Browse topics
Endocrinology
54 notes, 168 questions and 483 flashcards.
Tier 1 is core knowledge expected of every trainee. Tier 2 is deeper or less common.
Key conditions
- Glucocorticoid therapy complicationsDose equivalence, steroid-induced hyperglycaemia and how to dose morning isophane insulin, bone protection and PBS criteria, infection prophylaxis (PJP, strongyloides, hepatitis B, live vaccines), HPA suppression and safe tapering.Tier 1, condition, 4 questions, 9 flashcards
- Obesity and metabolic syndromeDefining obesity (BMI, waist, the 2025 Lancet Commission's clinical and preclinical obesity) and metabolic syndrome, secondary causes, the Australian burden and weight bias, lifestyle and very low energy diets, semaglutide and tirzepatide with their trials, and bariatric surgery and its long-term complications.Tier 1, condition, 3 questions, 9 flashcards
- Osteoporosis and osteopeniaCase finding with FRAX and DXA, the RACGP/Healthy Bones Australia 2024 treatment thresholds, secondary causes, bisphosphonates, denosumab and why it can't just stop, anabolic-first therapy for very high risk, PBS criteria including the 2026 abaloparatide listing, and drug holidays.Tier 1, condition, 4 questions, 9 flashcards
- Polycystic ovary syndromeDiagnose with the 2023 international criteria after excluding mimics, screen for diabetes and cardiometabolic risk, treat symptoms with the COCP, metformin and anti-androgens, and use letrozole first for infertility.Tier 1, condition, 3 questions, 10 flashcards
Acute metabolic derangements
- Adrenal crisisFree sampleRecognising acute adrenal insufficiency, giving hydrocortisone before the tests come back, finding the trigger, and preventing the next crisis with sick-day rules.Tier 1, condition, 3 questions, 8 flashcards
- Diabetic ketoacidosisDiagnosis (including euglycaemic DKA with SGLT2 inhibitors), fluids, fixed-rate insulin, potassium and safe transition to subcutaneous insulin.Tier 1, condition, 4 questions, 9 flashcards
- Electrolyte disorders: potassium, magnesium and phosphateWorking up and replacing low potassium, magnesium and phosphate, recognising refeeding syndrome, and handling the high levels that matter.Tier 1, approach to a presentation, 3 questions, 9 flashcards
- Hyperglycaemic hyperosmolar stateDiagnosis of HHS and mixed DKA/HHS, slow rehydration with osmolality targets, low-dose insulin only when needed, and the thrombosis, foot and osmotic risks.Tier 1, condition, 3 questions, 8 flashcards
- Hypo- and hypercalcaemiaSorting hypercalcaemia by PTH, treating severe hypercalcaemia and malignancy, surgery thresholds in primary hyperparathyroidism, and managing acute and chronic hypocalcaemia.Tier 1, approach to a presentation, 3 questions, 10 flashcards
- HypoglycaemiaTreating a hypo, sulfonylurea and insulin hypos, impaired awareness and driving, and working up hypoglycaemia in someone without diabetes (Whipple triad, insulin and C-peptide).Tier 1, approach to a presentation, 3 questions, 10 flashcards
- Pituitary apoplexyThunderclap headache with visual loss or ophthalmoplegia from bleeding into a pituitary adenoma. Give hydrocortisone, get an MRI, and choose surgery or watchful care by vision and consciousness.Tier 1, condition, 3 questions, 8 flashcards
- Thyroid stormLife-threatening thyrotoxicosis with organ dysfunction. Diagnose clinically, then give a beta-blocker, a thionamide, iodine an hour later, and glucocorticoid, while treating the trigger.Tier 1, condition, 3 questions, 9 flashcards
Diabetes mellitus
- Type 1 diabetes mellitus and its complicationsDiagnosing type 1 diabetes in adults, staging and teplizumab, insulin regimens and technology, glycaemic targets, complication screening, pregnancy and Australian access to CGM and pumps.Tier 1, condition, 3 questions, 10 flashcards
- Type 2 diabetes mellitus and its complicationsDiagnosis and screening, individualised targets, choosing drugs by comorbidity and PBS rules (SGLT2 inhibitor first in heart failure and CKD), starting insulin, remission, complications, and older, pregnant and First Nations patients.Tier 1, condition, 3 questions, 9 flashcards
Thyroid disease
- HyperthyroidismFind the cause of thyrotoxicosis with TRAb and, if needed, a technetium scan, then choose between carbimazole, radioactive iodine and surgery, with Graves orbitopathy and agranulocytosis as the traps.Tier 1, condition, 3 questions, 10 flashcards
