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SA1 - Child Health > Clinic - Endocrine > Flashcards

Clinic - Endocrine Flashcards

1
Q

What are the signs of congenital hypothyroidism

A

FTT

Macroglossia

jaundice

umbilical hernia

corse facial features

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2
Q

When is the Gurthrie test and what is tested for?

A

Day 5

Congenital hypothyroidism

SCA

CF

Metabolic diseases eg phenylketonuria

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3
Q

What are the symptons, investigations and treatment of Primary Hyperparathyroidism.

What is the process?

A

Increased PTH causing increased calicum and calicum blocks transmission

Symptoms - Stones, moans, groans, thrones psychiatric overtones

Investigations. HIGH PTH, HIGH CALCIUM, HIGH URINE CALCIUM LOW PHOSPHATE

Treatment - Surgery, observation

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4
Q

What are the symptoms, investigations and treatment of secondary hyperparathyroidism?

What is the process?

A

Low calcium causes an increase in PTH

Symptoms - Stones, moans, groans, thrones psychiatric overtones or NONE

Investigations. HIGH PTH, Normal CALCIUM, HIGH PHOSPHATE

Treatment - Surgery, observation

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5
Q

What is the relatioship between calcium and phosphate?

A

Usually mirror, except in seconday hyperparathyroidism

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6
Q

What are the symptoms, investigations and management of tertiary hyperparathyroidism?

What is the process?

A

Long term low Calcium leads to hight PTH and high calcium. Different to secondary where calcium levels are normal

Symptoms - Stones, moans, groans, thrones psychiatric overtones

Investigations. HIGH PTH, HIGH CALCIUM, LOW PHOSPHATE

Treatment - Surgery, observation

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7
Q

What are the symptoms and investigations of malignant hypercalcemia?

What is the process?

A

Malignancy causing high calcium levels. This needs to be addressd by treating the malignancy

Symptoms - Stones, moans, groans, thrones psychiatric overtones and WEIGHT LOSS

Investigations - Low PTH, HIGH Calcium, Low phosphate

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8
Q

What are the symptoms, investiagations, treatment and pathology of hypoparathyroidism?

A

Symptoms - Diarrhoea, pins and needles, tinnitus, clonus, Increased bone density.

Investigations - LOW PTH, LOW CALCIUM, HIGH PHOSPHATE, HIGH BONE DENSITY

Treatment - with calcium or vitamin D to increase absorption

Pathology - Underactive parathyroid meaning less calcium in the blood but more in the bones

Calcium limits nerve transmission so without it there are postiive nerve signs

This is often associated with surgery

Investigations - LOW PTH, LOW CALCIUM, HIGH PHOSPHATE, HIGH BONE DENSITY

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9
Q

What are the symptoms, investigations, treatment and pathology of pseudohypoparathyroidism?

A

Symptoms - Should metacarpals and round face - Albrights heriditary dystrophy

Investigations - High PTH, Low Calcium, High phosphate

Pathology - An end organ resistance to PTH so althought it is here there is low calcium, causing symptoms.

Treatment - Vitamin D to try and increase calcium levels

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10
Q

What are the symptoms, investigations, management and pathology of hypomagneasimia?

A

Symptoms - Tinnitus, diarrhoea, clonus, pins and needles

Investigations - Low calcium, low PTH and low magnesium

Pathology - Magnesium is needed for PTH

Treatment - Magnesium

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11
Q

What are the symptoms, investigations and treatment of hypervitamindosis and what is it associated with?

A

Symptoms - Stones, moans, groans, bones, psychiatric overtones

Investigations - High Vit D, high Calcium, Low PTH

Treament - Stop diet, steroids for sarcoidosis

Pathology - Associated with diet, or SARCOIDOSIS

Too much VIt D causes increased Calcium and associated symptoms

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12
Q

What are the symptoms, pathology, investigations and treatment of a phaeochromocytoma?

A

Symptoms - Headache, tachycardia, sweating

Pathology - Tumour of the adrenal medulla

Investigations - Increased 24 hr urine catecholamines Investigate futher via MRI

Treatment - Surgery

Medical Treament - B blockers plus low sodium diet to counteract high BP

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13
Q

What are the symptoms, pathologies and treatments of Cushings disease and cushings Syndrome?

A

Symptoms - Poor wound healing

Central obesity

Straie/brusing from thin skin and dilated vessels

Buffal hump

Moon face

Depression, fatigue

Hirsutism

Cushings - Increased ACTH and cortisol

Cushings Disease - ACTH producing tumour in pituatry

Cushings Syndrome - Ectopic ACTH production

All of these result in an increased cortisol level and the symptoms mentioned.

Treatment - Surgery or metyrpone. This blocks 11b hydroxylase which makes cortisol

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14
Q

How do you differentiate between Cushings disease and Cushings Syndrome?

A

Dexamethasone test.

Low dose and low ACTH means its not cushings as levels are falling as normal.

High dose and low ACTH means cushings disease

High dise and no fall in ACTH means ectopic

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15
Q

What are the symtoms, investigations, pathology and treatments of Conns Syndrome?

