Endocrine Flashcards
What is Hashimoto Disease?
Hashimoto’s disease is anautoimmune disorderthat can causehypothyroidism, or underactive thyroid –sometimes resulting in a goiter
What are the symptoms of Hashimoto Disease?
Fatigue, sluggish
puffy face
pale dry skin
constipation
How do you diagnose Hashimoto disease?
Lab value TPO
what are the causes of Hyperthyroidism?
- Graves Disease
- Thyroid Nodule
- Thyroiditis
What is the treatment for Hyperthyroidism?
- Methimazole/Propylthiouracil
- Beta Blockers
- Radioactive Iodine
- Surgery
What is Graves Disease?
Graves’ disease is an autoimmune complication that causes the thyroid gland to produce way too much thyroid hormone causing near fatal consequences if not treatedGraves’ disease is often the underlying cause of hyperthyroidism.
In what condition do you see puffy eyes, exopthalmos?
Graves Disease, an autoimmune condition that stimulates the thyroid gland to produce too much thyroid hormone
What are the risk factors for diabetes (american)
family with diabetes
45 or older
ethnicity
stress
Sleeping too little/too much
smoking
What are the american values for diagnosing diabetes?
- A1c
- Fasting plasma Glucose
- Oral Glucose Tolerance test
- 6.5%
- greater than 126 (fasting plasma glucose)
- Oral glucose test greater than 200
When would you consider starting insulin in patients who have type 2 diabetes?
Start when the A1C is 9% or in the double digits
What is metabolic syndrome, and what criteria must be met
you need three of the following:
- Large waist circumference
- Low HLD
- HTN
4, Elevated fasting blood sugar
What are the three problems caused by pituitary tumors?
- Hypersecretion of a hormone
- Hyposecretion of a hormone
- Tumor mass effects: as a pituitary tumor grows and presses against the pituitary gland it can cause headaches, vision changes, or other health effects
What are three examples of pituitary tumors that result in hormonal over production?
- Acromegaly (excess growth hormone)
- Cushing Disease (excess adrenocorticotropic hormone)
- Galactorrhea (excess prolactin)
What are the symptoms of Growth Hormone Deficiency?
Children:Growth delay
Adults: Decreased muscle mass, increased body fat, elevated cholesterol, low bone density (osteoporosis), impaired psychological well-being
Treatment Human Growth Hormone
What are the symptoms of LH/FSH deficiency
Decreased libido, erectile dysfunction, irregular or absent menses, decreased body hair, decreased muscle strength, hot flashes, mood changes
Treatment: testosterone for men, estrogen/progesterone women
What are the symptom of adrenocorticotropic hormone deficiency
low appetite
nausea
weakness
low blood sugar
low blood pressure
dizziness
bodyaches
treated with hydrocortisone or prednisone
What does the adrenocorticotropic hormone do?
It regulates cortisol
Cortisol is released by the adrenal gland and it regulates:
blood pressure
blood sugar, the immune system, and the response to stress.
What are the symptoms of Prolactin deficiency?
inability to lactate, no treatment
What are the symptoms of anti-diuretic-hormone deficiency?
Increased thirst and frequent urination
What is Addison’s disease?
Addison’s disease, also called adrenal insufficiency, is an uncommon disorder that occurs
when your body doesn’t produce enough of the cortisol hormone
What are the symptoms of Addisons disease?
Muscle weakness
Abdominal pain
Salt cravings
Loss of appetite
Weight loss
Fatigue
Hyperpigmentation/bronzed skin
What are the names for these conditions?
- Thyroid Diseases (hyper.hypo)
- Adrenocorticotropic (hyper/hypo)
Thyroid conditions:
Graves Disease (too much thyroid hormone) vs. Hashimoto (hypo)
Cushing Disease (Hyper cortisol) vs. Addison’s Disease (Hypo)
What are the 4 causes of Addisons disease?
Abrupt stop of steroid usage
Autoimmune
Infection (HIV/TB/Fungi)
Congenital
Pituitary Dysfunction
how do you diagnose Addison disease?
- ACTN stimulation test
- Early morning serum cortisol
Low serum sodium; elevated potassium
What is Cushings Syndrome?
Cushing’s syndrome is a disorder that occurs when your body makes too much of the hormone cortisol over a long period of time.
What are the symptoms of Cushings Syndrome?
- Moon face (round rosy)
- Weight gain, in upper body
- Buffalo hump, in upper back of base of neck
- Acne
- Fatigue
- Hypernatremia (fluid retention), low potassium
What is the most common cause of Cushing syndrome?
Taking too much steroids
How do you diagnose cushings syndrome?
- 24 hr urinary free cortisol test
- Late night salivary cortisol test
- Dexamethasone supression test
- Dexamethasone CRH test
What is the treatment of Cushing?
- Remove adrenal glands
- Remove pituitary tumor
What are some of the symptoms of lupus?
- Oral ulcers
- Discoid Rash/Butterfly Rash
- Photosensitivity
- Renal Disease
- Neuro/psych symptoms
^. Serositis - Hematological disorders
What are some of the complications of lupus?
Bone tissue death
pregnancy complications
infection
What symptoms can you see in bulimia nervosa
Parotid gland enlargement
hand abrasions
Hypokalemia
metabolic alkalosis
dehydration
What are the risk factors for thyroid cancer?
single painless nodule greater than 2.5cm
Hx of childhood neck irradiation
If you do a thyroid scan and it shows a cold spot vs warm spot what are you worried for?
Cold spot is not metabolically active and more concerning for thyroid cancer
what is the preferred medication of treatment for a pregnant women with hyperthyroidism?
PTU
What considerations do you need to make if your patient with hyperthyroidism is treated with radioactive iodine?
this treatment permanently destroys the thyroid, so they will need synthroid for life
What is the range for prediabetic patients?
fasting blood glucose of 110-125 mg/Dl
What diabetic medication is contraindicated in moderate to severe CHF because it can retain water in the body?
Thiazolindiones
what is the Dawn Phenomenon ?
It is a normal physiologic event for the plasma glucose to rise in the early morning
because of the reduction of tissue sensitivity to insulin between 5 a.m and 8 a.m.
(from physiologic spike of growth hormone).
What is the Somogyi Effect ?
Rebound hyperglycemia, it occurs when you overtreat diabetic patients with insulin in the evening/bedtime, causing severe nocturnal hypoglycemia
This hypoglycemia causes the liver to release more sugar, leading to a spike in 7am blood sugar
have a snack before bed
What are the 5 symptoms of pheochromocytoma?
5 H’s
Hypertension
hypermetabolism
Hyperglycemia
Headache
Hyperhidrosis