- HypothyroidismDiagnose on TSH and free T4, treat overt disease with levothyroxine, think twice before treating subclinical disease in older people, and never miss central hypothyroidism or myxoedema coma.Tier 1, condition, 3 questions, 9 flashcards
- Thyroid nodulesCheck TSH first, scan hot nodules instead of needling them, use ultrasound risk (TI-RADS) and size to decide on FNA, and act on the Bethesda category.Tier 1, condition, 3 questions, 9 flashcards
Less common or complex conditions
- Multiple endocrine neoplasiaFree sampleMEN1 (menin, tumour suppressor) and MEN2 (RET, proto-oncogene), their tumours, who to test, surveillance under the 2025 MEN1 guideline, genotype-timed thyroidectomy in MEN2, and excluding phaeochromocytoma before any operation.Tier 1, condition, 4 questions, 10 flashcards
- Diabetes insipidusHypotonic polyuria from AVP deficiency (cranial) or AVP resistance (nephrogenic). Exclude glucose, calcium and potassium causes, separate it from primary polydipsia with stimulated copeptin or water deprivation, treat AVP deficiency with desmopressin and never omit it in hospital.Tier 2, condition, 3 questions, 9 flashcards
- Gender dysphoria and management of transgender patientsAdults in Australia can start gender-affirming hormones in primary care under the AusPATH informed-consent standards (2025). Know the regimens, the monitoring targets, the main risks (VTE with oral oestradiol, meningioma with high-dose cyproterone, erythrocytosis with testosterone) and the unsettled, state-dependent rules for under 18s.Tier 2, condition, 3 questions, 8 flashcards
- Neuroendocrine and hormone-secreting tumoursGrading by Ki-67 and differentiation, carcinoid syndrome and carcinoid heart disease, the functioning pancreatic tumours, the right tests (urine 5-HIAA, Ga-68 DOTATATE PET, chromogranin A and its false positives) and the treatment ladder from somatostatin analogues to Lu-177 DOTATATE.Tier 2, condition, 3 questions, 10 flashcards
- Parathyroid diseasePrimary hyperparathyroidism under the Australian and New Zealand position statements (online 2021, Clin Endocrinol 2024) and the 2022 Fifth International Workshop (who to operate on, how to localise, what cure looks like), plus FHH, lithium, parathyroid carcinoma, secondary and tertiary hyperparathyroidism and hypoparathyroidism.Tier 2, condition, 3 questions, 10 flashcards
- Pituitary tumours and thyrotropinomaThe three questions for any pituitary mass (what is it secreting, is anything deficient, is it pressing on the chiasm), managing incidentalomas and non-functioning adenomas under the 2025 Pituitary Society guideline, and telling a TSH-secreting adenoma from thyroid hormone resistance and assay interference.Tier 2, condition, 3 questions, 9 flashcards
- Thyroid malignancyThe main thyroid cancer types and how they behave, de-escalated treatment of differentiated thyroid cancer under the 2025 ATA guideline (lobectomy up to 2 to 4 cm, active surveillance of microcarcinoma, no routine RAI for low risk, TSH by response), thyroglobulin follow-up, and when to think anaplastic, medullary or lymphoma.Tier 2, condition, 3 questions, 9 flashcards
Adrenal gland disorders
- Adrenal incidentaloma and adrenal carcinomaWorking up an adrenal mass found on imaging under the 2023 ESE/ENSAT guideline (unenhanced CT density, 1 mg dexamethasone test, who needs metanephrines and aldosterone-renin ratio), mild autonomous cortisol secretion, and recognising and treating adrenocortical carcinoma.Tier 2, condition, 3 questions, 8 flashcards
- Adrenal insufficiencyRecognising chronic primary, secondary and glucocorticoid-induced adrenal insufficiency, confirming it with morning cortisol, ACTH and a short synacthen test, and getting hydrocortisone and fludrocortisone replacement right.Tier 2, condition, 3 questions, 8 flashcards
- Congenital adrenal hyperplasia21-hydroxylase deficiency in adults, from classic salt-wasting disease to non-classic CAH that mimics PCOS, with 17-hydroxyprogesterone testing, glucocorticoid and fludrocortisone treatment, adult complications such as testicular adrenal rest tumours, fertility, pregnancy and crinecerfont.Tier 2, condition, 3 questions, 8 flashcards
Bone metabolism disorders
- Osteomalacia and vitamin D deficiencyWho to test for vitamin D deficiency under Australian MBS rules, the 50 nmol/L target and how to replace, and recognising osteomalacia (bone pain, proximal myopathy, high ALP, low phosphate, Looser zones) including phosphate-wasting causes such as ferric carboxymaltose, XLH and tumour-induced osteomalacia.Tier 2, condition, 3 questions, 8 flashcards
