Endocinology Flashcards

1
Q

Thyroid hormones

A

T3 and T4 are transported by proteins controlled and secreted by the liver.
T3 and T4 drive digestive functions.
T3: nuclear transcription factor which drives transcription and translation impacting all cells.

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2
Q

Hyperthyroidism (thyrotoxicosis)

A

Sxs: abdominal pain, vomiting, weight loss, change in bowel habits.

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3
Q

Hyperthyroidism associated autoimmune disease

A

pernicious anemia (PA) Celiac and IBD

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4
Q

Hyperthyroidism Upper Digestive Tract

A
  • Dysphagia (compression from goiter) neurohormonal regulation, skeletal myopathy affecting pharynx and upper esophagus.
  • Atrophic gastritis (Graves disease; PA) achlorhydria, hypergastrinemia
  • Recurrence of Helicobacter pylori
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5
Q

Hyperthyroidism GI motility issues and Lower Digestive tract

A
  • Esophageal contractility increasing velocity of esophageal contractions
  • Increase or decrease gastric emptying
  • Lactose intolerance.
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6
Q

Hypothyroidism (Hashimoto thyroiditis)

A

Sxs: anorexia, N/V, abdominal pain, constipation.
- weight gain (myxedema),
-anemia: menorrhagia, pernicious anemia/achlorhydria
-ascites (high protein content)-responds to hormone treatment.
-GI bleeding
- Interferon induced hypothyroidism

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7
Q

Hypothyroidism associated autoimmune disorders

A

IBD, PA (B12 malabsorption), DM, Celiac, Downs Syndrome
GI disease can affect exogenous thyroid hormone absorption

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8
Q

Hypothyroidism GI Motility

A

Esophageal motor and LES/goiter: dysphagia and dyspepsia
GER
Delayed gastric emptying
Ileus: SIBO,
Megacolon
Comorbidity with Down’s

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9
Q

Hyperparathyroidism: Hypercalcemia due to increased PTH. DDX

A

-Sporadic Adenoma
- MEN

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10
Q

Hyperparathyroidism (high calcium) Symptoms:

A

Gastroparesis: N/V, abdominal pain
PUD (gastric hypersecretion)
Decreased colonic transit: constipation
Pancreatitis: acute and chronic, abdominal pain, steatorrhea

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11
Q

Hypoparathyroidism (Hypocalcemia): Causes:

A
  • Congenital: DiGeorge, 22q11 deletion
  • Acquired: Autoimmune polyendocrinopathy syndrome type 1 (AIRE), IPEX, post surgical, radiation destruction
  • Infiltrative: Wilson’s disease, hemochromatosis, neoplasm, sarcoidosis
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12
Q

Hypoparathyroidism (Hpyocalcemia)

A

-Hypomagnesemia/hypermagnesemia
-Low Ca causes decreased cholecystokinin: liver-steatorrhea, poor GB contractility, pancreas: decreased enzyme secretions
Associated with celiac, steatorrhea, Vitamin D deficiency

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13
Q

Cushing’s Disease, Acromegaly (chronic glucocorticoid excess)

A
  • Cushingoid facies, failure of longitudinal growth, hirsutism, muscle weakness, acne, striae, hypertension
  • Increased serum ACTH and Cortisol level: gastric ulceration (NSAIDs).
  • Increased serum growth hormone level: colorectal polyps and cancer
  • GI issues of DM
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14
Q

Addison’s disease (Adrenal insufficiency)

A

Nausea, vomiting, anorexia, diarrhea, abdominal pain. Symptoms can mimic cyclic vomiting syndrome. Chronic: weakness, fatigue, anorexia, weight loss, hypotension and hyperpigmentation.
Enterocyte dysfunction: diarrhea, malabsorption, FTT

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15
Q

Adrenal Insufficiency Acute

A

hypotension, shock weakness, apathy, confusion, anorexia, N/V dehydration, abdominal pain, hyperthermia, hypoglycemia

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16
Q

Adrenal Insufficiency (Addison’s disease) Associated autoimmune

A

Pernicious anemia (atrophic gastritis and achlorhydria), Celiac disease

17
Q

Multiple Endocrine Neoplasia Genes

A

MEN type 1: MEN1
MEN type 2a: RET
MEN type 2b: RET

18
Q

MEN 1

A

AD, 10% denovo,
constellation of tumors: parathyroid, pituitary, pancreas, duodenum.
Sxs: hyperparathyroidism (hypercalcemia), and anterior pituitary tumors, and neuroendocrine tumors (Carcinoid).

19
Q

MEN1 Neuroendocrine tumors

A

PPoma
Gastrinoma (Zollinger Ellison Syndrome)
Insulinoma
Glucagonoma
Somatostatinoma
VIPoma

20
Q

MEN 1 anterior pituitary tumors

A
  • Prolactin
  • GH
  • ACTH
21
Q

MEN1 does NOT have:

A

Medullary thyroid carcinoma or Pheochromocytoma

22
Q

MEN 2A: RET proto oncogene

A

AD or denovo.
Bilateral medullary thyroid carcinoma
bilateral pheochromocytoma
Primary hyperparathyroidism.

23
Q

MEN2B

A

De Novo
Medullary Thyroid Carcinoma (100%)
Pheochromocytoma: 50%
oralcutaneous neuromas.
Thyroid disease is rare.

24
Q
A