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BDS2 BAMS Endocrinology > 2. Pituitary and Thyroid Disease > Flashcards

2. Pituitary and Thyroid Disease Flashcards

1
Q

Endocrine disease can be (2)

A

Primary - gland failure

Secondary - control failure

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2
Q

Types of multiple endocrine neoplasia (3)

A

MEN 1 - parathyroid, pancreatic islets
MEN 2a - parathyroid, phaeochromocytoma
MEN 2b - medullary thyroid, phaeochromocytoma

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3
Q

Divisions of pituitary (2)

A

Anterior

Posterior

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4
Q

Hormones secreted by anterior pituitary (6)

A 
TSH
ACTH
GH
LH
FSH
Prolactin
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5
Q

Hormones secreted by posterior pituitary (2)

A

ADH

Oxytocin

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6
Q

Types of pituitary tumours (2)

A

Functional adenoma

Non-functional adenoma

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7
Q

Features of functional adenoma (2)

A

Well-differentiated

Hormone-producing

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8
Q

Functional adenoma associated with age (2) and diseases (2)

A

<40yrs old - Cushing’s disease

>40yrs old - Acromegaly

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9
Q

Features of non-functional adenoma (2)

A

Space-occupying

Non-hormone producing

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10
Q

Effects of non-functional adenoma (2)

A

Visual field defects

Other hormone deficiencies

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11
Q

Pituitary tumour treatment

A

Surgery - trans-sphenoidal surgery

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12
Q

Unregulated GH in children can lead to (2)

A

Excess - gigantism

Insufficient - growth failure

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13
Q

Unregulated GH in adults can lead to (2)

A

Excess - acromegaly

Insufficient - metabolic changes (increased fat, reduced vitality)

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14
Q

How do you measure GH

A

IGF-1

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15
Q

Definition of acromegaly

A

Hormonal disorder caused by excess GH in adulthood

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16
Q

Result of acromegaly

A

Appositional bone growth (hands, feet, face - mandible)

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17
Q

Acromegaly presentation changes (9)

A 
Coarse features
Enlarged supra-orbital ridges
Broad nose, thickened lips and soft tissues
Enlarged hands (Carpal tunnel syndrome)
Type 2 diabetes mellitus
CVD
Visual field defects (CN III, IV and VI nerve palsies)
Hyperprolactinaemia
Hypopituitarism
18
Q

Intra-oral acromegaly changes (4)

A

Enlarged tongue
Interdental spacing
Shrunk dentures
Reverse overbite

19
Q

Types of thyroid dysfunction (2)

A

Hyperthyroidism

Hypothyroidism

20
Q

Causes of hyperthyroidism (4)

A

Graves’ disease
Toxic multi-nodular goitre
Toxic adenoma
Pituitary tumour (rare)

21
Q

Symptoms and signs of hyperthyroidism ((17)

A 
Hot and excess sweating
Weight loss
Diarrhoea
Palpitations
Muscle weakness
Irritable, manic and anxious
Warm moist skin
AF and tachycardia
Increased BP
HF
Tremor and hyperreflexia
Eyelid retraction and lid lag
22
Q

Cause of Graves’ disease

A

Auto-antibodies stimulating TSH receptors

23
Q

Symptoms and signs of Graves’ disease (2)

A

Ophthalmopathy (thyroid eye disease) - scleral injection, proptosis, periorbital oedema
Conjunctival oedema - chemosis

24
Q

Types of hypothyroidism (2)

A

Primary

Secondary

25
Q

Causes of primary hypothyroidism (6)

A 
Autoimmune (Hashimoto's) thyroiditis
Idiopathic atrophy
Radioiodine treatment, thyroidectomy surgery
Iodine deficiency
Drugs
Congenital
26
Q

Causes of secondary hypothyroidism

A

Hypothalamic/pituitary disease

27
Q

Outcome of hypothyroidism

A

Reduced metabolism

28
Q

Symptoms and signs of hypothyroidism (16)

A 
Tired
Cold intolerance
Weight gain
Constipation
Hoarse voice
Goitre
Puffed face and extremities
Angina
Slow, poor memory
Dry coarse skin
Bradycardia, hyperlipidaemia
Psychiatric confusion
Hashimoto's goitre
Delayed reflexes
29
Q

Population for Hashimoto’s thyroiditis

A

Middle-aged to elderly women

30
Q

Presenting features of Hashimoto’s thyroiditis (2)

A

Goitre

Hypothyroid features

31
Q

Hashimoto’s thyroiditis is associated with (2)

A

FH of autoimmune disease (vitiligo, PA, type 1 DM, Addison’s)
Downs syndrome

32
Q

Causes of idiopathic atrophy (2)

A

Lymphocyte infiltration

Associated with organ specific autoimmune disease

33
Q

Thyroid disease investigations (3)

A

Blood tests - TSH, T3, T4
Imaging - ultrasound, radioisotope scan
Tissue (fine needle aspirate/biopsy)

34
Q

Secondary hyperthyroidism investigation results (2)

A

Raised TSH

Raised T3

35
Q

Primary hyperthyroidism investigation results (2)

A

Low TSH

Raised T3

36
Q

Secondary hypothyroidism investigation results (2)

A

Low TSH

Low T4

37
Q

Primary hypothyroidism investigation results (2)

A

High TSH

Low T4

38
Q

Hyperthyroidism treatment (4)

A

Carbimazole
B-blockers
Radioiodine
Surgery

39
Q

Hypothyroidism treatment

A

T4 (thyroxine) tablets

40
Q

Causes of thyroid enlargement (2)

A

Goitre

Solitary nodular enlargement

BDS2 BAMS Endocrinology (5 decks)

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