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Question 1
Correct
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A 72-year-old man comes to the clinic for his yearly check-up and expresses worry about osteoporosis. He has questions about bone formation and calcium homeostasis, and you explain the role of parathyroid hormone (PTH) in regulating calcium levels.
Which of the following statements about PTH is accurate?Your Answer: It causes indirect osteoclastic activation via RANK-L
Explanation:Parathyroid hormone (PTH) indirectly activates osteoclasts by increasing the production of RANK-L by osteoblasts. This leads to bone degradation and the release of calcium. PTH also decreases the release of osteoprotegerin, which is a decoy receptor for RANK-L. This further enhances osteoclast activity and bone degradation. Additionally, PTH causes a decrease in serum calcium by promoting calcium release from bone. It also enhances renal phosphate excretion by decreasing phosphate reabsorption.
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This question is part of the following fields:
- Endocrinology
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Question 2
Correct
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A 35-year-old patient presents to her doctor with complaints of excessive sweating and feeling very warm. Upon examination, no significant thyroid nodule is observed. The patient's blood tests reveal the following results:
Investigation Result Normal value
Thyroid-stimulating hormone (TSH) < 0.1 µU/l 0.4–4.0 µU/l
Free thyroxine (T4) 30 pmol/l 10–20 pmol/l
What is the most probable diagnosis?Your Answer: Graves’ disease
Explanation:Thyroid Disorders: Causes and Symptoms
Thyroid disorders are common and can cause a range of symptoms. Here are some of the most common thyroid disorders and their associated symptoms:
1. Graves’ disease: This is the most common cause of thyrotoxicosis in the UK. Symptoms include a low TSH and an elevated T4.
2. De Quervain’s thyroiditis: This is a subacute thyroiditis that can cause hypothyroidism.
3. Hashimoto’s thyroiditis: This is an autoimmune disorder that is associated with hypothyroidism.
4. Toxic multinodular goitre: There is insufficient information to suggest that the patient has this condition.
5. Thyroid adenoma: Patients usually present with a neck lump, which is not seen in this case.
If you are experiencing any symptoms of a thyroid disorder, it is important to speak with your healthcare provider for proper diagnosis and treatment.
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This question is part of the following fields:
- Endocrinology
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Question 3
Incorrect
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A 28-year-old man comes to the clinic complaining of gradual weight loss. He has lost 8 kg over the past three months, and his previous weight was 62 kg.
Two years ago, he volunteered at a child rehabilitation program in India and contracted pulmonary tuberculosis, which was successfully treated. A recent chest x-ray showed no suspicious lesions in the lungs, and there is no lymphadenopathy. He denies having a fever or night sweats.
During the examination, he reveals that he has been drinking one bottle of wine per day for the past three weeks, following a breakup with his girlfriend.
Which test is likely to show a positive result for the weight loss?Your Answer: Liver function test
Correct Answer: Abdominal x ray
Explanation:Overlooked Causes of Weight Loss: Addison’s Disease
Weight loss can be caused by a variety of factors, and it is important to consider all possibilities when investigating the underlying cause. One often overlooked cause is Addison’s disease, which can occur as a result of past tuberculosis affecting the adrenal glands. This rare condition can be identified through abdominal x-rays, which may show adrenal calcification shadows.
While alcohol abuse can lead to liver damage and hepatitis, it is not likely to be the cause of weight loss in this case. Similarly, steatorrhoea, a manifestation of malabsorption, can cause weight loss, but there are no other indications of malabsorption in this patient’s history.
Thyrotoxicosis, or an overactive thyroid, can also cause weight loss, but it is usually accompanied by other symptoms such as anxiety, tremors, and eye signs. Finally, surreptitious laxative abuse can lead to weight loss, but it is not likely to be the cause in this case given the patient’s history of tuberculosis.
Overall, it is important to consider all possible causes of weight loss, including rare conditions like Addison’s disease, in order to provide the most effective treatment and care for patients.
