Adult - Endocrine (sans DM) Flashcards
Which is more common - hyper or hypo thyroidism?
HYPO thyroidism is more common
What is the most common presentation of hyperthyroidism?
Grave’s disease
What is the most common presentation of HYPOthyroidism?
Hashimoto’s disease
What are the symptoms of HYPERthyroidism?
nervousness
anxiety
fine tremor
exophthalmos
What are the symptoms of HYPOthyroidism?
fatigue
cramps
cold intolerance
weight gain
puffy eyes
What are the labs of hyperthyroidism?
low TSH
high T3
What are the labs of hypothyroidism?
high TSH
low or low normal T4
How is hyperthyroid managed? (5)
- propranalol for symptoms
-
thiourea drugs
- methimazole (Tapazole)
- PTU
- radioactive iodine 131-I
- thyroid surgery (must be euthyroid)
- Lugol’s solution
How is hypothyroid managed?
levothyroxine (Synthroid)
50 - 100 mcg
Who typically presents with hyperthyroidism?
women between the ages of 20 and 40
With what condition is myxedema associated?
decompensated hypothyroidism
primary symptoms?
altered mental status
hypothermia
What condition is caused by prolonged exposure to cortisol?
Cushing’s sydrome
What are the potential causes for Cushing’s syndrome?
- prolonged use of corticosteroids
- hypersecretion of ACTH by the pituitary
- adrenal tumor
Signs and symptoms of Cushing’s syndrome -
what does cortisol due to fat distribution in the body?
Due to too much steroid causes fat redistribution:
- moon face
- buffalo hump
- central obesity
Signs and symptoms of Cushing’s syndrome -
what effect does increased ACTH have?
Increased androgens which cause:
- acne
- purple striae
- hirsutism
Signs and symptoms of Cushing’s syndrome -
what effect do steroids have on the cells with regard to glucose? (6)
“THINK DM”
Steroids prevent the cells from taking up glucose, causing:
- hyperglycemia
- weakness
- polyuria
- polydipsia
- labile mood
- frequent infection
Signs and symptoms of Cushing’s disease -
what effect does cortisol have on the vasculature? (1)
Vasoconstriction leading to HTN
Signs and symptoms of** Cushing’s syndrome** -
what is the cause of poor healing?
steroids decrease inflammation
increase blood glucose
What are the significant labs of Cushing’s syndrome?
HYPERglycemia
HYPERnatremia
HYPOkalemia
What tests can be used to differentiate between causes of Cushing’s syndrome?
- ACTH
- dexamethasone suppresion test
What is the management of Cushing’s Syndrome?
depends on the cause
- d/c medication if causative
- resection of pituitary adenoma
- surgical removal of adrenal tumor
Primary adrenal cortical insufficiency.
Addison’s disease
What deficiencies characterize Addison’s disease?
cortisol
**androgens **
aldosterone
What do androgens and aldosterone combine to form?
mineralocorticoids
What are the signs and symptoms of Addison’s disease?
- hyperpigmentation in buccal mucosa and skin creases
- scant axillary and pubic hair
- orthostasis and hypotension
What are the significant labs in Addison’s disease?
HYPOglycemia
HYPOnatremia
HYPERkalemia
What is the treatment in Addison’s disease?
replacement of:
glucocorticoids (ex: hydrocortisone)
AND
**mineralocorticoids **(ex: fludrocortisone/Florinef)
