosphate levels, along with increased parathyroid hormone levels. This is indicative of secondary hyperparathyroidism, which is a common complication of hypercortisolism. Elevated serum cortisol levels can lead to hypocalcaemia and secondary hyperparathyroidism, causing increased osteoclast activity and osteoblast dysfunction, ultimately resulting in osteoporosis and pathological fractures.

      If the patient had increased phosphate levels instead of decreased levels, it would suggest renal impairment. If the patient had increased calcium levels and decreased phosphate levels, it would suggest primary hyperparathyroidism. If the patient had decreased calcium levels and increased phosphate levels, it would suggest hypoparathyroidism. If all levels were normal, it may be too early in the course of hypercortisolism to see changes in these markers.

      In summary, interpreting calcium, phosphate, and parathyroid hormone levels can provide valuable information in diagnosing and managing complications of hypercortisolism.

    • This question is part of the following fields:

      • Endocrinology
      82.5
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  • Question 16 - A 65-year-old individual with diabetes complains of difficulty reading newsprint. Fundoscopy reveals clouding...

    Correct

    • A 65-year-old individual with diabetes complains of difficulty reading newsprint. Fundoscopy reveals clouding of the lens, making it difficult to visualize the retina.
      What is the probable reason for this person's vision impairment?

      Your Answer: Cataract

      Explanation:

      Premature Cataracts and their Association with Diabetes and Other Conditions

      Cataracts can develop prematurely in individuals with certain medical conditions such as diabetes, Cushing’s syndrome, and those who have undergone steroid therapy or experienced trauma. In such cases, it is important to treat the cataracts in order to properly evaluate the back of the eye for signs of diabetic retinopathy. This condition occurs when high blood sugar levels damage the blood vessels in the retina, leading to vision loss. Therefore, it is crucial to monitor the eyes of individuals with these medical conditions to ensure early detection and treatment of any potential complications.

    • This question is part of the following fields:

      • Endocrinology
      14.1
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  • Question 17 - A patient with diabetes who is 60 years old is admitted with confusion...

    Incorrect

    • A patient with diabetes who is 60 years old is admitted with confusion and is found to have a blood glucose level of 1.2 mmol/L.

      Which injectable diabetes therapy is a mixed insulin?

      Your Answer: Insulin glargine (Lantus)

      Correct Answer: Humulin M3

      Explanation:

      Insulin Types and Mixtures

      Insulin is a hormone that regulates blood sugar levels in the body. Premix or mixed insulin is a combination of short and long-acting insulin. It is identified by a number that represents the percentage of rapid-acting insulin it contains. For instance, Novomix 30 has 30% rapid-acting insulin and 70% long-acting insulin. Mixed insulin is usually taken twice daily and must be administered with meals as it contains rapid-acting insulin.

      Insulin detemir, also known as Levemir, is a long-acting analogue that lasts for about 12-20 hours and is usually given twice a day. Insulin glargine, also known as Lantus, is another long-acting analogue that lasts for about 20-24 hours and is usually given once a day. Novorapid is a fast-acting insulin that is often used to cover the increase in blood glucose levels following a meal. Patients taking Novorapid will usually require treatment with a long-acting insulin.

      Exenatide is an injectable therapy for type 2 diabetes that is based on the hormone glucagon-like peptide 1 (GLP-1) and is not insulin. It is important to note that lipohypertrophy can occur in all insulin treatments. This refers to the accumulation of fatty deposits at injection sites, which can affect the rate of insulin absorption and, in turn, affect the patient’s glycaemic control. Therefore, it is crucial to rotate injection sites regularly to avoid lipohypertrophy.

    • This question is part of the following fields:

      • Endocrinology
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  • Question 18 - What is the underlying cause of primary hyperthyroidism associated with Graves' disease? ...

    Correct

    • What is the underlying cause of primary hyperthyroidism associated with Graves' disease?

      Your Answer: Anti-TSH receptor antibodies

      Explanation:

      Graves’ Disease

      Graves’ disease is a medical condition that is characterized by the presence of anti-TSH receptor antibodies that stimulate the thyroid gland. This results in hyperthyroidism and a diffusely enlarged thyroid gland, also known as a goitre. Patients with Graves’ disease may also experience other symptoms such as exophthalmos, which is the protrusion of the eyes, lid retraction, lid lag, and ophthalmoplegia.

      It is important to note that Graves’ disease is often associated with other autoimmune diseases such as vitiligo, Addison’s disease, and type 1 diabetes. This means that patients with Graves’ disease may be at a higher risk of developing these conditions as well.

    • This question is part of the following fields:

      • Endocrinology
      7
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  • Question 19 - A 32-year-old woman visits her GP after experiencing sudden hair growth, specifically on...

    Incorrect

    • A 32-year-old woman visits her GP after experiencing sudden hair growth, specifically on her face. She is feeling increasingly self-conscious about it and wants to address the issue. Blood tests were conducted, revealing an elevated testosterone level of 9.8 nmol/l (reference range 0.8-3.1 nmol/l). What is the next course of action in managing her condition?

      Your Answer: Refer for an ultrasound scan of her pelvis to look for polycystic ovary disease

      Correct Answer: Refer to Endocrinology as a suspected cancer referral

      Explanation:

      Referral for Suspected Androgen-Secreting Tumour in a Patient with Hirsutism

      This patient presents with sudden-onset hair growth and a raised testosterone level, which raises suspicion for an androgen-secreting tumour. An urgent referral for further investigation is necessary to rule out malignancy. While polycystic ovary syndrome can also cause hirsutism, the patient’s testosterone level warrants exclusion of a tumour. Topical eflornithine may provide symptomatic relief, but it is not a substitute for further investigation. Routine referral to endocrinology is not appropriate in this case, as it may delay diagnosis and treatment of a potential malignancy.

    • This question is part of the following fields:

      • Endocrinology
      24.5
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  • Question 20 - A 27-year-old woman visits her GP for a routine health examination before beginning...

    Correct

    • A 27-year-old woman visits her GP for a routine health examination before beginning a new job. During the examination, thyroid function tests are conducted on her serum, which reveal elevated thyroid-stimulating hormone (TSH), reduced total thyroxine (T4), reduced free T4, and reduced triiodothyronine (T3) uptake. What is the most probable clinical manifestation that this patient will exhibit?

      Your Answer: Weight gain

      Explanation:

      Understanding the Symptoms of Hypothyroidism and Hyperthyroidism

      Hypothyroidism and hyperthyroidism are two conditions that affect the thyroid gland, resulting in a range of symptoms. In hypothyroidism, there is a decrease in T4/T3, leading to symptoms such as lethargy, weight gain, depression, sensitivity to cold, myalgia, dry skin, dry hair and/or hair loss, constipation, menstrual irregularities, carpal tunnel syndrome, memory problems, difficulty concentrating, and myxoedema coma (a medical emergency). On the other hand, hyperthyroidism results in an increase in thyroid hormones, causing symptoms such as hyperactivity, diarrhea, heat intolerance, and tachycardia. Understanding these symptoms can help in the diagnosis and management of these conditions.

    • This question is part of the following fields:

      • Endocrinology
      17.8
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SESSION STATS - PERFORMANCE PER SPECIALTY

Endocrinology (12/20) 60%
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