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This question is part of the following fields:
- Endocrinology
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Question 4
Incorrect
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What is a factor that can lead to a delay in bone maturation?
Your Answer: Central precocious puberty
Correct Answer: Newly diagnosed growth hormone deficiency in a 6-year-old girl
Explanation:Factors affecting bone age in children
Bone age, which refers to the degree of maturation of a child’s bones, can be influenced by various factors. In a child with normal thyroid function, bone age would be expected to be normal if they are receiving adequate treatment. However, in cases of growth hormone deficiency, bone age may be delayed. On the other hand, in cases of exogenous obesity resulting from over-nutrition and lack of exercise, bone age may be advanced.
If a child has an underlying endocrine disorder such as hypothyroidism, their bone age may be delayed. Turner’s syndrome, a genetic disorder affecting females, is also associated with delayed bone age by approximately 2 years during childhood. Conversely, congenital adrenal hyperplasia and central precocious puberty can cause advanced bone age.
In summary, bone age can be affected by various factors, including thyroid function, growth hormone deficiency, obesity, endocrine disorders, and genetic conditions. these factors can help healthcare providers assess a child’s growth and development and provide appropriate treatment if necessary.
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This question is part of the following fields:
- Endocrinology
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Question 5
Correct
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A 50-year-old woman presents with symptoms of lethargy, weight gain, dry hair and skin, cold intolerance, constipation and low mood. What is the most probable diagnosis?
Your Answer: Hypothyroidism
Explanation:Understanding Hypothyroidism and Differential Diagnosis
Hypothyroidism is a condition characterized by a range of symptoms, including 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. Diagnosis is made by measuring TSH and T4 levels, with elevated TSH and decreased T4 confirming the diagnosis. Treatment involves titrating doses of levothyroxine until serum TSH normalizes and symptoms resolve. Differential diagnosis includes hypercalcaemia, hyperthyroidism, Addison’s disease, and Cushing’s disease, each with their own unique set of symptoms. Understanding these conditions and their symptoms is crucial for accurate diagnosis and effective treatment.
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This question is part of the following fields:
- Endocrinology
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Question 6
Incorrect
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A 50-year-old woman has been diagnosed with Addison's disease. What would be advantageous to prescribe for her along with hydrocortisone?
Your Answer: Combined oral contraceptive pill
Correct Answer: Fludrocortisone
Explanation:Medications for Addison’s Disease: What Works and What Doesn’t
Addison’s disease is a condition where the adrenal glands do not produce enough hormones. Patients with this condition require replacement therapy with both glucocorticoid and mineralocorticoid medications. Fludrocortisone is a common mineralocorticoid replacement therapy used in Addison’s disease. However, medications such as aspirin, the combined oral contraceptive pill, and the progesterone only pill have no role in treating this condition. Additionally, dexamethasone is not used as a replacement therapy for Addison’s disease. It is important for patients with Addison’s disease to work closely with their healthcare provider to determine the appropriate medications for their individual needs.
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This question is part of the following fields:
- Endocrinology
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Question 7
Correct
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A 16-year-old athlete attends a routine check-up. Her past medical history is significant for type 1 diabetes since the age of 7. Her glucose is well controlled with self-administration of insulin. She reports that she is training for the upcoming national championship. She has specific questions regarding the effects and actions of insulin.
Which of the following is correct regarding the action of insulin?Your Answer: Insulin increases protein synthesis in muscle
Explanation:The Effects of Insulin on the Body: Promoting Protein Synthesis, Sodium Secretion, and More
Insulin is a crucial hormone synthesized in pancreatic β cells that plays a vital role in the metabolism of carbohydrates and lipids in the body. This peptide hormone promotes glycogen synthesis, increases potassium uptake, and reduces lipolysis and proteolysis in cells. Additionally, insulin is known to increase protein synthesis in muscle and decrease triglyceride synthesis and storage in adipocytes.
