2: Endocrine Complaint: Thyroid, Parathyroid, Adrenals Flashcards
Thyroid H production pathway
Hypothalamus makes TRH -> pituitary makes TSH -> thyroid makes T4 and T3
Which thyroid H is made in the periphery?
T3
What typically causes goiter?
Increased TSH, which stimulates thyroid growth
Parathyroid function
Maintain calcium balance by increasing Ca in the blood
Three ways PTH works
- Increases bone resorption
- Increases intestinal Ca absorption
- Decreases Ca excretion in kidney
Differential consideration for primary hyperparathyroidism
Hypercalcemia of malignancy, but is usually symptomatic at discovery
Trousseau’s sign
Carpal spasms caused by inflation of a sphygmomanometer (present in hypoparathyroidism)
Chvostek’s sign
Facial muscle contraction when tapping the facial nerve -> painful twitching (present in hypoparathyroidism)
Four categories of products of the adrenal glands
Mineralocorticoids, glucocorticoids, catecholamines, adrenal androgens
Mineralocorticoids function
Regulate Na and K in kidney, which affects BP
Glucocorticoid function
glucose metabolism, inflammatory and immune responses, maintenance of BP and cardiac output
Glucocorticoid and mineralocorticoid production pathway
Hypothalamus makes CRH -> pituitary makes ACTH -> adrenal glands make cortisol
What pathway mainly regulates mineralocorticoid production
renin-angiotensin-aldosterone pathway
How are adrenal masses usually found?
Typically incidental
Majority of benign adrenal masses are what?
Endocrine inactive
Management of an adrenal mass that is less or greater than 1cm in size
Less than 1cm: monitor
Greater than 1cm: requires diagnostic eval for malignancy, endocrine activity
Dxing metabolic syndrome: need 3+ of the following 5 things
- Central obesity
- High triglycerides
- High LDL
- BP > 130/85
- Fasting glucose > 100 mg/dL
Four dx criteria for DM II
- A1c > 6.5%
- Fasting glucose > 126
- 2hr glucose > 200
- Random glucose > 200 with Sx hyperglycemia
8 conditions that youre studying that have to do with hyper or hypo endocrine
- Hypothyroid
- Hyperthyroid
- Hypoparathyroidism
- Primary hyperparathyroidism
- Hypoadrenalism
- Hypercortisolism (Cushing’s)
- Aldosteronism
- Pheocytochromia
Most common endocrine malignancy
Thyroid cancer
Most common cause of hyperparathyroidism
Autonomously functioning adenoma s
Most common cause of primary and secondary hypoadrenalism
1: Addisons
2. : exogenous glucocorticoids
