Endocrine Flashcards
viral disease causing inflammation and swelling of parotid glands
mumps
cause: mumps
contact w/virus via respiratory droplets
what is the incubation period for mumps
14-21 days
how long is a pt with mumps contagious for
1-7 days
how is mumps diagnosed
- clinical picture
- history of exposure
- serum amylase elevated
- tenderness of testes
- PCR test
tx: mumps
acetaminophen, warm/cold compress, soft/liquid diet, scrotal support, isolation
list complications of mumps
- orchitis
- meningitis
- encephalitis
when should MMR vaccines be given
- 1st dose @ 12 months
- 2nd dose before going to school
acute tonsillitis is caused by many organisms but most with ___ is most common
group A betahemolytic streptococci
how is acute tonsillitis diagnosed
throat culture & elevated WBC count
tx: acute tonsillitis
liquid diet, penicillin, saline throat irrigations, tonsillectomy
hypersecretion of growth hormone before puberty
gigantism
cause of gigantism
anterior pituitary adenoma
list the hormones of the anterior pituitary gland
GH, TSH, ACTH, FSH, PRL (prolactin), LH
list the hormones of the posterior pituitary gland
oxytocin, ADH
how is gigantism diagnosed
clinical picture, elevated GH, pituitary MRI, CT, bone xrays
tx: gigantism
- surgery to remove pituitary adenoma
- meds/radiation to reduce pituitary size
hypersecretion of Growth hormone after puberty
acromegaly
cause of acromegaly
pituitary tumor of adenoma
how is acromegaly diagnosed
- clinical picture
- elevated GH and IGF-1
- glucose tolerance test
- MRI
- pituitary CT scan
tx: acromegaly
- surgery
- meds/radiation to reduce pituitary size
deficiency or absence of any anterior pituitary hormones
hypopituitarism
causes of hypopituitarism
pituitary tumor, hypothalamus tumor, damage to the pituitary, panhypopituitarism, unknown
tx: hypopituitarism
- removal of tumor
- hormone replacement therapy
how is hypopituitarism diagnosed
- clinical sx
- low plasma of all/some pituitary hormones
- xrays of skull
- cranial CT
- MRI
abnormal development of body in kids with max height of 4’10
dwarfism
cause of dwarfism
congenital, cranial tumor, hemorrhage, unknown
how is dwarfism diagnosed
physical exam, delayed secondary tooth eruption, fat deposits on trunk, persistently low serum GH, CT
tx: dwarfism
-somatotropin (hGH) until 5 ft
- replacement hormones
causes of diabetes inspidus
- reduced vasopressin
- heredity
- insult to hypothalamus or pituitary
- head trauma
- cerebral edema
- intracranial lesion
- renal tubular resistance to vasopressin
- unknown
how id diabetes insipidus diagnosed
almost colorless urine, low specific gravity, water restriction test
tx: diabetes insipidus
vasopressin injections, nasal sprays, oral desmopressin acetate, tx of underlying cause
any enlargement of thyroid gland
simple goiter
cause of simple goiter
deficiency of iodine
how is simple goiter diagnosed
- physical exam
- elevated thyrotropin
- reduced T3 and T4
- radioactive iodine uptake
- thyroid ultrasound
tx: simple goiter
- 1 drop per week of saturated solution of potassium iodine
- add iodine to diet
aka: simple goiter
nontoxic goiter; hyperplasia of thyroid gland
what is adequate intake of iodized salt in diet
150-300 micrograms
list examples of goitrogenic foods
broccoli, cauliflower, turnips, radishes, brussel sprouts, cabbages
immune attacks thyroid gland
hashimoto thyroiditis
demographics of hashimoto thyroiditis
- affects women 8 times more
- 45-65 yrs
what is the leading cause of goiter and hypothyroidism
hashimoto thyroiditis
cause of hashimoto thyroiditis
heredity
how is hashimoto thyroiditis diagnosed
- elevated serum TSH levels
- thyroid peroxidase antibodies in blood
- changes in thyroid gland
entire thyroid gland hypertrophies
graves disease
cause of graves disease
autoimmune and genetics
how is graves diseases diagnosed
- elevated serum T3 and T4
- low TSH
- increased uptake of radioiodine
- certain antithyroid IgG elevated
tx graves disease
- antithyroid drugs (propylthiouracil and methimazole)
- B blockers
- surgery
- radioactive iodine therapy
hypothyroidism is more common in
women
congenital hypothyroidism in infancy or early childhood
cretinism
cause of cretinism
- error in development
- maternal thyroid deficiency
- antithyroid drugs
- diet deficient in iodine
how is cretinism diagnosed
- absence or abnormally low T4
- thyroid scan
tx cretinism
thyroid hormone
hypothyroidism with lowmetabolic rate
myxedema
severe untreated hypothyroidism and acute event
myxedema coma
cause of myxedema
- impaired ability to synthesize T4
- reduced thyrotropin
- radiation destruction of thyroid
- surgical removal of gland/tumor
- failure
how is myxedema diagnosed
- clinical pictures
- abnormally low thyroid hormones
- significantly elevated TSH
tx myxedema
thyroid replacement therapy
tx myxedema coma
levothyroxine sodium
what are teh 4 main types of thyroid cancer
papillary, follicular, medullary, anaplastic
women are nearly ___ more likely to get thyroid cancer than men
three times
list risks for thyroid cancer
- head and neck radiation
- diet deficient in iodine
- genetics
how is thyroid cancer diagnosed
- physical exam
- fine needle aspiration
- histologic exam
tx thyroid cancer
- surgery
