CASE STUDY. One of the key strengths of the programme is the strength of the Q-PlaNet network with the great personal commitment of all the partners involved. A further strength in the transnational approach taken which allows good practice to be spread across different regions. One of the project weaknesses is in the further funding of the project which could reduce the ability to disseminate and further develop the initiatives to get the most impact. Additionally it takes a lot of time and effort to create the network and outreach is needed as well in order to reach an EU-wide acceptance of the quality placements concept .The result of the Q-PlaNet project is a new model for quality assurance for practical placements for a student that is based on a trans-national placement's network. The approach to the quality of student placements and the methodology of quality assurance in this field could be used by interested partners hosting students for placements and also by HEIs organising student placements. Moreover, the Quality Reference Centres of student placements are an efficient, flexible structure, especially for systems and regions with a high number of student placement motilities.

Question 21 What else could we use instead of propranolol in thyrotoxicosis with bronchial asthma?

Question 22 At what dose, and for how long, would steroid therapy give rise to secondary adrenal insufficiency? For adrenal insufficiency due to longterm steroid use, when should we start to give a cortisone supplement? How should we monitor these patients?

Question 23 What dose of Synacthen is equivalent to adrenocorticotrophic hormone (ACTH)?

Question 24 I want to know the mechanism that causes anaemia in Addison's disease. I am unable to find the real cause.

Question 25 What causes hypercalcaemia in Addison's disease?

Question 26 In the diagnosis of Cushing's disease using the high-dose dexamethasone suppression test, how can the exogenous steroid suppress adrenocorticotrophic hormone (ACTH) when the grossly elevated serum cortisol levels fail to do so?

Question 27 Does alternate-day therapy with steroids decrease their efficacy compared with daily therapy?

Question 28 Regarding the renin-angiotensin-aldosterone axis, it states that dietary sodium excess suppresses renin secretion. Then why are we asking hypertensives to restrict sodium intake? Also if we are using angiotensinconverting enzyme (ACE) inhibitors, the plasma renin activity increases due to loss of feedback inhibition. Wouldn't that be counterproductive?

Question 29 How does a phaeochromocytoma give rise to Raynaud's phenomenon?

Question 30 How well do symptoms of hypercalcaemia correlate with serum calcium levels. Can I ignore an asymptomatic patient with a serum calcium of 3.7 mmol/L but have to give treatment to a symptomatic patient who has a serum calcium of 3.3 mmol/L?