A patient with type 2 diabetes mellitus has been trying to control their cholesterol with an improved diet, however his repeat bloods reveal an LDL of 5.0 mmol/L. How do you manage this?
1.Lifestyle advice
2.Ezetimibe
3.Simvastatin
4.A Fibrate
5.Another 6 month trial of diet control
Which of the following is not a feature of Phaeochromocytoma?
1.Headache
2.Palpitations
3.Hypertension
4.Anxiety
5.Diarrhoea
How would you manage a patient with Type 1 Diabetes mellitus who has a BM of 1.9 mmol/L, who is drowsy?
1.50% dextrose
2.Biscuit
3.IM glucagon
4.IV hydrocortisone
5.Lucozade
What test is most sensitive for carcinoid syndrome?
1.Plasma Chromogranin A
2.Urinary 5 HIAA
3.LFTs
4.AFP
5.Somatostatin
A patient is diagnosed with a microadenoma which has lead to acromegaly. How should this patient be managed?
1.Pegvisomant
2.Octreotide
3.Bromocriptine
4.Transsphenoidal surgery
5.Radiotherapy
Which of the following is most likely to lead to a pericardial effusion?
1.Graves Disease
2.Hyperthyroidism
3.Type 2 Diabetes Mellitus
4.Hypothyroidism
5.Panhypopituitarism
The following are direct thrombin inhibitors except for;
a)Bivalirudin
b)Romiplostim
c)Argatroban
d)Hirudin
How should a male with hypogonadotrophic hypogonadism be managed?
1.GnRH analogues
2.IM testosterone plus GnRH when fertility required
3.Nil
4.Gonadotrophins
5.Oral testosterone plus GnRH when fertility required
How should a male with hypogonadotrophic hypogonadism be managed?
1.GnRH analogues
2.IM testosterone plus GnRH when fertility required
3.Nil
4.Gonadotrophins
5.Oral testosterone plus GnRH when fertility required
A 24 year old male who is known to have Addisons disease has been unwell with the flu. He is brought to A and E as he has been found collapsed. His BM is 3.9. How would you manage this patient initially?
1.Dopamine
2.IV dextrose
3.IV hydrocortisone
4.IV fluid resuscitation and IV steroids
5.IV fluids
A 54 year old gentleman who is a smoker presents with a dry cough and weight loss. He is also constipated with some abdominal pain has urinary frequency and is feeling fatigued and depressed. He is found to have a calcium of 3.0 mmol/l. What is the most likely diagnosis?
1.Sarcoidosis
2.Thyrotoxicosis
3.Hyperparathyroidism
4.Addisons
5.PTH like peptide secretion secondary to malignancy
Which of the following side effects of growth hormone replacement makes it attractive to some athletes?
1.Increased lean body mass
2.Carpal tunnel syndrome
3.Fluid retention
4.Reduced cholesterol
5.Reduced risk of diabetes
A 50-year-old woman was admitted because of progressive shortness of breath. She has been a smoker of 5 cigarettes a day for the past two years. She has a past medical history of seropositive rheumatoid arthritis,
diabetes mellitus and hypertension. On examination the fingers were clubbed and there were bilateral basal crepitations.
Lung function tests showed :
forced expiratory volume in one second (FEV1) of 2.09 l (predicted 3.18 l) forced vital capacity (FVC) of 2.33 l (predicted 4.04).
Carbon monoxide transfer factor (TLCO) was reduced to 67% predicted.
There was 5% improvement following salbutamol nebulisers.
What is the likely diagnosis?
1- COPD
2- Asthma
3- Pulmonary embolus
4- Interstitial lung disease
5- Pneumothorax