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Blood/Lymphatic/Endocrine/Immune > Conditions of the Endocrine System > Flashcards

Conditions of the Endocrine System Flashcards

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1
Q

What are some of common signs and symptoms of adrenocortical carcinoma?

A

Cushing’s Syndrome
Pain in abdomen or flank
Weight gain
Weakness
Insomnia
Virilization

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2
Q

What is a benign tumor of the Islets Langerhans called that secretes insulin?

A

Pancreatic Tumor, Insulinoma
80% have MEN I syndrome

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3
Q

What are some of common signs and symptoms of pancreatic cancer?

A

Fasting hypoglycemia causing mental status abnormalities such as headache, confusion, motor weakness, personality changes

Usually advanced stage before diagnosis
Abdominal (epigastric) pain
Jaundice
Weight Loss
Fatigue

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4
Q

What are the modern classifications of pituitary adenomas?

A

Secretory or non-secretory
Micro or Macro adenoma

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5
Q

What is the sequela of GH-secreting pituitary adenoma?

A

Giganitism in Children (excess GH secretion before epiphyseal fusion)
Acromegaly in Adults (excess GH in adults after epiphyseal fusion)

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6
Q

What are the signs and symptoms of prolactin secreting pituitary adenoma?

A

Headache
Vision changes- bilateral hemianopia
Acne, excess hair growth on face and body
Female: amenorrhea, galactorrhea, vaginal dryness
Male: Erectile dysfunction, infertility

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7
Q

What are the four types of thyroid cancer?

A

Papillary
Follicular
Anaplastic
Medullary (Parafollicular)

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8
Q

Which of the four types of thyroid cancer is the most common?

A

Papillary

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9
Q

Which of the four types of thyroid cancer is the most aggressive?

A

Anaplastic

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10
Q

What are some of the predisposing factors for the development of thyroid cancer?

A

Radiation Exposure
Low Dietary iodine intake: not causative
Family hx of thyroid cancer

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11
Q

What are the common signs and symptoms of thyroid cancer?

A

Painless, palpable solitary thyroid nodule
Cervical LAO
Diarrhea (calcitonin secreting)
Facial flushing (Calcitonin secreting)

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12
Q

What are some of the conditions of pituitary hypo-secretion? Name the hormone associated?

A

Addison’s Disease (ACTH)
Diabetes Insipidus ( ADH)
Impaired or failed lactation (Prolactin)
Secondary Hypothyroidism (TSH)

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13
Q

What are common causes of panhypopitutarism?

A

Congenital, trauma, space occupying lesions, radiation, stroke

All productions and secretions are reduced

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14
Q

What are the common signs and symptoms of growth hormone deficiency?

A

Children: Short stature
Adult: Decrease in lean body mass, bone density, increase in fat mass, fractures and cardiovascular disease

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15
Q

What is the difference between central and nephrogenic diabetes insipidus?

A

Central DI involves a deficient secretion of antidiuretic hormone where nephrogenic DI is related to a resistance to the action of ADH

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16
Q

What are the common signs and symptoms of diabetes insipidus?

A

Polyuria
Polydipsia
Nocturia
Hypernatremia

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17
Q

What are some of the conditions of pituitary excess? Name the hormone associated?

A

Cushing’s Syndrome (ACTH)
Gigantism and acromegaly (GH)
Hyper-prolactinemia (Prolactin)
Secondary Hyperthyroidism (TSH)

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18
Q

What is the difference between acromegaly and gigantism?

A

1) Acromegaly is after growth is done. Result in coarse features, oil skin, hyperhydrosis and protrusion of lower jaw

2) Gigantism is before the growth plates close. Result in elongated bones and macrocephaly

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19
Q

What are some of the signs and symptoms of Syndrome of Inappropriate anti-diuretic hormone (SIADH)?

A

Hyponatremia
Decreased reaction time
Confusion
Anorexia
Nausea
Malaise
Headache
Muscle Cramps

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20
Q

What is an autoimmune disorder that can cause hypothyroidism?

A

Hashimoto Thyroiditis
Non-toxic Goiter

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21
Q

What is an autoimmune disease that can cause hyperthyroidism?

A

Graves Disease

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22
Q

What are some of the signs and symptoms of hyperthyroidism?

A

Palpitations and/or tachycardia
Agitation or anxiety
Fatigue/weakness
Goiter
Insomnia
Tremor
Hyperreflexia
Weight Loss

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23
Q

What lab changes are noted with hyperthyroidism?

A

Low TSH
High FT3

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24
Q

What herbs are indicated for hyperthyroidism?

