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Endocrinology

Hormones | Endocrine function|anterior pituitary tumours | hyperprolactinaemia | acromegaly | Hypopituitarism | Hyperthyroidism | Hypothyroidism | thyroid nodule and goitre | thyroid carcinoma |adrenal disorders | adult hypogonadism | disorders of fertility | androgen excess syndromes |Endocrine causes of hypertension | hypernatremia | hyponatremia |hypercalcemia| hypocalcemia| osteoporosis and fractures with minimal trauma | bone mineral density reports |Paget's disease of bone | ectopic humoral syndromes| Investigation and management of hyperlipidemia| diabetes ocular complications| diabetes renal complications | diabetes neurologic complications | diabetes vascular complications|Initial management of newly presenting diabetes | The pathophysiological basis of insulin-dependent and non insulin-dependent diabetes and implications of this for treatment | diabetes and surgery | diabetes and acute illness | hyperglycaemia/ketoacidosis | hypoglycaemia | dyslipidaemia and other diabetes related cardiovascular risk factors | Management of erectile dysfunction |Management of renal disease in diabetes | the diabetic foot | diabetes in pregnancy

Exam questions

2002 paper one question 60 hypopituitarism and growth hormone
repeat question 2003 paper one question 41 hypopituitarism and growth hormone

2005 paper two question 33 - hypopituitarism requiring hydrocort Rx

2002 paper two question 67 - non specific clinical presentation on HRT and pituitary disorder

Reference

Hypopituitarism
Schneider HJ, Aimaretti G, Kreitschmann-Andermahr I, Stalla GK, Ghigo E
The Lancet - Vol. 369, Issue 9571, 28 April 2007 , Pages 1461-1470

  • Thyroid disorders: top
    • Diagnosis and management of
      • hyper- and

      exam questions

      2003 paper two question 79 uptake of iodine in thyrotoxicosis

      2005 paper two question 21 Thyrotoxic, Non- tender, Low radioiodine updake is most consistent with silent thyroiditis

      note the above two questions used the same image to ask a different question

      references

      Drug Therapy: Antithyroid Drugs
      Cooper D. S. N Engl J Med 2005; 352:905-917, Mar 3, 2005. Review Articles

      Current Concepts: Thyroiditis
      Pearce E. N., Farwell A. P., Braverman L. E.
      N Engl J Med 2003; 348:2646-2655, Jun 26, 2003. Review Articles

      Clinical review Diagnosis and management of thyrotoxicosis Elizabeth N Pearce
      BMJ 2006; 332: 1369-1373.

      SCIENTIFIC REVIEW AND CLINICAL APPLICATIONS:
      Martin I. Surks; Eduardo Ortiz; Gilbert H. Daniels; Clark T. Sawin; Nananda F. Col; Rhoda H. Cobin; Jayne A. Franklyn; Jerome M. Hershman; Kenneth D. Burman; Margo A. Denke; Colum Gorman; Richard S. Cooper; Neil J. Weissman
      Subclinical Thyroid Disease: Scientific Review and Guidelines for Diagnosis and Management
      JAMA, January 14, 2004; 291: 228 - 238.

      SCIENTIFIC REVIEW AND CLINICAL APPLICATIONS:
      Nananda F. Col; Martin I. Surks; Gilbert H. Daniels
      Subclinical Thyroid Disease: Clinical Applications
      JAMA, January 14, 2004; 291: 239 - 243.

      Anne R. Cappola; Linda P. Fried; Alice M. Arnold; Mark D. Danese; Lewis H. Kuller; Gregory L. Burke; Russell P. Tracy; Paul W. Ladenson
      Thyroid Status, Cardiovascular Risk, and Mortality in Older Adults
      JAMA, March 1, 2006; 295: 1033 - 1041.

      Hyperthyroidism Cooper DS
      The Lancet - Vol. 362, Issue 9382, 09 August 2003, Pages 459-468

      American Thyroid association – guidelines
      http://www.thyroid.org/professionals/index.html

      http://www.thyroidmanager.org

      hypothyroidism, top

      exam questions

      references

      http://www.thyroidmanager.org

      SCIENTIFIC REVIEW AND CLINICAL APPLICATIONS:
      Martin I. Surks; Eduardo Ortiz; Gilbert H. Daniels; Clark T. Sawin; Nananda F. Col; Rhoda H. Cobin; Jayne A. Franklyn; Jerome M. Hershman; Kenneth D. Burman; Margo A. Denke; Colum Gorman; Richard S. Cooper; Neil J. Weissman
      Subclinical Thyroid Disease: Scientific Review and Guidelines for Diagnosis and Management
      JAMA, January 14, 2004; 291: 228 - 238.

      SCIENTIFIC REVIEW AND CLINICAL APPLICATIONS:
      Nananda F. Col; Martin I. Surks; Gilbert H. Daniels
      Subclinical Thyroid Disease: Clinical Applications
      JAMA, January 14, 2004; 291: 239 - 243.

      • thyroid nodule and goitre top

      exam questions

      2002 paper one question 42 cold thyroid nodule, includes thyroid cancer fast facts

      2004 paper one question 36 hot thyroid nodule,and the TSH receptor

      references

      The Thyroid Nodule
      Hegedüs L. N Engl J Med 2004; 351:1764-1771, Oct 21, 2004. Clinical Practice

      http://www.thyroidmanager.org


    • Diagnosis and principles of management of thyroid carcinoma. top

    Exam questions

    2002 paper one question 42 cold thyroid nodule, includes thyroid cancer fast facts

    2003 paper two question 73 Expression of RET proto-oncogene in (MEN) type 2 and Medullary Thyroid Carcinoma

    References

    http://www.thyroidmanager.org

  • Adrenal Disorders top
  • Diagnosis and management of syndromes of adrenocortical insufficiency and excess.

