Formative

Question 1

How much oily fish, F&V, exercise and alcohol a week for a healthy lifestyle?

Answer 1

Aim for:

• 1 portion of oily fish a week
• 150 minutes of moderate exercise a week
• 5 portions of F&V a day

Don’t drink >14 units a week

Question 2

Which of these isn’t part of hypoglycaemia:

• Itch
• Headache
• Sweating
• Irritability
• Loss of Conc.

Answer 2

Itching!

Question 3

23 yr old hyperthyroidism patient started on Carbimazole. What does he need counselling on regaring his medication?

Answer 3

Potential side effects:

• Rash
• Agranulocytosis - Causes !Neutropenia!

Question 4

38 yr old women:

• Tanned
• Tired
• Dizzy
• Hyperkalemic
• Hyponatremic
• Hypocortisolaemic
• Normal Ca2+
• Normal TFTs

Whats she got?

Answer 4

ADDISON’s!

High K+ and low Na+ are typical electrolytes of addison’s. The lack of aldosterone means your not resorping Na+ or excreting Potassium in the kidneys.
Tanned = Hyperpigmentation
Fatigue is common in addison’s
Dizzy may be down to hypotension due to Na+ loss
Low cortisol due to adrenal insufficiency

Question 5

Which of the following doesn’t cause Secondary DM?

• Haemochromatosis
• Chronic Pancreatitis
• Addison’s Disease
• Cushing’s Disease
• Acromegaly

Answer 5

Addison’s, loss of cortisol can actually risk hypoglycaemia

Haemochromatosis - Fe2+ infiltrating pancreas can limit insulin release
Pancreatitis - Damages Beta Cells
Cushing’s Disease - Excess cortisol increases gluconeogenesis, lipolysis, proteolysis and action of glucagon
Acromegaly - GH increases gluconeogenesis & lipolysis

Question 6

What is the first diagnositic test done on a diabetes patient and do you need a fasting sample?

Answer 6

Random Blood Glucose

Won’t need a fasting sample if the random sample is +ve (>11.1mmol) and the patient has symptoms