Endo Flashcards

1
Q

hyperthyroidism signs and symptoms

A

tremor
anxiety
palpitations
heat intolerance
diarrhoea
oligomenorrhoea

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2
Q

causes of hyperthyroidism

A

Grave’s disease
toxic multinodular goitre
thyroiditis
drugs (i.e amiodarone)

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3
Q

management of hyperthyroidism

A

propanolol
carbimazole (TPO inhibitor)
radioiodine

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4
Q

which antibodies are associated with Grave’s disease

A

anti-TSH receptor antibodies

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5
Q

how does propanolol work to treat hyperthyroidsm

A

used to block b receptors as in hyperthyroidism T4/3 excess leads to increased expression of b-adrenergic receptors thus increased sympathetic tone

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6
Q

antibodies associated with Hashimoto’s thyroiditis

A

anti-TPO antibodies

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7
Q

hypothyroidism signs and symptoms

A

lethargy
cold intolerance
weight gain
constipation
menorrhagia
reduced deep tendon reflexes

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8
Q

causes of hypothyroidism

A

Hashimoto’s thyroiditis
subacute (de Quervain’s) thyroiditis
drugs (i.e. amiodarone, lithium)
iodine deficiency

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9
Q

hypothyroidism mx

A

levothyroxine

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10
Q

thyroid eye disease features

A

bilateral exophthalmos
diplopia
conjunctival oedema (chemosis)
ophthalmalgia
exposure keropathy
optic neuropathy
lid lag and retraction (caused by sympathetic hyperactivity of muscle in upper eyelid)

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11
Q

thyroid eye disease pathophysiology

A

anti TSH receptor antibodies bind to TSH receptor behind eye

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12
Q

Grave’s disease niche signs

A

thyroid eye disease
pretibial myxoedema
thyroid acropachy

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13
Q

thyroid cancer features

A

non-functional, painless, rapidly growing
solitary, irregular (nodular) shape
hoarse voice (recurrent laryngeal nerve)
dysphagia
haemoptysis
airway obstruction
cervical lymphadenopathy

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14
Q

thyroid cancer Ix

A

fine needle aspiration biopsy with USS, CT/PET, thyroid scan

TFTs may be useful to exclude benign (functional) nodules

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15
Q

types of thyroid cancer

A

papillary carcinoma (70%) (female, childhood radiation exposure)

follicular carcinoma (20%) (female, low iodine intake)
- Hurthle cell carcinoma is a variant

medullary carcinoma (5%) - associated with MEN 2A and MEN 2B

anaplastic carcinoma (1%)

lymphoma (rare)

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16
Q

what would biopsy show for thyroid follicular carcinoma

A

neoplastic papillae + psammoma bodies + ground glass nuclei

17
Q

which cells are affected in thyroid follicular carcinoma

A

follicular cells

18
Q

which cells are affected in thyroid papillary carcinoma

A

follicular cells

19
Q

which cells are affected in thyroid medullary carcinoma

A

c-cells
produce calcitonin which is measured in the blood

20
Q

typical age onset for MEN1

A

teens and 20s

21
Q

typical age onset MEN2

A

any age but mostly later in life (50-70)

22
Q

how is MEN1 inherited

A

autosomal dominant inheritance of an inactivating mutation of the tumour suppressor gene MEN1

23
Q

organs affected with MEN1

A

remember 3 Ps

Parathyroid, pancreatic, pituitary
others (eg. carcinoid, adrenal, thyroid)

24
Q

MEN1 signs and symptoms

A

varies depending on organ affected

hypercalcaemia (due to hyperPTH from parathyroid adenoma/hyperplasia)
-stones, moans, groans

peptic ulcer (caused by too much gastrin)
insulinomas, glucagonomas, gastrinomas (gastrinomas most likely to be functional)

pituitary tumours mainly secrete prolactin

25
MEN1 Ix
check PTH and Ca for primary hyperthyroidism elevated gastrin from gastrinoma hypoglycaemia and raised c-peptide for insulinoma hyperglycaemia and raised glucagon for glucagonoma stage with CT/MRI and DEXA for hyper PTH
26
how is MEN2 inherited
autosomal dominant inheritance of activating mutation of the proto-oncogene, RET
27
how does MEN2A present
presents with parathyroid involvement so hypercalcaemia symptoms and phaeochromocytoma (sweating, palpitations, hypertension, headaches)
28
MEN1 Ix
check PTH and Ca for primary hyperthyroidism elevated gastrin from gastrinoma hypoglycaemia and raised c-peptide for insulinoma hyperglycaemia and raised glucagon for glucagonoma stage with CT/MRI and DEXA for hyper PTH genetics