Endocrine

Question 1

what is the most common cause of hyperthyroidism

Answer 1

graves disease

Question 2

what causes graves disease

Answer 2

autoimmune disorder in which autoantibodies attach to thyroid stimulating hormone (TSH) receptors and stimulate thyroid hyperfunctioning

Question 3

who is graves common in

Answer 3

women 20-40 years old

Question 4

what other autoimmune disorders is graves associated with?

Answer 4

pernicious anemia, cardiomyopathy, myasthenia gravis, DM

Question 5

what is a person with graves at risk of

Answer 5

Addisons, alopecia, celiac, cardiomyopathy, hypokalemic periodic paralysis

Question 6

what are symptoms of thyrotoxicosis

Answer 6

heat intolerance, sweating, weight loss, increased appetite, nervousness, loose stools, frequent urination, muscle cramps, irritability, fatigue, weakness, dyspnea on exertion and menstrual irregularities
Patients could have tachycardia, or A fib or other cardiac arrhythmias

Question 7

hyperthyroidism with graves disease

Answer 7

patient have a goiter with a bruit
20-40% of patients will have mild opthalmopathy (chemosis, conjunctivitis or proptosis
Pretibial myxedema

Question 8

what are complications of thyrotoxicosis

Answer 8

A fib, hypercalcemia, osteoporosis, impotence, nephrocalcinosis, decreased libido, gynecomastia, decreased sperm count

Question 9

what can chronic thyrotoxicosis cause

Answer 9

osteoporosis, clubbing and finger swelling

Question 10

what is thyroid storm

Answer 10

follows stressful illness, thyroid surgery, or radioactive iodine administration

Question 11

how does thyroid storm present

Answer 11

high fever, tachycardia, vomiting, diarrhea, dehydration, marked weakness, and muscle wasting, extreme restlessness, confusion, delirium

Question 12

what laboratory studies are noticed in primary hyperthyroidism

Answer 12

TSH is low
serum T4, T3 Free T4, free T4 index and thyroid resin uptake usually will be elevated
ESR may be elevated

Question 13

what antibodies are found in thyrotoxicosis

Answer 13

TSH receptor antibody and antithyroglobulin or antithyroperoxidase are usually high graves disease

Question 14

what do thyroid radioactive iodine uptake scan reveal in graves

Answer 14

high iodine uptake and toxic multinodular goiter

Question 15

what is the treatment for graves disease

Answer 15

B-blocker (propranolol)
Thiourea drugs (methimazole or propythiouracil)
they are taken for 12-24mths
useful in preparing patient for surgery or radioactive iodine Tx

Question 16

which thiourea drugs is used in a pregnant patient or breast feeding with thyrotoxicosis.

Answer 16

Propythiouracil

Question 17

what is the benefit of thiourea drugs

Answer 17

lower risk of post treatment hypothyroidism

Question 18

what is the preferred treatment for permanent control of thyrotoxicosis

Answer 18

radioactive iodine ablation especially in the elderly

its CI in pregnancy patients with large goiters and when malignancy is likely

Question 19

how do you treat ophthalmopathy in thyrotoxicosis

Answer 19

responds best to IV methylprednisolone

Question 20

hypothyroidism general characteristics

Answer 20

almost always results from autoimmune thyroiditis, previous thyroid surgery or radiation therapy

Question 21

what are the clinical features of hashimotos thyroiditis

Answer 21

fatigue, lethargy, anorexia, constipation, depression and menstrual abnormalities, muscle stiffness, memory impairment, cold intolerance and dry skin
peripheral edema, weight gain, thinning hair, weakness, hypotension, bradycardia, hyporeflexia, dementia and psychosis

Question 22

what will laboratory studies look like in primary disease

Answer 22

TSH will be elevated in primary disease

Low T4 and Free T4 and T3 may be normal

Question 23

general characteristics of hashimotos

Answer 23

most common thyroid disorder in the US and maybe associated with other autoimmune or polyglandular
its more common in women and patients with hep C
increased frequency is increased with excess dietary iodine supplementation and exposure to head and neck radiation during childhood

Question 24

what drugs can cause thyroiditis

Answer 24

amiodarone, interleukins, and interferon

Question 25

what are clinical features of hypoparathyroidism

Answer 25

tetany, carpopedal spams, cramping, convulsions, cirucumoral and distal extremity tingling and irritability
postive chvostek’s sign

Question 26

how is hypoparathyroidism diagnosed

Answer 26

corrected serum calcium, urinary calcium and PTH are low

Serum phosphate will be high

Question 27

what is the treatment for hypoparathyroidism

Answer 27

IV calcium gluconate in severe cases or

just oral calcium gluconate and vitamin D

Question 28

What are clinical features of hyperparathyroidism

Answer 28

stone bone abdominal groans and psychiatric overtones

Renal stones, bone pain and arthralgias, increase in fractures, depression, increased need for sleep, muscle weakness

Question 29

what causes secondary hyperparathyroidism

Answer 29

malignant tumors of the breast, lung , pancreas, uterus

Question 30

how is hyperparathyroidism diagnosed

Answer 30

Hypercalcemia
low serum phosphate
elevated PTH

Question 31

what is the treatment for hyperparathyroidism

Answer 31

surgical

Question 32

what is addisons disease

Answer 32

autoimmune destruction of the cortex of the adrenal gland

Question 33

clinical features of addisons

Answer 33

fatigue, weakness, weightloss, salt craving, delayed deep tendon reflexes, hyper pigmentation

Question 34

lab finding with addison’s disease

Answer 34

Hyperkalemia, hyponatermia, hypoglycemia, hypercalcemia