endocrine Flashcards
1
Q
parathyroid adenoma (ie primary hyperparathyroidism):
- risk factors? 4
- what electrolyte abnormality occurs
- four groups of symptoms?
A
- elderly
- female (post-menopausal)
- radiation to neck
- MEN syndromes
- hypercalcaemia
Bones:
- aches/pains in large joints/bones
- osteoporosis/fractures
Stones:
- kidney stones
Moans:
- lethargy/fatigue
- depression
Groans:
- non-specific abdo pain
- constipation
- ‘groan’ about going to the toilet at night (nocturia) - also polydipsia and polyuria
2
Q
parathyroid adenoma (ie primary hyperparathyroidism):
- blood tests? 2 (+ results)
- other investigation?
- treatment?
A
- U+E (high Ca)
- serum PTH (low PTH)
nb this is if primary hyperparathyroidism - radioisotope scanning (+/- USS) to localise adenoma
- surgical parathyroidectomy
nb can use drugs if surgery contraindicated but not as good/curative
3
Q
Addison’s disease
- commonest cause?
- other causes? 4
- risk factor?
- commonest cause of secondary adrenal insufficiency?
A
- autoimmune destruction of adrenal cortex (80%)
- TB (commonest cause worldwide)
- adrenal mets from elsewhere
- lymphoma
- adrenal haemorrhage
- other autoimmune conditions
- sudden withdrawal of long term steroid use (much more common that primary Addison’s disease)
4
Q
Addison’s disease signs + symptoms:
- systemic? 6
- GI? 4
- psychiatric? 3
- symptoms of addisonian crisis? 5
- commonest causes of addisonian crisis? 2
- treatment?
A
- anorexia
- weight loss
- hyperpigmentation (buccal mucosa, pressure points, skin creases, recent scars)
(- vitiligo + hair loss) - postural hypotension
- fatigue
- myalgia
- nausea
- vomiting
- abdo pain
- diarrhoea/vomiting
(think Addison’s in any unexplained abdominal pain or vomiting) - depression
- psychosis
- low self-esteem
- vomiting
- abdo pain
- profound weakness
- hypoglycaemia
- hypovolemic shock
nb if caused by withdrawal of exogenous steroids then won’t cause hyper pigmentation (as this is caused by raised ACTH reacting w melanocytes)
- someone forgetting to take steroids (on long course)
- someone with known Addison’s getting ill with other infection and their steroids not being increased
- lifelong steroid therapy (try to mimic natural cortisol cycle)
5
Q
dd for Addison’s disease?
A
- anorexia nervosa
nb in anorexia: K is low, K is high in Addison’s
- any malignancy
many other things as well….