Endo Flashcards

1
Q

Causes of a diffuse goitre

A

Idiopathic
Puberty, pregnancy and postpartum
Graves’ disease
Thyroiditis - Hashimotos, subacute thyroiditis
Iodine deficiency
Goitrogens - iodine excess, drugs - lithium
Inborn errors of thyroid hormone synthesis - Pendred’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Causes of thyrotoxicosis

A
Primary:
Graves
Toxic adenoma or multinodular goitre 
Hashimoto’s thyroiditis 
Subacute thyroiditis 
Iodine induced 
Excess thyroid hormone replacement 
Postpartum thyroiditis 
Drugs - amiodarone 

Secondary:
Pituitary or ectopic thyroid- stimulating hormone hypersecretion
Hydatidiform mole
Struma ovarii

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of hypothyroidism

A
Primary:
Without a goitre:
Idiopathic atrophy
Treatment (radioiodine, surgery)
Agenesis or a lingual thyroid
Unresponsiveness to TSH
With a goitre:
Chronic thyroiditis 
Drugs (amiodarone, lithium)
Endemic iodine deficiency
Iodine-induced hypothyroidism 
Inborn errors

Secondary
Pituitary lesions

Tertiary
Hypothalamic lesions

Transient
Thyroid hormone treatment withdrawn
Subacute thyroiditis
Postpartum thyroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Signs of Acromegaly disease activity

A

SSHHEGG

Skin tag number
Sweating excessively
HTN
Headache Symptoms + Increasing ring size, shoe size, and dentures
Eyes (Increasing visual field loss or development of CN pathology (3,4,5,6))
Goitre enlarging
Glycosuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Diagnosis of Acromegaly

A

Biochemical
-Increased IGF-1 in plasma with no suppression in a glucose tolerance test or a paradoxical rise in GH

Anatomical

  • Skull XR film
  • MRI B for pituitary adenoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Causes of Acromegaly

A

Pituitary adenoma
Ectopic production of growth hormone releasing hormone
Ectopic production of GH (Hypothalamic, carcinoid, and pancreatic tumors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cushings Screening tests

A

Cortisol levels in morning and evening
24 hour urinary free cortisol (positive test is 3 fold increase above normal)
Overnight Dexamethasone suppression test
FBE (For secondary polycythemia, neutrophilia, and eosinopenia)
UEC for electrolytes
BSLs for hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Definitive tests for Cushings

A
  • Low dose Dexamethasone suppression test
  • High dose Dexamethasone suppression test (Cushings Syndrome has no suppression, but Cushings disease will suppress)
  • ACTH level (High in ectopic production and Cushings disease; Low in adrenal cause of Cushings Syndrome)
  • Petrosal Sinus ACTH levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Autoimmune associated disease

A
Addisons
Hypoparathyroidism
Mucocutaneous candidiasis
T1DM
Hashimotos
Graves
Primary ovarian failure
Pernicious anaemia
Vitiligo
Alopecia
Hypophysitis
Myasthenia gravis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Features of Autonomic neuropathy

A
  • Postural Hypotension
  • Loss of sinus arrhythmia
  • Valsalva manoeuvre causes no slowing of the pulse
  • Loss of sweating
  • Erectile dysfunction
  • Nocturnal diarrhea
  • Urinary retention and incontinence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Signs of diabetic retinopathy

A

Nonproliferative

  • Dot haemorrhages
  • Blot haemorrhages
  • Hard and soft exudates
  • Microanuerysms
  • Dilated veins

Proliferative

  • New vessels
  • Vitreous hemorrhage
  • Scar formation
  • Retinal detachment
  • Laser scars
How well did you know this?
1
Not at all
2
3
4
5
Perfectly