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| Section | Weight | Objectives |
|---|---|---|
| Pituitary and Hypothalamic Disorders | 15% | - Diabetes insipidus and SIADH - Hypothalamic dysfunction - Hypopituitarism and hormone replacement - Pituitary adenomas: prolactinoma, acromegaly, Cushing's disease |
| Diabetes Mellitus | 40% | - Type 1 Diabetes
|
| Adrenal and Parathyroid/Metabolic Bone Disorders | 15% | - Osteoporosis, osteomalacia, Paget's disease - Hyperparathyroidism, hypoparathyroidism - Primary/secondary hyperaldosteronism - Cushing's syndrome, Addison's disease, phaeochromocytoma |
| Reproductive and Other Endocrine Conditions | 15% | - Endocrine hypertension and rare syndromes - Polycystic ovary syndrome - Disorders of puberty and sex development - Obesity and lipid disorders |
| Thyroid Disorders | 15% | - Hyperthyroidism: Graves’ disease, toxic nodular disease - Thyroiditis and subclinical dysfunction - Hypothyroidism and myxoedema coma - Thyroid nodules and cancer |
A 24-year-old woman was referred with an 18-month history of worsening hirsutism, primarily on her face, but also new hair growth on her chest. She was shaving weekly. She had always been overweight, but had recently gained 5 kg and her body mass index was 31 kg/m2 (18-25). Her periods were regular.
What is the most relevant next investigation?
Correct Answer: D 🗳️
A 72-year-old woman presented with a painless swelling in the front of the neck, which she had first noticed 2-3 months previously. She was otherwise well, with no symptoms of mass effect in her neck, and was not taking any medication.
On examination, her thyroid gland was moderately enlarged, and felt uniformly nodular. There was no associated lymphadenopathy. Her pulse was 78 beats per minute and regular, and there were no signs of thyrotoxicosis.
Investigations:
serum thyroid-stimulating hormone<0.01 mU/L (0.4-5.0)
serum free T424.8 pmol/L (10.0-22.0)
serum free T310.3 pmol/L (3.0-7.0)
technetium-99m scan of thyroid (20-min uptake)patchy uptake in both thyroid lobes
What is the most appropriate management?
Correct Answer: E 🗳️
A 17-year-old Caucasian girl presented with primary amenorrhea.
On examination, her body mass index was 21 kg/m2 (18-25). Her body habitus was normal and she had appropriate breast development. There was no hirsutism or acne.
Investigations:
serum oestradiol<180 pmol/L (200-400) serum testosterone31.7 nmol/L (0.5-3.0) serum follicle-stimulating hormone4.0 U/L (2.5-10.0) serum luteinising hormone6.0 U/L (2.5-10.0)
What is the most likely diagnosis?
Correct Answer: D 🗳️
A 35-year-old man presented with newly diagnosed type 2 diabetes mellitus. He had no medical history of note.
When should he inform the UK Driver and Vehicle Licensing Agency (DVLA) of his medical condition?
Correct Answer: C 🗳️
A 28-year-old woman presented to the emergency department with a 3-day history of abdominal pain. Her past medical history included intermenstrual bleeding, and she was undergoing 6-monthly renal ultrasound surveillance for a cystic lesion.
Investigations:
serum creatinine84 umol/L (60-110)
serum corrected calcium3.20 mmol/L (2.20-2.60)
serum phosphate0.7 mmol/L (0.8-1.4)
plasma parathyroid hormone19.5 pmol/L (0.9-5.4)
What is the most likely condition underlying the clinical presentation?
Correct Answer: C 🗳️
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