Endocrinology Case-based Questions with Answers 2021_all.pptx

Endocrinology Case-based Quiz Questions with Answers Anna Crown Mr Albert, 57 years old, kidney stones Blood results: Questions: Renal function normal What is the diagnosis? Calcium 2.9 mmol/L ( ) What is the likely cause? PTH 125 ng/L ( ) What symptoms might he have? What imaging would be helpful...

Endocrinology Case-based Quiz Questions with Answers Anna Crown Mr Albert, 57 years old, kidney stones Blood results: Questions: Renal function normal What is the diagnosis? Calcium 2.9 mmol/L ( ) What is the likely cause? PTH 125 ng/L ( ) What symptoms might he have? What imaging would be helpful? What treatment would be recommended? Mr Albert, 57 years old, kidney stones Questions: What is the diagnosis? What is the likely cause? What symptoms might he have? What imaging would be helpful? What treatment would be recommended? Answers: Primary hyperPTH Parathyroid adenoma Asymptomatic or “stones, bones, abdo groans, psychic moans” Neck USS and Sestamibi scan (isotope scan) Parathyroidectomy Mr Bramble, 38 years old, usually well. Sweaty with palpitations, relieved by eating Fasted blood test results: Plasma glucose 2.2 mmol/L ( ) Insulin C-peptide 1253 pmol/L ( ) Cortisol 560 nmol/L ( ) Questions: What is the explanation for his symptoms? What is the insulin Cpeptide? What is the likely diagnosis? Why is his cortisol high? His wife takes gliclazide – What is gliclazide? – Could that be relevant? Do any other conditions need to be considered? Mr Bramble, 38 years old, usually well. Sweaty with palpitations, relieved by eating Questions: Answers: What is the explanation for his symptoms? What is the insulin Cpeptide? What is the likely diagnosis? Why is his cortisol high? His wife takes gliclazide Hypoglycaemia Cleavage product of proinsulin (reflects endogenous insulin production) Insulinoma? Physiological stress response Sulphonylurea – stimulates insulin production MEN-1 (pituitary, parathyroid, pancreas) – What is gliclazide? – Could that be relevant? Do any other conditions need to be considered? Mr Prince, 28 years old Gaining weight Results: Questions: 24 hour urinary cortisol 900 nmol/day (ref 100-380) What is the likely diagnosis? Explain the results What is the likely cause? What signs might you find? What other hormone tests does he need? What imaging does he need? What complications might he already have? Cortisol after dexamethasone 111 nmol/L (normal 200 LH