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| Section | Objectives |
|---|---|
| Thyroid Disease | - Thyroid nodules and cancer - Hyperthyroidism and hypothyroidism |
| Reproductive Endocrinology | - Hypogonadism and infertility - Polycystic ovary syndrome (PCOS) |
| Pituitary and Hypothalamic Disorders | - Diabetes insipidus and SIADH - Pituitary adenomas and hypopituitarism |
| Metabolic Disorders | - Obesity management - Lipid disorders |
| Neuroendocrine Tumours and Multiple Endocrine Neoplasia | - MEN syndromes - Carcinoid and pancreatic NETs |
| Adrenal Disorders | - Cushing syndrome - Addison disease and adrenal insufficiency |
| Diabetes Mellitus | - Type 1 and Type 2 diabetes management - Diabetic complications and emergencies |
| Endocrine Emergencies | - Thyroid and adrenal crisis - Diabetic ketoacidosis and hyperosmolar states |
| Calcium, Bone and Metabolic Disease | - Calcium and vitamin D disorders - Osteoporosis and metabolic bone disease |
A 27-year-old woman with type 1 diabetes mellitus was invited to attend a structured education (e.g. DAFNE) coursE.
Which quality of life domain is most affected when a person is found to have type 1 diabetes mellitus?
Correct Answer: C 🗳️
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 29-year-old woman presented with primary infertility, having had unprotected sexual intercourse for 15 months. Menarche had occurred at the age of 13.5 years. Her menstrual cycle was irregular, occurring every 20-60 days. There was no history of galactorrhoea. She denied abnormal hair growth.
On examination, her body mass index was 28.9 kg/m2 (18-25) and she had normal secondary sexual characteristics. Her visual fields were full to confrontation.
Investigations:
serum androstenedione12.8 nmol/L (0.6-8.8)
serum oestradiol205 pmol/L (200-400)
serum testosterone2.4 nmol/L (0.5-3.0)
serum sex hormone binding globulin23 nmol/L (40-137)
serum follicle-stimulating hormone4.3 U/L (2.5-10.0)
serum luteinising hormone8.5 U/L (2.5-10.0)
serum prolactin420 mU/L (<360)
hysterosalpingogrampatent fallopian tubes
partner's semen analysisnormal sperm count and motility
What is the most appropriate first-line intervention?
Correct Answer: A 🗳️
A 20-year-old man presented with a 6-month history of lethargy and weakness. His brother had been found to have adrenal failure at the age of 18. He had two sisters who were well and there was no other family history of endocrine autoimmune disease.
On examination, his blood pressure was 100/60 mmHg.
Investigations:
serum sodium136 mmol/L (137-144)
serum potassium4.8 mmol/L (3.5-4.9)
short tetracosactide (Synacthen@) test (250 micrograms):
baseline serum cortisol100 nmol/L
serum cortisol (30 min after tetracosactide)250 nmol/L (>550)
anti-adrenal antibodiesnegative
What is the most important diagnosis to consider?
Correct Answer: B 🗳️
A 62-year-old woman was referred with difficulty in swallowing and a painful, swollen neck.
On examination, her neck was tender to palpation with a small, diffuse goitre. There was no
associated neck lymphadenopathy.
Investigations:
serum thyroid-stimulating hormone<0.04 mU/L (0.4-5.0)
serum free T426.0 pmol/L (10.0-22.0)
serum free T312.0 pmol/L (3.0-7.0)
What is the most likely diagnosis?
Correct Answer: A 🗳️
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