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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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….

How well did you know this?
1
Not at all
2
3
4
5
Perfectly