Endocrine 1 Flashcards
Parathyroid regulates what
calcium
what does the kidney do to vitamin D?
enzyme 1-alpha hydroxylase converts 25 hydroxyvitamin d to 1,25 dihydroxyvitamin D (the active form)
thyroidectomy
numbness and tingling around the mouth and fingers. muscle pain, mild activity.
what do you expect in labs?
what gland is not working?
hypocalcemia
parathyroid.. this is hypoparathyroidism. it can’t break down stuff to increase Ca
signs and symptoms of hypocalcemia?
neuropsychiatric
neuromuscular
CV
autonomic
other?
hypoparathyroidism
neuropsychiatric –> seizures, dementia, anxiety.
neuromuscular –> parasthesia around mouth and fingers
CV: CHF, hypotension
Autonomic –> Biliary colic
other –> cataracts, dry coarse skin, hyperpigmentation, eczema.. steatorrhea.
Chvostek sign?
hypocalcemia / hypoparathyroidism
tapping on facial nerve just anterior to the ear and you’ll elicit spasms of the lips.
Trousseau’s Sign
hypocalcemia / hypoparathyroidism
blood pressure cuff is squeezing on brachial artery and you have spasm of the hand.
left sided flank pain. constipated, urinating. leg cramps, leg pain.
kidney stone on side that hurts.
what should you see in the labs?
what could be causing this?
hypercalcemia
hyperparathyroidism
caused by the increase in calcium. enlargement of the glands, benign tumor or malignant tumor.
what causes hyperparathyroidism?
adenoma 80% of cases
15% hyperplasia
if you have hypercalcemia and it’s not coming from the parathyroid, what’s happening?
renal failure, vitamin D deficiency, causing increased PTH
2ndary hyperparathyroidism
increase in calcium does what?
slows down everything.. weakness, confusion, lethargy,
dehydration, nocturne, renal stones
Hyperparathyroidism mnemonic?
Stones --> renal or biliary calculus Bones --> bone pain Groans --> abdominal pain Thrones --> polyuria, dehydration Psychiatric Overtones --> depression
thyroid makes what? which is active?
what makes this? (axis)
t3 and t4. t3 is active
hypothalamus makes TRH which makes the anterior pituitary make TSH
how do you palpate the thyroid?
posteriorly. have them swallow water or swallow in general.
person feels cold all the time, hair loss, thinks they’re getting older, feels rundown all the time
hypothyroidism
most common cause of hypothyroidism?
Hashimoto’s thyroiditis (autoimmune)
or thyroidectomy
how do you test for hypothyroidism?
what are the levels that you expect?
TSH and free T4
high TSH, low T3 and T4
woman has a ton of weight loss and irritability. hot all the time and racing heart. bulging of eye
what is happening?
what lab values would you see?
most common cause?
hyperthyroidism
too much T3 T4, so lower TSH
Grave’s disease (autoimmune) –> stimulating TSH through TSIs
other hyperthyroidism problems?
excessive consumption of iodine or meds
goiter sometimes
thyroiditis
hyperthyroidism symptoms
irregular heart rate fatigue hand tremors mood swings weight loss hot all the time. skin dryness diarrhea
Exophthalmos?
pushes the eye forward from fat behind the eyes in Graves’ disease.
hyperthyroidism
Weakness and extreme fatigue. dizziness and joint pain.
hyperpigmentation of the skin and intermittent GI distress
Addison’s disease (adrenal insufficiency)
what happens during Addison’s disease?
most common cause?
what is going on?
what is also happening?
adrenal insufficiency
most common is autoimmune. surgical removal of thy
you’re underproducing cortisol and you’re hypotensive because you’re not making as much aldosterone
Symptoms of Addison’s?
skin darkening, N/V/D 50% of cases
salt food craving (because no aldosterone) –> hypotension
Addisonian Crisis/Acute Adrenal Insufficiency?
patient has almost no use of their adrenal gland
appears at time of stress
sudden penetrating pain of back, extremities, vomiting, diarrhea.
leads to death if not treated