One of the lesser-known effects of insulin is its ability to promote sodium secretion in the renal tubules. Insulin is also responsible for increasing tubular sodium reabsorption in the kidney, which halves sodium excretion.
Furthermore, insulin is used in the management of hyperkalaemia as it increases serum potassium levels by causing a shift of potassium into the cells, thereby lowering circulating potassium and increasing intracellular potassium concentration.
However, insulin does decrease glycogen storage in cells by activating enzymes involved in glycogen synthesis in the liver and tissues, causing the conversion of glucose to glycogen.
In summary, insulin has a wide range of effects on the body, from promoting protein synthesis to regulating potassium and sodium levels.
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This question is part of the following fields:
- Endocrinology
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Question 8
Incorrect
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What is the most frequent organic cause of anxiety symptoms?
Your Answer: Phaeochromocytoma
Correct Answer: Hypoglycaemia
Explanation:Organic Causes of Anxiety
Anxiety can be caused by various factors, including organic causes. One of the more common organic causes of anxiety is hypoglycaemia. However, there are other organic causes that can also lead to anxiety. These include alcohol withdrawal, drug intoxication or withdrawal, thyroxine, and paroxysmal supraventricular tachycardias. While phaeochromocytoma is a rare cause of anxiety, carcinoid does not cause anxiety at all. It is important to note that carcinoma of the bronchus and hyperparathyroidism are more likely to present with depression rather than anxiety.
It is crucial to identify the underlying cause of anxiety to provide appropriate treatment. If an organic cause is suspected, further evaluation and testing may be necessary to determine the root cause of the anxiety. By addressing the underlying cause, it may be possible to alleviate or even eliminate the symptoms of anxiety. Therefore, it is important to consider all possible causes of anxiety, including organic causes, to provide the best possible care for patients.
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This question is part of the following fields:
- Endocrinology
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Question 9
Incorrect
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A floppy 1-month-old infant presented with vomiting, weight loss and circulatory collapse. Blood tests demonstrated hyponatraemia and hyperkalaemia. Further tests confirmed metabolic acidosis and hypoglycaemia. The paediatrician noticed that the penis was enlarged and the scrotum pigmented. The child was treated with both a glucocorticoid and a mineralocorticoid.
What is the most likely underlying diagnosis?Your Answer: Addisonian crisis
Correct Answer: Congenital adrenal hyperplasia
Explanation:Congenital adrenal hyperplasia is a group of genetic conditions that affect the production of hormones and steroids from the adrenal glands. The most common cause is a deficiency in the enzyme 21-hydroxylase. This leads to overactivity of the steroid-producing cells and inadequate cortisol production, resulting in an excess of mineralocorticoids and androgens/oestrogens. Symptoms can include ambiguous genitalia at birth in females, hyperpigmentation and penile enlargement in males, and biochemical abnormalities such as hyponatraemia and hyperkalaemia. Treatment involves hormone replacement therapy. Addisonian crisis is a potentially fatal episode caused by glucocorticoid and mineralocorticoid deficiency, usually occurring in adulthood and precipitated by stress. It presents with hyponatraemia, hyperkalaemia, hypoglycaemia and hypercalcaemia, and is managed with urgent administration of glucocorticoids. Conn syndrome is associated with primary hyperaldosteronism and presents with hypernatraemia and hypokalaemia. Cushing syndrome is due to cortisol excess and presents with weight gain, hypertension, oedema, hyperglycaemia, hypokalaemia and skin pigmentation. Thyrotoxic crisis is a life-threatening condition associated with excessive production of thyroid hormones, presenting with a range of symptoms including tachycardia, hypertension, fever, poor feeding, weight loss, diarrhoea, nausea, vomiting, seizures and coma. Prompt treatment is essential to prevent serious complications.
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This question is part of the following fields:
- Endocrinology
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Question 10
Incorrect
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A 35-year-old woman visits her GP complaining of secondary amenorrhoea and suspects she may be pregnant. Which of the following sets of results is indicative of early pregnancy?
