ENDOCRINE

Question 1

what is hypothyroidism? signs and symptoms?

Answer 1

a condition in which the thyroid produces too little thyroid hormone, low BMR, affects all body systems/ cells

S+S= lethargy, intolerance to cold, anorexia, constipation, dry skin, brittle nails and hair, muscle weakness, extreme fatigue

Question 2

what is hyperthyroidism? S+S?

Answer 2

when your thyroid produces too much thyroxine, accelerates BMR,

S+S= heat intolerance, diarrhoea, weight loss, increase HR, increased systolic BP, facial flushing, enlarged thyroid, sweating, nervousness, insomnia.

Question 3

what are some causes of hypothyroidism? hyperthyroidism?

Answer 3

hypo= hashimotos thyroiditis, previous tx for hyper (surgery), iodine deficiency, meds- lithium.

hyper= graves disease, excessive iodine intake, subacute thyroiditis

Question 4

what is the treatment for hypothyroidism?

Answer 4

LEVOTHYROXINE (synthetic form of thyroxine-T4)

Question 5

what is the treatment for hyperthyroidism?

Answer 5

• radioactive iodine (destroys thyroid cells over time)
• surgery - full or partial removal oh thyroid
• beta blockers - for syx
• thionamides - interferes w/ synthesis of thyroid hormones

Question 6

what is a thyroid crisis/ storm?

Answer 6

exaggerated hyperthyroidism, life threatening, caused by untreated/ undertreated hyperthyroidism.
SYX: increased hr, T= 38.5+, SOB, confusion

Question 7

myxoedema/ myxoedema coma

Answer 7

myxoedema= extreme syx of hypothyroidism

myxoedema coma= life-threatening, pt is hypothermic and unconscious

Question 8

name the 2 hormones that the thyroid produces.

Answer 8

• thyroxine (t4)

- triiodothyronine (t3)

Question 9

what is the most sensitive test available to test thyroid function?

Answer 9

serum thyroid stimulating hormone (TSH)

low levels indicate hyperthyroidism
high levels indicate hypothyroidism

Question 10

what is the function of the thyroid hormones?

Answer 10

act to increase BMR
affect protein synthesis
help regulate long bone growth

Question 11

explain the hypothalamic, pituitary, thyroid axis in the negative feedback process

Answer 11

the HYPOTHALAMUS produces and secretes THYROTROPIN RELEASING HORMONE (TRH), this stimulates the ANTERIOR PITUITARY to secrete THYROID STIMULATING HORMONE (TSH), this increases the production of t3 and t4.

if thyroid hormones levels are high, TRH secretion from hypothalamus and TSH from pituitary slows down to maintain homeostasis. AND VICE VERSA.

Question 12

what is cushings syndrome/ disease? Symptoms?

Answer 12

disorder caused by exposure to excess levels of cortisol in the blood.
CAUSES: excessive levels of cortisol in the blood, tumors of the adrenal/ pituitary gland, taking medications that have cortisol- long term glucocorticosteroids.

SYMPTOMS: weight gain, acne, poor wound healing, thin skin & bruising, stretch marks, fatigue, sleep disorders

Question 13

what is the treatment for cushings syndrome/ disease?

Answer 13

depends on underlying cause.

• tumor removal/ radiation
• discontinue/ alter glucocorticosteroid dose

Question 14

what is adrenal insufficiency/ addinsons disease? Symptoms?

Answer 14

causes:
PRIMARY: impairment of adrenal glands (addinsons) -cortisol + aldosterone
SECONDARY: problem w/ pituitary or hypothalamus -CRH or ACTH

SYMPTOMS: weight loss, fatigue, GI upset, low BP, skin hyperpigmentation, hypoglycaemia

Question 15

what is the treatment for adrenal insufficiency?

Answer 15

medications- hormone replacement therapy

eg. oral corticosteroids.

Question 16

what is an adrenal crisis?

Answer 16

medical emergency, syx of severe adrenal insufficiency-insufficient levels of cortisol.
SYX: confusion, fatigue ++, increased HR, decreased BP,
TREATMENT: injection of hydrocortisone