Adult - Endocrine (sans DM)

Question 1

Which is more common - hyper or hypo thyroidism?

Answer 1

HYPO thyroidism is more common

Question 2

What is the most common presentation of hyperthyroidism?

Answer 2

Grave’s disease

Question 3

What is the most common presentation of HYPOthyroidism?

Answer 3

Hashimoto’s disease

Question 4

What are the symptoms of HYPERthyroidism?

Answer 4

nervousness

anxiety

fine tremor

exophthalmos

Question 5

What are the symptoms of HYPOthyroidism?

Answer 5

fatigue

cramps

cold intolerance

weight gain

puffy eyes

Question 6

What are the labs of hyperthyroidism?

Answer 6

low TSH

high T3

Question 7

What are the labs of hypothyroidism?

Answer 7

high TSH

low or low normal T4

Question 8

How is hyperthyroid managed? (5)

Answer 8

• propranalol for symptoms
• thiourea drugs
  
  • methimazole (Tapazole)
  • PTU
• radioactive iodine 131-I
• thyroid surgery (must be euthyroid)
• Lugol’s solution

Question 9

How is hypothyroid managed?

Answer 9

levothyroxine (Synthroid)

50 - 100 mcg

Question 10

Who typically presents with hyperthyroidism?

Answer 10

women between the ages of 20 and 40

Question 11

With what condition is myxedema associated?

Answer 11

decompensated hypothyroidism

primary symptoms?

altered mental status

hypothermia

Question 12

What condition is caused by prolonged exposure to cortisol?

Answer 12

Cushing’s sydrome

Question 13

What are the potential causes for Cushing’s syndrome?

Answer 13

• prolonged use of corticosteroids
• hypersecretion of ACTH by the pituitary
• adrenal tumor

Question 14

Signs and symptoms of Cushing’s syndrome -

what does cortisol due to fat distribution in the body?

Answer 14

Due to too much steroid causes fat redistribution:

• moon face
• buffalo hump
• central obesity

Question 15

Signs and symptoms of Cushing’s syndrome -

what effect does increased ACTH have?

Answer 15

Increased androgens which cause:

• acne
• purple striae
• hirsutism

Question 16

Signs and symptoms of Cushing’s syndrome -

what effect do steroids have on the cells with regard to glucose? (6)

“THINK DM”

Answer 16

Steroids prevent the cells from taking up glucose, causing:

• hyperglycemia
• weakness
• polyuria
• polydipsia
• labile mood
• frequent infection

Question 17

Signs and symptoms of Cushing’s disease -

what effect does cortisol have on the vasculature? (1)

Answer 17

Vasoconstriction leading to HTN

Question 18

Signs and symptoms of** Cushing’s syndrome** -

what is the cause of poor healing?

Answer 18

steroids decrease inflammation

increase blood glucose

Question 19

What are the significant labs of Cushing’s syndrome?

Answer 19

HYPERglycemia

HYPERnatremia

HYPOkalemia

Question 20

What tests can be used to differentiate between causes of Cushing’s syndrome?

Answer 20

• ACTH
• dexamethasone suppresion test

Question 21

What is the management of Cushing’s Syndrome?

Answer 21

depends on the cause

• d/c medication if causative
• resection of pituitary adenoma
• surgical removal of adrenal tumor

Question 22

Primary adrenal cortical insufficiency.

Answer 22

Addison’s disease

Question 23

What deficiencies characterize Addison’s disease?

Answer 23

cortisol

**androgens **

aldosterone

Question 24

What do androgens and aldosterone combine to form?

Answer 24

mineralocorticoids

Question 25

What are the signs and symptoms of Addison’s disease?

Answer 25

• hyperpigmentation in buccal mucosa and skin creases
• scant axillary and pubic hair
• orthostasis and hypotension

Question 26

What are the significant labs in Addison’s disease?

Answer 26

HYPOglycemia

HYPOnatremia

HYPERkalemia

Question 27

What is the treatment in Addison’s disease?

Answer 27

replacement of:

glucocorticoids (ex: hydrocortisone)

AND

**mineralocorticoids **(ex: fludrocortisone/Florinef)