2 Endocrine Workshop Flashcards

1
Q

What is the purpose of cortisol

A

Maintains BP - water and salt homeostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the three main hormones secreted by the thyroid and their actions

A

T3 - main hormone
T4 - pro-hormone
Calcitonin - reduced blood calcium for bone turnover - opposing effect to parathyroid hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

t 3 or t 4 is more powerful?

A

T 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

More t 3 or 4 is produced

A

80% t 4 - converted peripherally to t3 in the liver etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How is thyroid hormone regulated

A

Hypothalamus releases trh
Pituitary releases TSH
Thyroid releases thyroid hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is trh

A

Tyroppid releasing hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does iodine in affect thyroid funciton

A

Thyroid hormone is synthesised from circulating iodine. Excessive or insufficient causes dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are 2 main physiological functions of thyroid hormone

A

Growth and development

Metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name three drugs that can induce thyroid diseases

A

Lithium
Amioderone
Cholestyramine p

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does amioderone affect thyroid function

A

Hypo caused by blocking conversion of T4 to T3

Hyper due to iodine content of the drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does lithium affect thyroid function

A

Hypo – inhibits iodine uptake and thyroid hormone release

Hyper – unknown mechanism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does cholestyramine affect thyroid funciton?

A

Affects absorbtion of levothyroxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Signs of hypothyroidism

A
Fatigue
Cold sensitivity
Dry skin and hair
Depression
Impaired concentration and memory
Muscle pain and weakness
Horse voice
Pernicious anaemia (megloblstic b12 deficient)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Treatment for hypo thyroidism

A

T four is treatment of choice.

Exclude hyhpopituitaryism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Signs of hyperthyroidism

A
Insomnia
Tremor
Irritability
Weight loss
Decreased appetite
AF
Diarrhoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment for hyperthyroidism

A

Antithyroid drugs - propylthiouracil, thiamazol, carbimazole

17
Q

Symptoms of Cushings

A
Weight gain
Thinning skin, brides easily
Purple stretch marks
Moon face, buffalo hump
Decreased interest in sex
Oestoperosis
18
Q

Treatments for Cushings

A

Eradicate tumours
Reduce steroid dose
Metyropone/ketoconazole

19
Q

Symptoms of addisons diseases

A
Fatigue
Lethargy
Muscle weakness
Low mood
Loss of appetite 
Frequent urination
Thirst
Hyperpigmentation
Craving salty food
20
Q

Treating Addisons diseases

A

Glucocorticoid replacement : hydrocortisone

Mineralocorticoid replacement: fludrocortisone

21
Q

Signs of over and under replacement in addisons

A

Over - hypertension, glucose intolerance, thin skin, hyperglycaemia, electrolyte abnormalities
Under - fatigue, postural hypotension, weight loss, salt craving.

22
Q

Goals of hypothyroidism treatment

A

symptom relief

Normal TSH levels - not too low as osteroperosis risk

23
Q

When to monitor TSH levels?

A

Change slowly so 4-6 weeks after initiating therapy and then annually.

24
Q

Laxative guidelines

A

exercise, fibre, fluids

1: bulk forming
2: osmotic if hard, stimulant if soft
Opioid- osmotic or docusate

25
Whilst waiting for hyperthyroidism therapy to kick in how can we treat symptoms
Beta blocker e.g. Propanolol
26
Monitoring for hyperthyroidism treatment
Free t4 and TSH during and after carbimazole treatment
27
Before starting carbimazole check
LFTs for liver tox | Full blood count (affects WBC so infection and platelets to bruising)
28
Give in patients with respiratory infection....
Oxygen
29
When someone with addisons has a temperature over 37.5....
Double the hydrocortisone dose
30
When done with addisons voms or is injured
20mg HC and ORT
31
If someone with addisons vomits twice
Use emergency HC injection and seek help
32
If someone with addisons uses antibiotics
Double the HC dose throughout therapy
33
Monitoring in addisons admission for infection 7
``` Fever HR and RR BP (postural is sign of insufficiency) CRP/WBC O2 stats Na and k Glucagon ```
34
Generally monitoring for addisons 7
``` BP BG Adrenal function Thyroid function U and e Signs and symptoms Pt wellbeing ```
35
What is Addisons?
Deficiency of aldosterone and cortisol | Primary adrenal insufficiency