Assessment of Endocrine Disorders Flashcards
for Endocrinology, what does a primary, secondary, and tertiary disease affect
Primary: inhibits the action of downstream glands
Secondary: indicitive of a problem with the pituitary gland
Tertiary: associated with dysfunction of the hypothalalmus and its releasing hormones
What are the three main causes of endocrine dysfunction
Hormone excess:
- neoplastic growth of endocrine cells
- Autoimmune
- Excess hormone administration
Hormone decicency:
- autoimmune destruction
- tumor infiltration
- surgery
Hormone resistance:
- inherited defects for hormone dysfunction: feedback signals, receptors
- Genetic
- Immunologic
What is the endocrine testing principles
Dynamic testing:
- suppression tests: asses endocrine hyperfunction
- stimulation test: assesses endocrine hypofunction
What is the main treatment to endocrine pathology
- replacing a deficient hormone
- suppressing excessive hormone production
clinical presentations of Hyperthyroidism
Excessive metabolic issues
- Low TSH
- High T3, T4
weight loss anxiety Diaphoresis heat intolerance increased appetite tremor palpations
What are some potential causes of Hyperthyroidism
- Graves disease
- Toxic multinodular goiter
- Subacute (de Quervain)s thyroiditis
- Hashimotos thyroiditis
- Amiodarone induced thyroiditis
clinical presentations of hypothyroidism
High TSH -low T3, T4 Low metabolic symptoms: -Fatigue -weight gain -dry coarse skin -cold intolerance -weakness and muscle cramps -depressed -impaired memory
what are potential causes of hypothyroidism
- Hashimotos thyroiditis
- Iodine deficiency
- subacute (de Quervains) thyroiditis aftr the hyper phase
- Drugs: lithium, sulfonamides, methimaxole
- Deficient pituitary TSH
what is a classic presentation with graves disease
Proptosis
Exophthalmos: eyes bulging
where are the two places that Calcium is converted or enters the body
intestine absorbs the Vitamin D and calcium
kidney will activate the Vitamin D to its biologically active form (1,25 dihydroxy vitamin D
Hypocalcemia and assesing for it
Low calcium levels
- Chvosteks sigh (hitting the facial nerve)
- Trousseaus sign (leave BP cuff on to ellict a carpopedal spasm)
Symptoms and signs of excess parathyroid hormone secretion
- Hypercalcemia
- BOne disease
- Hypophosphatemia
- Hypomagnesemia
- increased production of calcitrol
clinical manifestations of hypercalcemia
Polyuria Polydipsia -NEphrolithasis -Brady carda -hypertension -shortening of the QT interval -Muscle weakness -bone pain
what is primary Hypeparathyroidism and what are some potential causes and symptoms
to much PTH leading to:
- nephrolithiasis
- bone disease
- anorexia
- nasea
- constipation
- polydipsia
- polyuria
Causes:
- Parathyroid: adenoma, hyperplasia, carcinoma
- Multiple endocrine neoplasia (MEN syndromes)
- Chronic renal failure: secondary, or tertiary form of HPTH
Clinical manisfations of Hypoparathyroidism
Main cause of Hypocalcemia
-usually due to removal of glands during thyroidectomy, digeorge syndrome, or hereditary autoimmunity syndrome
symptoms:
-seizures, anxeity, depression, extrapyramidal symptoms (parkinsonism)
-Paresthesia around mouth and toes, muuscle stiffness, myalgia, spasms
CV: hypotension, prolongation of QT interval
-cataracts, hyperpigmentation
