mcq

Endocrine

Theme : Endocrine

A. Addison's disease

B. Congenital adrenal hyperplasia

C. Cushing's syndrome

D. Diabetes insipidus

E. Diabetes mellitus

F. Hyperthyroidism

G. Hypoparathyroidism

H. Hypothyroidism

I. Primary aldosteronism

J. Septo-optic dysplasia

Select the most likely diagnosis from the list above that would explain the presentations of the

following patients:

1) An 11 year old boy who was previously fit

and well presents to the GP with obesity and

purple abdominal striae. His blood pressure

is 140/90.

C. Cushing's syndrome

2) A breast-fed baby presents with poor

feeding. He has a hoarse voice and coarse

facial features. Examination of the skull

reveals wide sutures and a large anterior

fontanelle.

H. Hypothyroidism

3) A 7 year old girl with moderate learning

difficulties presents with dry skin, alopecia

and mucocutaneous candidiasis.

G. Hypoparathyroidism

Comments:

Cushing's syndrome is a disorder due to high circulating cortisol levels either exogenous or endogenesis

in origin. Clinical features include arrested growth, trunk obesity, hirsuitism, muscle wasting and mood

changes. Purple striae are often seen. Laboratory investigations may reveal polycythaemia, abnormal

glucose tolerance and high cortisol levels.

2-Congenital hypothyroidism is relatively common. Affected babies may have coarse facies, dry skin and

a hoarse cry. Other features include hypotonia, umbilical hernia and constipation and prolonged jaundice.

Blood tests reveal low T4 levels and a high TSH. In some infants brain development may be irreversibly

damaged before birth however early detection may avoid permanent neurology sequelae.

3-Hypoparathyroidism – in the neonatal period transient hypoparathyroidism occurs resulting in

hypocalcaemia, possibly convulsions or apnoeic episodes. Hypoparathyroidism is rare. Features include

headaches, vomiting, photophobia, cataracts, poor dentition and chronic diarrhoea. Investigations will

confirm low calcium and high phosphate levels.