A

Pathology - Increased aldosterone causing increased NA and water retention and hypertension

Symptoms - Hypertension, hypernaetremia, hypokaleamia

Investigations - High aldosterone but low renin

high NA, Low K, hypertension

Treatment - Low Na diet/surgery

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16
Q

What is the pathology, symptoms, investigations and treatment of Addisons. What is it associated with?

A

Pathology - This is adrenal insufficency usually caused by TB or AI.

Symptoms - Hypotension, hypoglycaemia, postural hypotension, hyperpigmentation, N+V, weight loss

Investigations - Hyponaetemia, hyperkalaemia, HIGH ACTH. If you give synctachen (Artificial ACTH) and there is no rise in cortisol, it is Addisons.

Treatment

Hydrocortisone (glucocorticoid)

Fludrocortisone (Minerocorticoid)

17
Q

What is congenital adrenal hyperplasia and what are the investigations?

A

A congenital disease with a lack of 21 hydroxylase. This is a key enzyme in the formation or minerocorticoids and glucocorticoids

Investigation - GIve synthetic ACTH and 17hydroxyprogesterone builds up but no 21 hydroxylase

18
Q

What are the two types of CAH?

A

Salt Wasting - N+V, FTT, hyponaetremia. This is due to a decrease in corticoids.

Treat with hydrocortisone, fludrocortisone

Virilising - Clitoromegaly, hirsuitism, ambiguous genitalia. This comes about due to an increase in androgens as a result of a decrease in corticoids

Treat with oestragen, dexamethasone to suppress ACTH

19
Q

What are the symptoms, investigations, pathology and treatment of male primary hypogonadism?

A

Symptoms - baldness, loss of libido, small or absent testicles, gynacoemastia, infertility

Investigations - High GNRH, HIGH LH/FSH, Low Testosterone

Treatment - Testosterone

Examples - Chemo, undescended testicles, Klinefelter 47XXY

20
Q

What are the symptoms, investigations and pathology of male secondary hypogonadism?

A

Pathology - This is a problem with the stimulation of the gonads. Eg a pituatry tumour, diabetes

Symptoms - baldness, loss of libido, small or absent testicles, gynacoemastia, infertility

Investigations - Low GNRH, LOW LH/FSH, Low testosterone

21
Q

What are the symptoms, pathology, investigations and treatment of foetal androgen insufficiency?

A

Symptoms - A women with infertility, amenorrhea

Investigations - High testosterone, XY karyotype

Pathology - This is a resistance to androgens in the womb making a man have female characteristics

Treatment - Surgery, testosterone

22
Q

What are the symptoms, pathology, investigations and treatment of PCOS

A

Symptoms - Amenorrhea, acne, virulence, infertility

Investigations - HIGH androgen, High FSH:LH ratio

Pathology - This is confirmed via US and is linked to diabetes

Treatment - Oestrogen and infertility treatment

23
Q

What are the symptoms, pathology, investigations and treatment of ovarian tumour?

A

Symptoms - Weight Loss, amenorrhea, hirsutism

Investigations - High testosterone, CA125

Confirmed via US/CT

Treatment - Treat the cancer

24
Q

What are the symptoms, pathology, investigations and treatment of Turners

A

Symptoms - Webbing, short, lymphodeama of hands and feet

Investigations - High FH/LSH, Low oestrogen, Low GH

Pathology - 46 XOnly one female chromosome

Treatment - Oestrogen or GH if young

25
Q

What are the symptoms, pathology, investigations and treatment of precocious puberty

A

Symptoms - Early menarche

Investigations - High GNRH, LH/FSH, oestrogen for her age

Treatment - LNRH/GNRH analogues for negative feedback

26
Q

What are the symptoms, pathology, investigations and treatment of premature ovarian failure

A

Symptoms - amennorhea before 40 for 6 months, hot flushes, low libido

Investigations - HIGH FSH x2

Treatment - Ovum replacement, Oestrogen

27
Q
  1. When can an addisonian crisis occur?
  2. what are the symptoms?
  3. Management
A

1) Undiagnosed Addisons or Infection
1) Vomiting and dehydration

  • Hypotension
  • Lethargy
  • convulstions
  • Pain
  • Confusion
  • Fever

3)Iv saline/glucose/hydrocortisone

Treat long term with hydrocortisone and fludrocortisone

28
Q

What are the key symptoms in T1DM?

A
  1. Polyuria
  2. Polydypsia
  3. Weight loss

also

  • Candida
  • Enuresis
  • tiredness
29
Q

What are the symptoms of DKA?

A
  • Acetone breathe
  • Vomiting/dehydration
  • Abdo pain
  • Hyperventilation
  • Hypovolaemic shock
  • Coma and death
30
Q

What are the diagnostic levels for DM?

A

1) Symptoms

PLUS

Random glucose >11.1 (or equal)

Fasting glucose > 7 (or equal)

OGTT >11.1 (or equal)

2) No symptoms plus the above values on two occasions

31
Q

What are the two complications of T1DM?

A
  1. Hypoglycaemia
  2. DKA
32
Q

What is the treament of DKA?

A
  1. Fluids
  2. Insulin infusion - 0.05 - 0.1 U/kg/hour
  3. Potassium as insulin and rehydration reduces it
  4. Bicarb if shocked or not responding
  5. Reestablish fluids and subcut insulin

SA1 - Child Health (11 decks)

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