A
FSH (follicular phase 2.9-8.4 U/L): 0.5
LH (follicular phase 1.3-8.4 U/L): 1.1
Oestrogen (pmol/L): 26
Progesterone (pmol/L): <5
B
FSH (follicular phase 2.9-8.4 U/L): 0.5
LH (follicular phase 1.3-8.4 U/L): 1.2
Oestrogen (pmol/L): 120
Progesterone (pmol/L): 18
C
FSH (follicular phase 2.9-8.4 U/L): 68
LH (follicular phase 1.3-8.4 U/L): 51
Oestrogen (pmol/L): 42
Progesterone (pmol/L): <5
D
FSH (follicular phase 2.9-8.4 U/L): 1.0
LH (follicular phase 1.3-8.4 U/L): 0.8
Oestrogen (pmol/L): 120
Progesterone (pmol/L): 160
E
FSH (follicular phase 2.9-8.4 U/L): 8.0
LH (follicular phase 1.3-8.4 U/L): 7.2
Oestrogen (pmol/L): 144
Progesterone (pmol/L): <5Your Answer: C
Correct Answer: D
Explanation:Blood Test Ranges in Pregnancy
During pregnancy, blood tests may have different ranges due to the dilutional effect caused by the increased circulating volume, which can peak at almost 4L. This can result in lower levels of sodium, potassium, albumin, gamma globulins, hemoglobin, urea, creatinine, and urate. Additionally, pregnancy is associated with raised prolactin, low LH and FSH, and increased levels of estrogen and progesterone, with progesterone typically being greater than estrogen.
Compared to non-pregnant women, pregnant women may have increased white blood cell count and platelets, as well as higher levels of cholesterol, triglycerides, and ESR. Alkaline phosphatase levels may also be increased, as the placenta produces this enzyme. It is important to note that while some changes in blood test results are due to the dilutional effect of pregnancy, others may indicate underlying health issues, such as iron deficiency anemia. Therefore, it is crucial for healthcare providers to interpret blood test results in the context of pregnancy and individual patient health.
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This question is part of the following fields:
- Endocrinology
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Question 11
Correct
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A 55-year-old male with a long history of smoking presents with a complaint of haemoptysis. Upon examination, muscle wasting and hypertension are observed. Further testing reveals elevated urine free cortisol, elevated ACTH, and non-suppressible cortisol following high dose dexamethasone testing. What is the most probable diagnosis?
Your Answer: Ectopic ACTH producing lung cancer
Explanation:Ectopic ACTH Production and Associated Tumours
Patients with Cushing’s syndrome and non-suppressible cortisol levels may have ectopic adrenocorticotropic hormone (ACTH) secretion, which is commonly associated with small cell lung cancer. Other tumours that may cause ectopic ACTH production include those of the thymus, pancreas, thyroid, and adrenal gland. Unlike typical hypercortisolism symptoms, patients with ectopic ACTH production may experience polyuria, polydipsia, oedema, muscle wasting, fatigue, hypertension, and hypokalaemia.
Laboratory tests can confirm excessive cortisol production and lack of dexamethasone suppression of morning cortisol levels. Plasma ACTH levels greater than 200 pg/mL may indicate ectopic ACTH production and prompt a search for an underlying malignancy, particularly a primary lung or pancreatic tumour. Therefore, it is crucial to investigate the possibility of ectopic ACTH production in patients with Cushing’s syndrome and non-suppressible cortisol levels, as it may indicate an underlying tumour.
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This question is part of the following fields:
- Endocrinology
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Question 12
Correct
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A 16-year-old girl has been referred due to a six-month history of amenorrhea and weight loss, without identifiable organic cause. What signs would indicate a possible diagnosis of anorexia nervosa (AN)?