A

Lycopus virginicus
Lithospermum ruderale
Melissa officinalis

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25
What heavy metal exposure is associated with Grave's disease?
Mercury and cadmium
26
What are the signs and symptoms of Grave's Disease?
1) Hyperthyroidism: Tachycardia, palpitations, weight loss, fatigue, diarrhea 2) Goiter 3) Exopthalmos: protrusion of eyeball 4) Pretibial Edema
27
What would you expect to see on a thyroid panel with Grave's disease?
Low TSH High T3 &T4 Postive Thyrotrophin receptor antibodies (TRab): Thyroid-stimulating immunoglobulin (TSI) Postive Thyroid Peroxidase Anitbodies (TPO)
28
How does propanolol work for hyperthyroidism?
It does not actually affect the hormone; rather via its beta 1 and beta 2 blocking ability it suppresses tachycardia and other catecholamine-induced symptoms
29
What condition has single or multiple autonomously functioning hyperthyroid nodules?
Toxic Nondular Goiter/Toxic Adenoma/ Plummer's Disease; one ore more nodule hypersecreting T3 and T4
30
What nutrient should be avoided with toxic nodular goiter?
Iodine
31
What diagnostic technique is often used for classifying thyroid nodules?
RAI scan and fine- needle biopsy Thyroid Scan (Technetium-99) Graves' Disease: Diffuse Uptake Toxic Multinodular Goiter: Multiple Discrete Area Solid Toxic Adenoma: Single Intense Area of Uptake
32
What are the changes seen on a thyroid panel in someone with Hashimoto's thyroiditis?
Normal to low T4 Increased TSH (+) Anti-TPO or anti-thyroglobulin antibodies
33
What are some of the signs and symptoms of hypothyroidism?
Weight gain Constipation Dry Coarse hair and skin Fatigue Muscle Cramps Cold Intolerance Loss of hair on lateral 1/3 of eyebrows
34
What reflex is often delayed in hypothyroid cases?
Achilles Reflex
35
What lab changes are noted with hypothyroidism?
High TSH Low T3 & T4
36
What happens to lipid levels in someone with hypothyroidism?
Increased LDL, triglyceride levels
37
Which drugs affect thyroid function ?
Amiodarone, Lithium, OCPs
38
Untreated congenital hypothyroidism can manifest as what condition in offspring?
Cretinism- characterized by physical deformity and learning disabilities
39
What are the features of myxedema?
Pretibial myxedema (thickening of dermis) due to excess glycosaminoglycans in the dermis Seen in severe adult hypothyroidism Non-pitting edema Swelling around lips and nose Decreased basal metabolic rate Can progress to coma in untreated cases
40
A condition that affects the thyroid itself cause what type of hypothyroidism?
Primary Hypothyroidism (90%) -Autoimmune: Hashimoto's thyroiditis (90% of cases) -Inadequate thyroid hormone production secondary to intrinsic thyroid defect -Hypopituitarism, iodine deficiency -Drugs: goitrogens (iodine), PTU, lithium, Amiodarone
41
What causes a tertiary hypothyroidism?
Insufficiency of hypothalamic TRH (rare) Hypothalamic Problem
42
What happens to the TSH level in secondary (pituitary) and tertiary hypothyroidism?
Insufficiency of pituitary TSH/hypothyroidism It is low
43
What proteins are used to carry thyroid in the body?
TBG (thyroid binding globulin) 80-85% TBPA (Thyroid binding pre-albumin) 10-15% Albumin 0-5%
44
What causes decrease in the thyroid binding globulin (TBG) or decrease in the protein that carries T3 and T4 in the blood?
Malnutrition (proteins) Liver Cirrhosis Nephrotic Syndrome Protein Losing Enteropathy Increase Androgens Hyperthyroidism Medication side effect
45
What are some of the medications used to treat hypothyroidism?
USP Thyroid: Porcine thyroid gland Levothyroxine or Levoxyl (T4) Liothyronine (T3)
46
What are the advantages of using USP Thyroid?
You get a full complement of secretions of thyroid gland: T4 and T3
47
What is an adverse effect of too much thyroid hormone supplementation?
Hyperthyroidism
48
What are some of the common signs and symptoms of hyperparathyroidism?
Hypercalcemia-elevated urinary calcium Headache Fatigue Kidney stone Formation Muscle Weakness Bone, pain, osteoporosis Thirst Nausea, vomiting Abdominal Pain Anxiety, Depression, Psychosis
49
What is the mnemonic for hyperparathyroidism?
Painful bones, renal stones, abdominal groans, psychic moans
50
What are some of the predisposing causes of hypoparathyroidism?
Thyroidectomy Radioactive Iodine Therapy Congenital (DiGeorge Syndrome) Hemochromatosis or Wilson's Disease Hypomagnesemia
51
