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PCM II Midterm > Assessment of Endocrine Disorders 2 > Flashcards

Assessment of Endocrine Disorders 2 Flashcards

1
Q

Management of endocrine disorders

A

need to understand metabolism, reproductive physiology, bone metabolism & growth

relies on history & physical

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2
Q

Practice for endocrine disorders

A

linked to understanding of hormone secretion, action & feedback control principles

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3
Q

Evaluation of endocrine disorders

A

measuring hormone concentration, function & feedback

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4
Q

What is important to assess endocrine disorders?

A

understanding physiology (feedback loops)

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5
Q

What are the 3 causes of endocrine dysfunction?

A

hormone excess
hormone deficiency
hormone resistance

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6
Q

What does clinical evaluation of endocrine dysfunction include?

A 
physical exam
ROS
presenting symptoms
family & social history
meds
knowledge of disease prevalence & pathophysiology
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7
Q

How to measure hormones

A

immunoassays
plasma & urinary samples
correct interpretation in clinical context

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8
Q

When is a suppression test used?

A

assess endocrine hyperfunction

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9
Q

When is a stimulation test used?

A

asssess endocrine hypofunction

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10
Q

Treatment of endocrine disorders

A

replace hormone deficiency

suppress excessive hormone production

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11
Q

What do you screen for in hypothyroidism?

A

TSH (confirm w/ free T4)

screen women after age 35

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12
Q

How should you screen for thyroid nodules & neoplasia?

A

physical exam of thyroid

fine needle aspiration biology

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13
Q

What do you screen for in hyperparathyroidism?

A

serum calcium
PTH
assess comorbid conditions

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14
Q

What is the major role of the thyroid gland?

A

metabolism

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15
Q

What are some common HPI findings for hyperthyroidism?

A

weight loss
anxiety
heat intolerance
increased appetite

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16
Q

What are some causes for hyperthyroidism?

A

Graves disease
Subacute thyroiditis
Amiodarone (Beta blocker that induces thyroiditis)

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17
Q

What are some hyperthyroid differential possibilities?

A

general anxiety or panic
mania
cancer
exopthalmos

18
Q

What are some common HPI findings for hypothyroidism?

A 
fatigue
weight gain
cold intolerance
depressed mood
less metabolism (no appetite)
19
Q

What are some potential causes of hypothyroidism?

A

Hashimoto thyroiditis
Iodine deficiency
Drugs (PTU, methimazole)
Subclinical hypo w/ elevated TSH

20
Q

What are some differential possibilities for hypothyroidism?

A

depression
chronic fatigue syndrome
heart failure
anemia

21
Q

How do you examine the thyroid?

A

posterior approach

22
Q

What is an enlarged thyroid gland?

A

goiter

23
Q

How does Grave’s disease present?

A

Proptosis

Exopthalmos

24
Q

What is associated with hyper PTH?

A

bones, stones, abdominal moans & psychic groans

increased calcium & PTH

25
Q

What do the PTH glands regulate?

A

regulate calcium levels (no effect on metabolism)

26
Q

How do you assess for hypocalcemia?

A

Trousseau (muscle spasm w/ BP cuff) & Chvostek signs (facial muscle twitch)

27
Q

Symptoms/signs of excess PTH hormone secretion

A 
bone disease (osteopenia)
nephrolithiasis
increased production of calcitriol
hypophosphatemia
prox renal tubular acidosis
gout
anemia
28
Q

Clinical manifestations of hypercalcemia

A

polyuria
polydipsia

muscle weakness

bradycardia & hypertension

vomiting, nausea

29
Q

Direct Abnormalities of Primary Hyperparathyroidism

A

nephrolithiasis & bone disease (b/c prolonged PTH excess)

30
Q

symptoms attributable to hypercalcemia

A

anorexia
nausea
constipation
polydipsia & polyuria

31
Q

What are potential causes of hyperparathryoidism?

A

PTH adenoma & carcinoma

multiple endocrine neoplasia

chronic renal failure

32
Q

What should be included on differential consideration of HPTH?

A 
hypercalcemia of malignancy
multiple myeloma
familial hypocalciuric hypercalcemia
vit D intoxication
sacroidosis
hyperthyroidism
33
Q

What are common causes of hypoparathyroidism?

A

surgical removal of glands in thyroidectomy
DiGeorge syndrome
hereditary autoimmune syndrome

34
Q

What are some signs & symptoms of hypo PTH & hypocalcemia?

A

neuropsych (seizures, anxiety)
neuromusc (numbness around mouth)
CV (hypotension)
Autonomic

35
Q

Cushing’s syndrome

A

caused by overproduction of ACTH by pituitary or ingestion of exogenous corticosteroids

36
Q

What are some presentations assoc w/ Cushing’s syndrome?

A 
HTN
Central obesity
weakness
hirsutism
depression
37
Q

What are some signs of Cushing syndrome?

A

overproduction of cortisol

round or red face
purple streaks across skin
buffalo hump
bruising
excessive hair growth
38
Q

What are causes of adrenal insufficiency?

A

primary (Addisons)

secondary (pituitary failure or excess exog steroids)

39
Q

What are some clinical manifestations of adrenal insufficiency?

A 
hyperpigmentation (b/c increased ACTH)-skin & oral
weakness
fatigue
anorexia
nasuea & vomiting
hypotension
salt craving
40
Q

What are some differential considerations for adrenal insufficiency?

A

hypotension
hyperkalemia (renal failure)
cancer

41
Q

What is associated w/ pituitary disorders?

A

usually due to pituitary adenoma

42
Q

How to document endocrine disorders?

A 
CC
HPI
ROS (vague)
Medical History
Physical Exam

PCM II Midterm (15 decks)

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