Possible revised output with paragraph spacing:
A 16-year-old girl has been referred to the clinic with a six-month history of amenorrhea and weight loss. Despite medical investigations, no organic cause has been identified for her symptoms. The healthcare provider suspects that the patient may have anorexia nervosa (AN), a serious eating disorder characterized by self-imposed starvation and distorted body image. To confirm or rule out this diagnosis, the provider needs to look for specific features that are commonly associated with AN.Your Answer: Delusion of being overweight
Explanation:Features of Anorexia Nervosa
Anorexia Nervosa (AN) is a serious eating disorder that is characterized by several features. One of the most prominent features is a phobic avoidance of normal weight, which leads to relentless dieting and self-induced vomiting. Laxative use and excessive exercise are also common behaviors associated with AN. Another feature of AN is amenorrhea, which is the absence of menstrual periods.
Physical symptoms of AN include hypotension and the growth of lanugo hair, which is fine, downy hair that grows on the body as a result of malnutrition. Denial and concealment are also common behaviors associated with AN, as individuals with this disorder often try to hide their symptoms from others.
In addition to these physical and behavioral symptoms, individuals with AN may also have an over-perception of their body image, leading them to see themselves as overweight even when they are underweight. Finally, AN is often associated with enmeshed families, where family members are overly involved in each other’s lives and have difficulty setting boundaries.
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This question is part of the following fields:
- Endocrinology
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Question 13
Correct
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What is an example of an exocrine function of the pancreas?
Your Answer: Secretion of amylase
Explanation:Functions of Digestive Enzymes and Hormones
Amylase is an enzyme that aids in the digestion of carbohydrates. It is present in both pancreatic juices and saliva. The exocrine function of the pancreas involves the secretion of substances into ducts that ultimately pass to the exterior of the body. Examples of exocrine glands include sweat glands, salivary glands, and mammary glands. On the other hand, the endocrine function of the pancreas involves the secretion of substances directly into the bloodstream. Insulin, which is secreted from the beta cells of the islets of Langerhans of the pancreas, is an example of an endocrine function.
Bile is another substance that aids in digestion. It is secreted by hepatocytes and stored in the gallbladder. Following a meal, bile is released to aid in the digestion of fats. Intrinsic factor, which is secreted by the parietal cells of the stomach, is responsible for binding vitamin B12 to allow its absorption in the terminal ileum. Finally, noradrenaline is a hormone that is released by the adrenal medulla. It plays a role in the body’s fight or flight response.
In summary, the digestive system relies on a variety of enzymes and hormones to function properly. These substances are secreted by various glands and organs throughout the body, and they work together to break down food and absorb nutrients.
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This question is part of the following fields:
- Endocrinology
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Question 14
Correct
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A 32-year-old woman visits her GP with complaints of palpitations, tremors, sweating, and diarrhoea. She has a medical history of gestational hypertension and type 1 diabetes, which is managed with insulin. The patient gave birth to her first child 8 weeks ago without any complications.
Upon examination, the patient is alert and oriented. Her vital signs are as follows: heart rate of 109 bpm, respiratory rate of 19 breaths/minute, temperature of 37.7ºC, oxygen saturation of 98%, blood pressure of 129/88 mmHg, and blood glucose of 4 mmol/L.
What is the most likely diagnosis, and what is the appropriate treatment?Your Answer: Propranolol
Explanation:The recommended treatment for the thyrotoxicosis phase of postpartum thyroiditis is typically propranolol alone. This is because the condition is usually temporary and self-resolving, with thyroid function returning to normal within a year after childbirth. Carbimazole is not necessary as it is typically reserved for more severe cases of hyperthyroidism. Dexamethasone is not appropriate as it is used to treat thyroid storm, a complication of thyrotoxicosis that is not present in this case. Levothyroxine is also not indicated as it is used to treat hypothyroidism, which is the opposite of the patient’s current condition.