- total thyroidectomy & involved lymph nodes
- radioiodine
- T4 therapy
out of all the forms of thyroid cancer, which is the most aggressive
anaplastic tumor
overactivity of at least 1 parathyroid gland
hyperparathyroidism
cause of hyperparathyroidism
- excessive growth of one parathyroid gland
- idiopathic hyperplasia of gland
- renal disease
- other disorders
how is hyperparathyroidism diagnosed
elevated serum intact PTH, increased calcium, reduced phosphorus, increased alkaline phosphatase, high urine calcium low bone mineral denstiy, DEXA
tx hyperparathyroidism
- surgery
- meds that increase excretion of calcium
cause of hypoparathyroidism
surgical destruction of parathyroid glands, injury, ischemia, accidental radiation, neoplasia, disease, congenital, autoimmune
how is hypoparathyroidism diagnosed
neuromuscular hyperexcitability, clinical picture, history of possible insult, presence of trousseau phenomenon, reduced serum calcium levels, increased serum phosphate, increased QT and ST intervals, reduced PTH
tx hypoparathyroidism
calcium replacement therapy w/vitamin D
chronic hypersecretion of adrenal cortex w/excessive cortisol
cushing syndrome
cause of cushing syndrome
hyperplasia of adrenal gland, excessive secretion of ACTH, adrenal cortex tumor, corticotropin production in another organ, prolonged admin/large doses of glucocorticoids
how is cushing syndrome diagnosed
clinical picture, continuous elevation of serum cortisol levels, cortisol levels elevated in 24 hr urine collection, CT, MRI
tx cushing syndrome
- surgery
- radiation
- drug therapy
partial/complete failure of adrenocortical function
addison disease
cause of addison disease
autoimmune, TB, hemorrhage, fungal infection, neoplasms, surgical resection, familial, hypopituitarism
how is addison diseases diagnosed
low blood & urine cortisol levels, low serum sodium and fasting glucose, elevated serum potassium/blood urea nitrogen/lymphocyte/eosinophil/hematocrit, adrenal calcification on xrays
tx addison disease
- hormone replacement
- correct salt & potassium levels
life threatening emergency of sudden decreases in adrenocortical hormone levels
addisonian crisis
disorder of carbs, fat, and protein metabolism
diabetes mellitus
cause of diabetes mellitus
genetics
cause of type 1 diabetes mellitus
- infection trigger autoimmune
- genetics
cause of type 2 diabetes mellitus
- pancreatic tumor
- trauma to pituitary
- endocrine disorder
- drugs
- genetics
tx diabetes mellitus
diet, insulin, oral meds, exercise, blood & urine testing, hygienic measures
cause of insulin reaction
- excessive insulin
- excessive exercise
- meal delay
- insufficient food
tx insulin reaction
give sugar, glucagon, or dextrose
cause of diabetic coma
- undiagnosed diabetes
- skipped insulin
- excessive food
- infection
- stress
tx diabetic coma
insulin, fluids, salt, sodium bicarbonate
tx type 2 diabetes mellitus
sulfonylureas, metformin, acarbose, rosigilitazone, pramlintide, incretin hormone, bromocriptine, sodium glucose linked transporter 2, meglitinide drugs (glipizide, glyburide, repaglinide, nateglinide)
damaged ability to process carbs during pregnancy
gestational diabetes
cause of gestational diabetes
- placenta destroys insulin
- elevated estrogen and progesterone
list risk factors of gestational diabetes
- family history
- obesity
- maternal age > 25 yrs
how is gestational diabetes diagnosed
glucose in urine on routine prenatal urine glucose test, elevated fasting glucose, glucose tolerance test, 2 hour postprandial test, glycated hemoglobin test
tx gestational diabetes
diet, close monitoring, limit simple sugars, consistent moderate exercise, oral hypoglycemic agent, insulin
sx that can increases risk of type 2 diabetes and cardiovascular disease
metabolic syndrome
aka metabolic syndrome
syndrome X
list the 5 main components of metabolic syndrome
- central obestiy
- increased BP
- abnormally high triglyceride
- abnormally low HDL
- high fasting glucose
cause of hypoglycemia
insulin overdose, excessive exercise, alcoholic hypoglecemia, sulfonylureas, fasting, adenoma/carcinoma, GI disorder, heredity
how is hypoglycemia diagnosed
- blood glucose < 50
- glucose tolerance test
- clinical picture
tx hypoglycemia
- glucagon
- complex carb & protein snack
- diet
puberty before 9 yrs in boys
precocious puberty in boys
cause of preciocious puberty in boys
- genetic
- intracranial pituitary or hypothalamic neoplasia
- testicular tumor, endocrine disorder
- sex steroids
tx precocious puberty in boys
- none if idiopathy
- hormone therapy
- surgery
puberty before 8 yrs old in women
precocious puberty in girls
cause of precocious puberty in girls
idiopathy, incranial tumors, encephalopathy, meningitis, endocrine disorders, oral contraceptives ,drug homone secretly ovarian or adrenal neoplasm
cause of precocious puberty in girls
idiopathic, intracranial tumors, encephalopathy, meningitis, endocrine disorders, oral contraceptives, estrogen drugs, hormone secreting ovarian, or adrenal neoplasms
how is precocious puberty in girls diagnosed
- normal adult FSH, LH, and sex steroids
- elevated urinalysis hormones and excretion of 17-ketosteroids
- ultrasound
- MRI
tx precocious puberty in girls
- surgery
- radiation
- hormone therapy
- counseling