- Paget disease of boneFocal high-turnover bone disease of older adults. Suspect it from an isolated raised ALP, confirm with X-ray and define extent with a bone scan, and treat bone pain with a single 5 mg infusion of zoledronic acid after replacing vitamin D.Tier 2, condition, 3 questions, 8 flashcards
Gonadal system
- Amenorrhoea, primary and secondaryExclude pregnancy first, then use FSH, LH, oestradiol, prolactin and TSH to place the problem in the hypothalamus, pituitary, ovary or outflow tract. Hypothalamic amenorrhoea, PCOS, hyperprolactinaemia and premature ovarian insufficiency cause most secondary amenorrhoea; protect bone when oestrogen is low.Tier 2, approach to a presentation, 3 questions, 9 flashcards
- InfertilityInvestigate both partners after 12 months (6 months if the woman is 35 or older), confirm ovulation, check tubes and semen, sort anovulation by the WHO groups, and never give testosterone to a man who wants children.Tier 2, approach to a presentation, 3 questions, 8 flashcards
- Male hypogonadismConfirm with two morning fasting testosterone levels, use LH and FSH to split primary from secondary, look for prolactin, iron and pituitary causes, and reserve PBS testosterone for pathological hypogonadism in men not seeking fertility.Tier 2, condition, 3 questions, 9 flashcards
- MenopauseDiagnose clinically after 45, test FSH only in younger women, offer menopausal hormone therapy as the most effective treatment for vasomotor symptoms when started before 60, protect the endometrium, prefer transdermal oestradiol when VTE risk is raised, and know the non-hormonal options.Tier 2, condition, 3 questions, 10 flashcards
Hypothalamic–pituitary axis disorders
- AcromegalyA GH-secreting pituitary adenoma diagnosed years late. Screen with IGF-1, confirm with a high IGF-1 or failed GH suppression on OGTT, image the pituitary, treat with transsphenoidal surgery first, then somatostatin analogues, pegvisomant or radiotherapy, and screen for heart, sleep, glucose and colon complications.Tier 2, condition, 3 questions, 9 flashcards
- Cushing syndromeWho to screen for endogenous hypercortisolism, which screening tests to use and what upsets them, how ACTH splits pituitary, ectopic and adrenal causes, and first-line surgery, medical therapy and the traps after cure.Tier 2, condition, 3 questions, 10 flashcards
- HypophysitisInflammation of the pituitary from autoimmunity (classically late pregnancy or postpartum), IgG4 disease, systemic disease or immune checkpoint inhibitors. Recognise early ACTH deficiency, replace hydrocortisone before thyroxine, and keep high-dose steroids for mass effect.Tier 2, condition, 3 questions, 8 flashcards
- HypopituitarismCauses of anterior and posterior pituitary failure, how to test each axis (basal tests, when to do a synacthen, ITT, glucagon or copeptin test), and replacement in the right order with the interactions that catch people out.Tier 2, condition, 3 questions, 9 flashcards
- Prolactin excess (prolactinoma and stalk effect)Working through a raised prolactin (drugs, hypothyroidism, CKD, macroprolactin, stalk effect and the hook effect), when to image, cabergoline as first line even with visual loss, withdrawal, pregnancy and the side effects worth asking about.Tier 2, condition, 3 questions, 10 flashcards
Secondary hypertensive disorders
- PhaeochromocytomaWho to test, why plasma free metanephrines come before any scan, the drugs that cause false positives and crises, alpha-blockade before beta-blockade and surgery, genetic testing for everyone, and follow-up for life.Tier 2, condition, 3 questions, 10 flashcards
- Primary hyperaldosteronismThe commonest curable cause of hypertension. Screen with aldosterone and renin (now in everyone with hypertension under the 2025 Endocrine Society guideline), confirm when needed, lateralise with adrenal vein sampling, then adrenalectomy for unilateral disease or a renin-guided MRA for bilateral disease.Tier 2, condition, 3 questions, 8 flashcards
Investigations and procedures
- Bone mineral tests and DXA interpretationFree sampleRead calcium, phosphate, ALP, PTH, 25(OH)D, 1,25(OH)2D, PTHrP and bone turnover markers as a pattern, then read a DXA report properly (which sites count, T versus Z scores, artefacts, least significant change) under ISCD positions and Australian Medicare and PBS rules.Tier 1, medical sciences concept, 3 questions, 8 flashcards