Understanding Postpartum Thyroiditis: Stages and Management
Postpartum thyroiditis is a condition that affects some women after giving birth. It is characterized by three stages: thyrotoxicosis, hypothyroidism, and normal thyroid function. During the thyrotoxicosis phase, the thyroid gland becomes overactive, leading to symptoms such as anxiety, palpitations, and weight loss. In the hypothyroidism phase, the thyroid gland becomes underactive, causing symptoms such as fatigue, weight gain, and depression. However, in the final stage, the thyroid gland returns to normal function, although there is a high recurrence rate in future pregnancies.
Thyroid peroxidase antibodies are found in 90% of patients with postpartum thyroiditis, which suggests an autoimmune component to the condition. Management of postpartum thyroiditis depends on the stage of the condition. During the thyrotoxic phase, symptom control is the main focus, and propranolol is typically used. Antithyroid drugs are not usually used as the thyroid gland is not overactive. In the hypothyroid phase, treatment with thyroxine is usually necessary to restore normal thyroid function.
It is important to note that many causes of hypothyroidism may have an initial thyrotoxic phase, as shown in a Venn diagram. Therefore, it is crucial to properly diagnose and manage postpartum thyroiditis to ensure the best possible outcomes for both the mother and the baby.
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This question is part of the following fields:
- Endocrinology
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Question 15
Correct
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A 30-year-old woman complains of menstrual irregularity and galactorrhoea for the past year. She also experiences occasional headaches. During examination, she was found to have bitemporal superior quadrantanopia. What is the most probable diagnosis?
Your Answer: Prolactinoma
Explanation:Prolactinomas cause amenorrhoea, infertility, and galactorrhoea. If the tumour extends outside the sella, visual field defects or other mass effects may occur. Other types of tumours will produce different symptoms depending on their location and structure involved. Craniopharyngiomas originate from the pituitary gland and will produce poralhemianopia if large enough, as well as symptoms related to pituitary hormones. Non-functioning pituitary tumours will have similar symptoms without the pituitary hormone side effects. Tumours of the hypothalamus will present with symptoms of euphoria, headache, weight loss, and mass effect if large enough.
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This question is part of the following fields:
- Endocrinology
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Question 16
Correct
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You are asked to review a 27-year-old man who has had two episodes of pancreatitis. On reviewing his notes, the surgeons noticed that he appeared to have had a serum calcium of 3.2 mmol/l when it was checked at the general practice surgery a few weeks before the latest episode. Urinary calcium excretion is markedly reduced.
Which of the following diagnoses fits best with this clinical picture?Your Answer: Familial hypocalciuric hypercalcaemia
Explanation:Differentiating Hyper- and Hypocalcaemia Disorders
One young male patient has experienced two episodes of pancreatitis due to hypercalcaemia. However, his urinary calcium levels are reduced, which suggests that he may have familial hypocalciuric hypercalcaemia. On the other hand, pseudohypoparathyroidism would result in hypocalcaemia, while hyperparathyroidism would cause hypercalcaemia without reducing urinary calcium excretion. Hypoparathyroidism would also lead to hypocalcaemia, but the calcium levels would be raised. Finally, Paget’s disease would not affect urinary calcium excretion. Therefore, it is crucial to differentiate between these disorders to provide appropriate treatment.
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This question is part of the following fields:
- Endocrinology
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Question 17
Incorrect
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A 25-year-old male patient arrives at the emergency department with symptoms of vomiting and dehydration. He reports a two-month history of weight loss and excessive thirst. Upon examination, the patient is diagnosed with diabetic ketoacidosis, with a blood glucose level of 29.3 mmol/L (3.0-6.0), a pH of 7.12 (7.36-7.44) on blood gas analysis, and +++ ketones in the urine. What is the percentage of individuals with type 1 diabetes who are initially diagnosed after presenting with diabetic ketoacidosis?
