endocrine Flashcards
why are appetite and weight changes important in endocrine hx?
increased appetite and wt loss: thyrotoxicosis or uncontrolled DM
increased appetite and wt gain: cushings
loss appetite and wt loss: adrenal insufficiency, GI disease
wt gain: hypothyroidism
why are changes in bowel habits important in endocrine hx?
diarrhoea=hyperthyroididm
constipation=hypothyroididm and constipation
what can cause amenorrhoea?
primary: gonadal dysgenesis, anatomical abnormalities, testicular ferminisation
secondary: excessive exercise or wt loss, medications, thyroid dysfunction, pituitary tumours, ovarian failure, PCOS, pregnancy
what can cause impotence?
neuropathies, htn, vascular disease, alcohol, recreastional drugs,
SE anti-hypertensives, anti-depressants, steroids
what can cause increased sweating?
hyperthyroidism, phaeochromocytoma, hypoglycaemia, acromegaly
what skin changes may occur in endocrine conditions?
hypothyroidism: coarse, pale, dry
acanthosis nigricans=acromegaly, diabetes, cushings, PCOS
excess glucocorticoids: atrophy of skin, easy bruising, striae
primary hypoadrenalism: pigmentation in palmar creases, elbows, gums and buccal mucosa
Cushings: increased pigmentation
what can cause polyuria?
DM, diabetes insipidus, hypercalcaemia
how do pituitary adenomas cause a bitemporal hemianopia?
compress optic chiasm
what psychological disturbances are seen in endocrine conditions?
depression: cushings, hypothyroidism, DM, adrenocortical insufficiency
delirium: thyrotoxicosis, hypothyroidism, hypoparathyroididm, phaechromocytoma, hypoglaycaemia
dementia: hypothyroidism
anxiety and panic disorder: hyperthyroidism, phaechromocytoma, hypoparathyroidism
why is medication important in endocrine hx?
excess steroids=cushings
abrupt cessation high dose corticosteroid therapy=acute adrenocortical insufficiency
lithium and amiodarone=hypothyroidism
amiodarone=thyrotoxicosis
give some sx of acromegaly.
arthralgia/arthritis, increased bp, carpal tunnel syndrome, diabetes, enlarged organs, field defects
give some symptoms of siadh.
spasms, no pitting oedema, anorexia, disorientation, hyponatraemia
what causes siadh?
surgery, intracranial (infection, head injury), alveolar (Ca, pus), drugs (opiates, antiepileptics, cytotoxics), hormonal (hypothyroid, low corticosteroid)
how is a goitre sized according to WHO criteria?
0=no visible or palpable goitre 1a=detectable on palpation 1b=palpable and visible when neck extended 2=visible with neck in normal position 3=visible from a distance
why is the consitency on palpation important?
soft=normal
firm=simple goitre
hard=rubbery in hashimotos thyroiditis, stony hard in carcinoma/cyst/fibrosis
when will bruits be heard in a goitre?
graves disease
what is necrobiosis lipoidica diabeticorum?
yellow/brown discolouration of shins, due to DM
what indicates hyperthyroidism
decrease wt despite increased appetite (although 10% will gain weight) increased appetite Increased frequency of defaecation or diarrhoea energy can increase or decrease, muscle weaness Anxious, irritable, emotionally labile decreased concentration refers a cool environment, wears fewer clothes Increased sweating. Fine hair and hair loss Clubbing (thyroid acropachy) Onycholysis (separation of the nail from the nailbed) Tachycardia, palpitations, atrial fibrillation Infrequent menses. Fertility problems.
what indicates hypothyroidism?
increased wt, decreased appetite hoarse voice constipation decrease energy Somnolent Slower movements and muscle weakness ethargy, depression decreased cocentration Prefers a warm environment, wears extra clothes Dry flaky skin Coarse thinning hair Brittle nails Bradycardia Heavy, prolonged or irregular menses. Fertility problems and increased risk of miscarriage
what drug hx is important in thyroid problems?
Specifically enquire about use of thyroxine, lithium, amiodarone and glucocorticoids
what social hx is important in thyroid problems?
Smoking, alcohol, diet (sufficient iodine?) and effect on activities of daily living