- Diabetes-related investigationsHow to read HbA1c (and when it lies), glucose tests including the 1-hour OGTT, fructosamine and CGM metrics, C-peptide and islet antibodies for classifying diabetes, urine albumin-to-creatinine ratio, and the acid-base workup of DKA and HHS, with worked examples.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Endocrine dynamic function testsStimulate when you suspect deficiency, suppress when you suspect excess. Protocols, cut-offs, interfering drugs and safety for the short synacthen test, insulin tolerance and glucagon tests, dexamethasone suppression, salivary and urinary cortisol, saline suppression, water deprivation and copeptin, the 72-hour fast and the GH suppression OGTT.Tier 1, medical sciences concept, 4 questions, 10 flashcards
- Interpreting thyroid function tests and thyroid antibodiesRead TSH first, then free T4 and T3, sort the result into one of six patterns, know the assay traps (biotin, heterophile antibodies, non-thyroidal illness, drugs), and use TPO, Tg and TSH-receptor antibodies, plus the diabetes and adrenal autoantibodies, for the questions they actually answer.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Anthropometric assessment and growth chartsHow to measure and interpret BMI, waist circumference, waist-to-hip and waist-to-height ratios, triceps skinfold and mid-upper arm circumference in adults, and how to read WHO and CDC growth charts, centiles and growth patterns in children and adolescents.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Fluid and electrolyte balance investigationsHow to read serum and urine osmolality, the osmolar gap, spot urine sodium, chloride and potassium, and fractional excretions of sodium, urea, magnesium and phosphate, with worked examples and the traps (diuretics, timing, bicarbonaturia).Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Interpreting sex hormone levelsHow to time and read testosterone, SHBG, LH, FSH, oestradiol and progesterone, with worked examples of the common patterns in men and women, assay pitfalls (immunoassay at low levels, biotin, ethinylestradiol) and the results that change management.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Investigations for phaeochromocytomaHow to order and read plasma free metanephrines (supine sampling, age-adjusted normetanephrine, the 3-times rule, the metabolite pattern), when to repeat or do a clonidine suppression test, and which scan to choose once biochemistry is positive.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Structural and functional imaging of endocrine organsWhich scan for which gland and in what order, how to read thyroid scintigraphy, parathyroid sestamibi and 4D-CT, adrenal CT density, pituitary MRI and somatostatin receptor PET, and the traps of incidentalomas, iodine contrast and pregnancy.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Tumour markers: carcinoid, GI hormone and endocrine neoplasiaHow to order and read urine 5-HIAA, chromogranin A, fasting gastrin and the other gut hormones, calcitonin, CEA and thyroglobulin, with the false positives (food, PPIs, renal failure) that make most abnormal results wrong.Tier 2, medical sciences concept, 3 questions, 8 flashcards
Specific issues
Diabetes mellitus management
- Diabetes complication screening, targets and transition to adult careWhen to start and repeat eye, kidney, foot and cardiovascular screening in type 1 and type 2 diabetes, the HbA1c, CGM, BP and lipid targets and how to individualise them, and how to move a young adult from paediatric to adult care without losing them, with Australian MBS, NDSS and First Nations specifics.Tier 1, topic overview, 4 questions, 10 flashcards
- Practical and psychological aspects of glucose monitoring and insulin therapyFingerprick and continuous glucose monitoring (accuracy, lag, interference, Australian access), injection technique and lipohypertrophy, needle phobia, diabetes distress and fear of hypoglycaemia, sharps safety, hypoglycaemia preparedness, and Austroads driving and occupational rules for people on insulin.Tier 1, topic overview, 3 questions, 9 flashcards
- Diabetes care: cultural context, Indigenous health and multidisciplinary teamsCultural, linguistic and religious influences on diabetes care (interpreters, health beliefs, Ramadan fasting), diabetes among Aboriginal and Torres Strait Islander peoples and Māori with current data and Australian and NZ supports, and how multidisciplinary diabetes care is organised and funded under Medicare.Tier 2, topic overview, 3 questions, 10 flashcards