Your Answer: 5%
Correct Answer: 25%
Explanation:Diabetic Ketoacidosis: A Dangerous Complication of Type 1 Diabetes
Approximately one quarter of patients with type 1 diabetes will experience their first symptoms in the form of diabetic ketoacidosis (DKA). However, it is important to note that these individuals may have previously ignored symptoms such as thirst, frequent urination, and weight loss. DKA is a serious and potentially life-threatening complication of diabetes that is characterized by high blood sugar levels, lactic acidosis, vomiting, and dehydration. It is crucial for individuals with type 1 diabetes to be aware of the signs and symptoms of DKA and seek medical attention immediately if they suspect they may be experiencing this condition. Proper management and treatment of DKA can help prevent serious complications and improve overall health outcomes.
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This question is part of the following fields:
- Endocrinology
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Question 18
Incorrect
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A 55-year-old man comes to his GP complaining of tingling in both hands that began a month ago and has been progressively worsening. He has no significant medical history. During the examination, you observe that the man has large hands, widely spaced teeth, and a prominent brow. You suspect that he may have acromegaly.
What is the most suitable initial investigation for acromegaly?Your Answer: Computed tomography (CT) Head
Correct Answer: Serum IGF1 levels
Explanation:Investigations for Acromegaly: Serum IGF1 Levels, CT/MRI Head, and Visual Field Testing
Acromegaly is a condition caused by excess growth hormone (GH) production, often from a pituitary macroadenoma. To diagnose acromegaly, insulin-like growth factor 1 (IGF1) levels are measured instead of GH levels, as IGF1 has a longer half-life and is more stable in the blood. If IGF1 levels are high, a glucose tolerance test is used to confirm the diagnosis. CT scans of the head are not as sensitive as MRI scans for investigating pituitary tumors, which are a common cause of acromegaly. Visual field testing is also important to assess whether a pituitary tumor is compressing the optic chiasm, but it is not specific to acromegaly and is part of the physical exam.
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This question is part of the following fields:
- Endocrinology
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Question 19
Incorrect
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Through which of the following molecules is the hypercalcaemia of malignancy most commonly mediated?
Your Answer: Parathyroid hormone
Correct Answer: Parathyroid hormone related protein
Explanation:The Role of Parathyroid Hormone-Related Protein in Hypercalcaemia
Parathyroid hormone-related protein (PTHrP) is a group of protein hormones that are produced by various tissues in the body. Its discovery was made when it was found to be secreted by certain tumors, causing hypercalcaemia in affected patients. Further studies revealed that the uncontrolled secretion of PTHrP by many tumor cells leads to hypercalcaemia by promoting the resorption of calcium from bones and inhibiting calcium loss in urine, similar to the effects of hyperparathyroidism.
Overall, PTHrP plays a crucial role in regulating calcium levels in the body, and its overproduction can lead to serious health complications. the mechanisms behind PTHrP secretion and its effects on the body can aid in the development of treatments for hypercalcaemia and related conditions.
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This question is part of the following fields:
- Endocrinology
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Question 20
Incorrect
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A 26-year-old waitress presents with a 2-day history of increasing confusion. She has no significant medical history, takes only oral contraceptives, and denies any substance use. Blood and urine tests suggest a possible diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following statements regarding SIADH secretion is accurate?
Your Answer: Hypernatraemia is typical
Correct Answer: It may occur in subarachnoid haemorrhage
Explanation:Understanding SIADH: Causes and Treatment Options
SIADH, or syndrome of inappropriate antidiuretic hormone secretion, is a condition characterized by excessive production of ADH, leading to hyponatraemia. While it can occur in various medical conditions, subarachnoid haemorrhage is a known cause of SIADH. In such cases, monitoring sodium levels is crucial. The treatment of choice for SIADH is fluid restriction, but in severe cases, hypertonic saline may be used. Demeclocycline, a tetracycline, is sometimes used to treat hyponatraemia in SIADH. It’s important to note that small cell lung cancer, not adenocarcinoma of the lung, is a well-known cause of SIADH through ectopic ADH secretion. Understanding the causes and treatment options for SIADH is essential for managing this condition effectively.
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This question is part of the following fields:
- Endocrinology
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