Endocrine Flashcards
Mechanism behind pretibial myxodema
Antibodies cause skin fibroblasts to produce excessive glycosaminoglycans which leads to deposition of hyaluronic acid in the skin
Other skin signs which may be present with pretibial myxoedema
Proptosis, exophthalmos, thyroid acropachy, onycholysis of 4th and 5th fingers
Workup for pretibial myxoedema
T3, t4 tsh, thyroid antibodies. Maybe useful to measure serum hyaluronidase, uss +/- digital thermal imaging
Tx of pretibial myxoedema
Potent Tcs with or without occlusion IL Cs Compression Pentixifylline Ivig
Ga investigations
Fasting glucose In disseminated and generalised: hiv, hep c. Consider lymphoma Consider thyroid disease
Work up for AN
Fasting glucose, insulin Fasting lipids Elfts TFTs Consider karyotype, prolactin, growth hormone, dexamethasone suppression test,acth(elevated in cushings, suppressed in adrenal tumours) Blood pressure
Hyperthyroidsm 12 skin signs
Soft, smooth, velvety
Increased skin temperature
Pruritus
Palmar erythema + Facial flushing
Hyperpigmentation
Vitiligo (AITD not HT per se)
Jellinek’s sign
Diamond’s triad
EMO syndrome
Cutaneous goitre signs: Pemberton sign; Maroni sign
Hyperthyroidism hair signs
Fine thin hair
Diffuse alopecia
Alopecia areata (AI dx not per se)
Hyperthyroidism nail signs
Fast nail growth
Soft nails, koilonychias
Plummer’s Nails = Koilonychia + distal onycholysis (typical onset 4th digit of hands)
Hypothyroidism skin signs
Purpura & Ecchymoses
Punctate telangiectasia
Palmoplantar Keratoderma
Delayed wound healing
Xerosis, asteatotic eczema, itch
Hyperthyroidism - hair signs
Coarse
Loss of pubic/axillary/facial
Hertog’s Sign = Madarosis (also refers to loss of eyelashes) = Loss of lateral eyebrow hair
Hypothyroidism
Brittle
Striated
Slow growth
