Questions for Wed tut

Here are some questions from Dr Veeren for you to attempt before Wednesday endocrine pharm tut.

1. With regards to patients on Chronic and Recent Steroid Therapy,

a) Why should these patients be given adjuvant steroids?      (10)
b) Draw the steroid biosynthetic pathway. (20)
b) What is your approach to steroid replacement therapy in these patients? (20)

2. A 38 year old female presents for a total thyroidectomy. The patient has no
features of airway or vascular compression. She is clinically and biochemically
hyperthyroid.

a) What are the clinical features of hyperthyroidism? (5)
b) Which drugs would you prescribe preoperatively for this patient? Describe
     in detail. (15)
c) The surgery is booked for the next day. Would you proceed with the case?
     Explain. (5)
d) The patient develops a thyroid storm intraoperatively.
     Briefly discuss the steps you would take in managing this emergency, with
     emphasis on drugs you would use. Include dose, MOA, route of
     administration. (25)

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