What are some of the common signs and symptoms of hypoparathyroidism?
Hypocalcemia Parasthesia Fatigue Chronic Tetany Muscle Cramps Emotional Instability: Anxiety, irritability
52
What are the 2 physical exam test that will be positive with hypoparathyroidism?
Chovstek's sign Trousseau's sign
53
Explain Chvostek's sign
When the facial nerve is tapped at the angle of the jaw the facial muscles on the same side of the face will contract momentarily (Typically a twitch of the nose or lips) because of hypocalcemia.
54
Explain Trousseau's Sign
When a carpopedal spasm of the hand and wrist occurs after an individual wears a blood pressure cuff inflated over their systolic blood pressure for 2 to 3 minutes. Spasm in the hand or the foot when a tourniquet is applied at the wrist or ankle due to electrolyte imbalance
55
What is the autoimmune disease resulting from adrenal cortex destruction?
Addison's Disease
56
What are the signs and symptoms of Addison's Disease?
Weakness, fatigue Weight loss, anorexia, salt cravings N/V, diarrhea or abdominal pain Depression Orthostatic hypotension, dizziness Hyperpigmentation
57
What are some of the tests used to help diagnose Addison's disease?
Morning serum cortisol ACTH stimulation test Abdominal CT
58
What is the syndrome resulting from adrenocortical excess?
Cushing's Disease
59
When is Cushing's syndrome considered Cushing's Disease?
When the excess cortisol comes from an ACTH-secreting pituitary adenoma it is considered Cushing's Disease
60
What are some of the classic signs and symptoms of Cushing's syndrome?
Moon facies Hirsutism or virilization in women Buffalo Hump Slim Distal Extremities Thinning skin, purple striae Hypertension Muscle Atrophy Bone Loss: Osteoporosis, increased risk of fractures
61
What are some of the test used to help diagnose Cushing's syndrome?
Urinary free cortisol (24- hour -elevated) Dexamethasone Supression Test -Normal inhibits ACTH, reduce cortisol -Individuals w/ ACTH secreting tumors, low- dose does not inhibit cortisol; high- dose dexamethasone does -With Adrenal Cortical Tumors; neither low or hight dose dexamethasone inhibits cortisol secretion
62
What will high levels of aldosterone secretion cause in the body?
Hypertension Hypokalemia Hypernatremia
63
What causes Type I Diabetes mellitus?
Autoimmune destruction of the beta cells of the pancreas
64
Which viruses may be associated with the development of Insulin Dependent or Type I DM in children?
Coxsackie B, rotavirus, mumps and cytomegalovirus
65
What is the classic triad of signs and symptoms for Insulin Dependent or Type 1 DM?
Polyuria Polydipsia Polyphagia accompanied by weight loss
66
Describe the signs and symptoms of Ketoacidosis
Acetone "fruity" smell on the breath Drunken behavior Disorientation Sudden loss of consciousness Low blood pressure N/V, abdominal tenderness Tachycardia
67
What is the definition of Non-Insulin Dependent or Type II Diabetes mellitus?
A syndrome of chronic insulin resistance and high blood glucose levels usually related to lifestyle factors
68
What are some of the sequelae of untreated diabetes mellitus?
Retinopathy, glaucoma, cataracts, blindness Nephropathy Neuropathy Peripheral vascular disease Extremity gangrene Death
69
What level of fasting blood glucose establishes a diagnosis of DM?
>126 mg/dl (US) or >/= 7.0 mmol/L (CA)
70
What level of random blood glucose establishes a diagnosis of DM?
>200 mg/dl (US) or >/= 11.1 mmol/L (CA)
71
What finding on an oral glucose tolerance test (OGTT) is diagnostic for DM?
2 hour plasma glucose >200 mg/dl (US) or >/= 11.1 mmol/L (CA)
72
How does DM affect urine specific gravity?
Increased it. Usually above 1.025
73
What kind of urine crystals would most often see with DM?
Uric acid crystals
74
What are some of the nutrients used to manage DM?
EFAs Fiber Vitamin C B3, B6 Zinc Chromium Magnesium Potassium Vanadium Glutamine, Alanine Bioflavanoids Biotin
75
What herbs are indicated for DM?
Allium Cepa Allium Sativum Momardica Charantia Panax ginseng Syzgium Jambolnum Gymmema sylvestre
76
Oral hypoglycemics are indicated for what type of DM?
Non-insulin dependent Type 2 DM
77
What is the diagnostic criteria for metabolic syndrome?
Abdominal obesity, waist circumference > 40 men; >35 women Hyperglycemia Dyslipidemia Hypertension

Blood/Lymphatic/Endocrine/Immune (3 decks)

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