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| Section | Objectives |
|---|---|
| Diabetes Mellitus | - Management
|
| Adrenal Disorders | - Adrenal Disease
|
| Thyroid Disorders | - Thyroid Disease
|
| Pituitary and Hypothalamic Disorders | - Pituitary Disease
|
| General Endocrinology | - Integrated Clinical Practice
|
| Reproductive Endocrinology | - Gonadal Disorders
|
| Calcium and Bone Metabolism | - Parathyroid and Metabolic Bone Disease
|
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: E 🗳️
A 28-year-old man was seen in the lipid clinic following a referral from the general surgical team. He had had two episodes of acute pancreatitis over the preceding 6 months, which settled spontaneously. He had a past medical history of HIV disease and was taking highly active antiretroviral (HAART) therapy. He drank 12 units of alcohol per week.
On examination, he had no stigmata of hyperlipidaemia.
Investigations:
fasting plasma glucose6.2 mmol/L (3.0-6.0)
haemoglobin A1c44 mmol/mol (20-42)
serum cholesterol7.5 mmol/L (<5.2)
fasting serum triglycerides23.70 mmol/L (0.45-1.69)
serum thyroid-stimulating hormone0.7 mU/L (0.4-5.0)
serum free T414.3 pmol/L (10.0-22.0)
What class of antiretroviral drug is the most likely cause of his metabolic disturbance?
Correct Answer: A 🗳️
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: D 🗳️
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 🗳️
A 27-year-old woman presented with oligomenorrhoea and hirsutism, and a 2-year history of infertility. Her body mass index was 26 kg/m2 (18-25). Her partner had a recent normal sperm count and motility test.
Investigations:
serum androstenedione17.0 nmol/L (0.6-8.8)
serum 17-hydroxyprogesterone2 nmol/L (1-10)
serum testosterone2.8 nmol/L (0.5-3.0)
serum sex hormone binding globulin18 nmol/L (40-137)
serum follicle-stimulating hormone2.3 U/L (2.5-10.0)
serum luteinising hormone8.3 U/L (2.5-10.0)
serum prolactin152 mU/L (<360)
A diagnosis of polycystic ovary syndrome was made.
What is the most effective next step to help her conceive?
Correct Answer: D 🗳️
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