Endocrine 1 Flashcards
Hypoparathyroidism
Hypocalcemia
-causes: surgical removal of parathyroid glands, DiGeorge syndrome, hereditary autoimmunity syndrome
**most common cause of hypocalemia
Signs and Sx:
-neuropsych: seizures, dementia, depression, paresthesia around mouth and fingers and toes, CHF, hypotension, prolonged QT, dry coarse skin, myalgia
Chvostek Sign
Trousseau’s Sign
Primary Sign and Sx of Hypoparathyroidsm
numbness and tingling around mouth and fingers
-myalgia
What is the primary cause of hypocalcemia?
hypoparathyroidism
Chvostek Sign
tap on the facial nerve at zygomatic arch
found with hypocalcemia
+ sign=twitching at the mouth, spasm of all muscles
Trousseau’s Sign
found in hypocalcemia
inflate blood pressure cuff: spasm of arm and hands
Workup for Hypocalcemia
Serum calcium, albumin, magnesium, PTH level
24 hr urine calcium
Management and Treatment
supplement calcium and vitamin D
Hyperparathyroidism
Hypercalcemia
-1 hyperparathyroidsim:
-2 hyperparathyroidism:
Symptoms: lethargy, weakness, confusion, coma, polyuria, dehydration, nocturia, renal stones, renal failure, constipation, nausea, anorexia, renal stone, syncope
“Stone, bones, groans, thrones, psychiatric overtones”
1 hyperparathyroidism
causes high PTH
Adenoma associated with MEN1
gland englargement of chief cells
carcinoma
2 hyperparathyroidism
low calicium causes high PTH
renal failure, vit D def, malabsorption
Presentation of Hyperparathyroidism
Stones: renal/biliary calulus Bones: bone pain Groans: abdominal pain, nausea, vomiting thrones: polyruria psychiatric overtones: depression, anxiety, cognitive dysfunction
Workup for hyperparathyroidism
serum calcium, albumin, magnesium, PTH level
workup for malignancy, genetic disorder, evaluate patients medications, diet evaluation
Management and Treatment
monitor dietary and medication high in calcium and vid D
keep well hydrated
maintain physical activity
surgery
Thyroid
anterior to trachea
synthesizes, stores, and secretes thyroid hormone (T3, T4)
T4: inactive
T3: active
Goiter
Enlarged Thyroid gland
Hypothyroidism
High TSH, Low T3, T4 caused by hashimotos thyroiditis-autoimmune medications: lithium pregnancy Thyroidectomy
Sx: constipation, depression, fatigue, pale dry skin, sensitivity to cole, increased cholesterol, weight gain
Workup for hypothyroidism
Serum TSH, T4
Hyperthyroidism
Low TSH, High T3 and T4 Grave's Disease: autoimmune Toxic nodular or multinodular goiter thyroiditis pregnancy or first year after birth
signs and symptoms: fatigue, hand tremors, mood swings, nervousness, anxiety, rapid heart rate, skin dryness, trouble sleeping, weight loss, thinning of hair
Grave’s Disease
Hyperthyroidism
Exophthalmos
Workup for Hyperthyroidism
serum TSH, T4
Radio-iodine uptake study
Management and Treatment
Methimazole
Radio-iodine ablation
Thyroidectomy
Adrenal Insufficiency
Addisons Disease
-under production of cortisol
primary: infection, surgical removal
secondary: lack of ACTH
Primary Adrenal Insufficiency
70% are autoimmune
20% due to TB
due to chronic infections, surgical removal, cancer cell affecting adrenals
Secondary Adrenal Insufficiency
lack of ACTH
- sudden exogenous glucocorticoids like prednisone
- surgical removal of ACTH producing tumors
- pituitary gland: suddenly stopes producing ACTH