Exam questions

2002 paper one question 19 Secondary hypoadrenalism following pituitary adenoma resection

2003 paper one question 16 cortisol excess and depression

2003 paper two question 49 Adrenal incidentaloma

2005 paper two question 82

References

The Incidentally Discovered Adrenal Mass
Young W. F. Jr. N Engl J Med 2007; 356:601-610, Feb 8, 2007. Clinical Practice

Carmine M. Pariante and Andrew H. Miller REVIEW: Glucocorticoid Receptors in Major Depression: Relevance to Pathophysiology and Treatment
Biol Psychiatry 2001;49:391–404 © 2001 Society of Biological Psychiatry

Holsboer F, Bardent N. Antidepressants and hypothalamic-pituitary-adrenocortical regulation. Endocr Rev. 1996 Apr;17(2):187-205. Review.

Mann JJ  The medical management of depression. N Engl J Med. 2005 Oct 27;353(17):1819-34. Review

The Journal of Clinical Endocrinology & Metabolism Vol. 88, No. 12 5593-5602
Copyright © 2003 by The Endocrine Society
Diagnosis and Complications of Cushing’s Syndrome: A Consensus Statement
G. Arnaldi, A. Angeli, A. B. Atkinson, X. Bertagna, F. Cavagnini, G. P. Chrousos, G. A. Fava, J. W. Findling, R. C. Gaillard, A. B. Grossman, B. Kola, A. Lacroix, T. Mancini, F. Mantero, J. Newell-Price, L. K. Nieman, N. Sonino, M. L. Vance, A. Giustina and M. Boscaro

 

exam questions

reference

Hirsutism Rosenfield R. L.
N Engl J Med 2005; 353:2578-2588, Dec 15, 2005. Clinical Practice

HYPERANDROGENISM, HIRSUTISM AND POLYCYSTIC OVARY SYNDROME
Chapter 6 - Randall B. Barnes, M.D., Adrienne B. Neithardt, M.D. and Suleena K. Kalra, M.D.
November 19, 2003

The Evaluation and Management of Hirsutism
Ricardo Azziz
Obstet Gynecol 2003 101: 995-1007


  • Endocrine causes of hypertension. top

Exam Questions

2002 paper two question 6 - Investigations for hypertension in a young person

2004 paper two question 96 - Hypertension and hypokalaemia

 

References

See Cardiology: Hypertension

AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS
MEDICAL GUIDELINES FOR CLINICAL PRACTICE
FOR THE DIAGNOSIS AND TREATMENT OF HYPERTENSION 2006

Essential hypertension
The LancetVolume 370, Issue 958718 August 2007-24 August 2007Pages 591-603
Franz H Messerli, Bryan Williams and Eberhard Ritz


Review Article: Mechanisms of Disease The New England Journal of Medicine
Volume 356: 1966-1978 May 10 2007 Number 19
Sodium and Potassium in the Pathogenesis of Hypertension
Horacio J. Adrogué, M.D., and Nicolaos E. Madias, M.D.

  • Investigation and management of top
    • hypernatremia and

     

    • hyponatremia. top

 

    exam questions

    references

    Clincial Practice NEJM Volume 356: 2064-2072 May 17,2007 number 20
     The Syndrome of Inappropriate Antidiuresis
    David H. Ellison, M.D., and Tomas Berl, M.D.

  • Diagnosis and management of hypercalcemia, including hyperparathyroidism and hypercalcemia of malignancy. top

exam questions

2002 paper two question 30 - Investigating the cause of hypercalcaemia

2004 paper two question 44 - Management of hypercalcaemia in symptomatic patient with ca - nausea, weakness and constipation

2005 paper one question 39 Mechanism of hypercalcaemia in lymphoma is Increased 1,25(OH)2-vitamin D synthesis.

references

Hypercalcemia Associated with Cancer
Stewart A. F. N Engl J Med 2005; 352:373-379, Jan 27, 2005. Clinical Practice

Clinical review Hypercalcaemia in cancer
Simon Conroy and Brendan O'Malley
BMJ 2005; 331: 954.

Asymptomatic Primary Hyperparathyroidism
Bilezikian J. P., Silverberg S. J. N Engl J Med 2004; 350:1746-1751, Apr 22, 2004. Clinical Practice

  • Investigation and management of hypocalcemia. top

Exam questions

2004 paper two question 69 - investigating hypocalceamia - vitamin D deficiency

References

exam questions

2002 paper two question 93 - Use of bone scintigram in the diagnosis of Paget's disease

References

also covered in Rheumatology

  • Diagnoses and management of important ectopic humoral syndromes. top
  • Investigation and management of hyperlipidemia. top

exam questions

2004 paper two question 75autosomal dominant familial hypercholesterolaemia

2005 paper one question 33 Genetic abnormalities in lipid metabolism

references

Medical Progress: Acquired and Inherited Lipodystrophies
Garg A. N Engl J Med 2004; 350:1220-1234, Mar 18, 2004. Review Articles

Mechanisms of Disease: Inflammation, Atherosclerosis, and Coronary Artery Disease
Göran K. Hansson, M.D., Ph.D

NEJM Vol 352: 1685-1695 Arpil 21, 2005 No 16

National Heart Foundation Postion Statement on lipid management