Endocrine Complaints II

Question 1

what is the most common cause of hypothyroidism worldwide?

Answer 1

iodine deficiency

Question 2

what is the most common cause of hypothyroidism in the US?

Answer 2

Hashimoto’s thyroiditis- an autoimmune-mediated process

Question 3

what are some key symptoms of hypothyroidism?

Answer 3

fatigue, weakness, dry skin, feeling cold, hair loss, constipation, weight gain

Question 4

what are some key signs of hypothyroidism?

Answer 4

puffy hands, edema, hyporeflexia

Question 5

what should you do if the TSH levels are elevated?

Answer 5

you should measure T4 levels?

Question 6

what do you have if there are elevated TSH levels and low T4 levels?

Answer 6

primary hypothyroidism

Question 7

how can you differentiate between autoimmune and other hypothyroidisms?

Answer 7

by measuring thyroid peroxidase antibodies

Question 8

what is the most common cause of hyperthyroidism in the US?

Answer 8

graves’ disease

Question 9

what would you expect the thyroid to look like in a patient with Graves’ disease?

Answer 9

diffusely enlarged, firm, not nodular

Question 10

what do you have if T4/ T3 levels are high and TSH levels are low?

Answer 10

primary hyperthyroidism

Question 11

what do goiters lead to

Answer 11

increased TSH

Question 12

what is the most common malignancy of the endocrine system?

Answer 12

thyroid cancer

Question 13

what is the role of parathyroid hormone?

Answer 13

it helps maintain an appropriate balance of calcium in the bloodstream and in tissues that depend on calcium for proper functioning

Question 14

what is the primary cause of primary hyperparathyroidism?

Answer 14

autonomously functioning adenomas

Question 15

what is the classic presentation of primary hyperparathyroidism?

Answer 15

it is mostly asymptomatic; if it does present it presents as, renal stones, abnormal bones, abdominal moans, and psychic groans

Question 16

what is the 2nd most common cause of hyperparathyroidism?

Answer 16

hypercalcemia of malignancy

Question 17

how do you manage primary hyperparathyroidism?

Answer 17

remove the parathyroid gland(s) surgically

Question 18

what is the most common cause of hypoparathyroidism?

Answer 18

it most commonly occurs after inadvertent damage or removal of parathyroid glands during neck surgery

Question 19

what are the key symptoms of hypoparathyroidism?

Answer 19

uncontrollable painful spasms in face, pins and needles sensation in hands, feet, around mouth

Question 20

what are the key signs of hypoparathyroidism?

Answer 20

Chvostek’s sign, Troussea sign

Question 21

how do you manage hypoparathyroidism?

Answer 21

there are no PTH preparations approved to replace, so use medications and dietary modification to increase calcium

Question 22

what is the role of mineralocorticoids?

Answer 22

they help regulate sodium and potassium handling in the kidney which affects BP and fluid volume

Question 23

what is the role of glucocorticoids?

Answer 23

they are responsible for aiding in glucose metabolism, the inflammatory and immune response to illness or injury, and maintenance of BP and cardiac output

Question 24

what is hormone excess of cortisol?

Answer 24

Cushing’s

Question 25

what is the most common cause of primary hypoadrenalism?

Answer 25

addison’s disease (autoimmune destruction of the adrenal gland)

Question 26

what is the most common cause of hypoadrenalism?

Answer 26

secondary- from suppression of the HPA axis from exogenous glucocorticoids

Question 27

what are the key symptoms/signs of glucocorticoid deficiency?

Answer 27

fatigue, weight loss, hypoglycemia, low blood pressure, and postural hypotension

Question 28

what are the key symptoms/signs of of mineralocorticoid deficiency?

Answer 28

salt craving, low blood pressure, hyponatremia, hyperkalemia, hyperpigmentation (primary adrenal insufficiency)

Question 29

how do you manage primary adrenal insufficiency?

Answer 29

replace glucocorticoid and mineralocorticoid

Question 30

how do you manage secondary adrenal insufficiency?

Answer 30

replace glucocorticoid

Question 31

what is hypercortisolism known as?

Answer 31

cushing’s syndrome

Question 32

what is cushing’s disease?

Answer 32

ACTH-dependent hypercortisolism; there is a pituitary adenoma which produces ACTH

Question 33

what is the most common cause of hypercortisolism?

Answer 33

iatrogenic; the medical use of glucocorticoids for immunosuppression or treatment of inflammatory disorders

Question 34

what are the key signs and symptoms of cushing’s syndrome?

Answer 34

weight gain around the abdomen, easy bruising, acne, hirsutism, weakness, abnormal menses, depression

Question 35

what do you get when you have mineralocorticoid excess?

Answer 35

aldosteronism

Question 36

what is the most common cause of primary aldosteronism?

Answer 36

adrenal adenomas aka CONN’S SYNDROME

Question 37

what is the clinical hallmark of aldosteronism?

Answer 37

HTN with low potassium (sodium usually normal)

Question 38

what is a pheochromocytoma?

Answer 38

a catecholamine-producing tumor derived from the sympathetic or parasympathetic nervous system

Question 39

what are the classic signs of a pheochromocytoma?

Answer 39

palpitations, headache, profuse sweating; dominant sign= HTN (often episodic)