Endocrine Complaints II Flashcards
what is the most common cause of hypothyroidism worldwide?
iodine deficiency
what is the most common cause of hypothyroidism in the US?
Hashimoto’s thyroiditis- an autoimmune-mediated process
what are some key symptoms of hypothyroidism?
fatigue, weakness, dry skin, feeling cold, hair loss, constipation, weight gain
what are some key signs of hypothyroidism?
puffy hands, edema, hyporeflexia
what should you do if the TSH levels are elevated?
you should measure T4 levels?
what do you have if there are elevated TSH levels and low T4 levels?
primary hypothyroidism
how can you differentiate between autoimmune and other hypothyroidisms?
by measuring thyroid peroxidase antibodies
what is the most common cause of hyperthyroidism in the US?
graves’ disease
what would you expect the thyroid to look like in a patient with Graves’ disease?
diffusely enlarged, firm, not nodular
what do you have if T4/ T3 levels are high and TSH levels are low?
primary hyperthyroidism
what do goiters lead to
increased TSH
what is the most common malignancy of the endocrine system?
thyroid cancer
what is the role of parathyroid hormone?
it helps maintain an appropriate balance of calcium in the bloodstream and in tissues that depend on calcium for proper functioning
what is the primary cause of primary hyperparathyroidism?
autonomously functioning adenomas
what is the classic presentation of primary hyperparathyroidism?
it is mostly asymptomatic; if it does present it presents as, renal stones, abnormal bones, abdominal moans, and psychic groans
what is the 2nd most common cause of hyperparathyroidism?
hypercalcemia of malignancy
how do you manage primary hyperparathyroidism?
remove the parathyroid gland(s) surgically
what is the most common cause of hypoparathyroidism?
it most commonly occurs after inadvertent damage or removal of parathyroid glands during neck surgery
what are the key symptoms of hypoparathyroidism?
uncontrollable painful spasms in face, pins and needles sensation in hands, feet, around mouth
what are the key signs of hypoparathyroidism?
Chvostek’s sign, Troussea sign
how do you manage hypoparathyroidism?
there are no PTH preparations approved to replace, so use medications and dietary modification to increase calcium
what is the role of mineralocorticoids?
they help regulate sodium and potassium handling in the kidney which affects BP and fluid volume
what is the role of glucocorticoids?
they are responsible for aiding in glucose metabolism, the inflammatory and immune response to illness or injury, and maintenance of BP and cardiac output
what is hormone excess of cortisol?
Cushing’s
what is the most common cause of primary hypoadrenalism?
addison’s disease (autoimmune destruction of the adrenal gland)
what is the most common cause of hypoadrenalism?
secondary- from suppression of the HPA axis from exogenous glucocorticoids
what are the key symptoms/signs of glucocorticoid deficiency?
fatigue, weight loss, hypoglycemia, low blood pressure, and postural hypotension
what are the key symptoms/signs of of mineralocorticoid deficiency?
salt craving, low blood pressure, hyponatremia, hyperkalemia, hyperpigmentation (primary adrenal insufficiency)
how do you manage primary adrenal insufficiency?
replace glucocorticoid and mineralocorticoid
how do you manage secondary adrenal insufficiency?
replace glucocorticoid
what is hypercortisolism known as?
cushing’s syndrome
what is cushing’s disease?
ACTH-dependent hypercortisolism; there is a pituitary adenoma which produces ACTH
what is the most common cause of hypercortisolism?
iatrogenic; the medical use of glucocorticoids for immunosuppression or treatment of inflammatory disorders
what are the key signs and symptoms of cushing’s syndrome?
weight gain around the abdomen, easy bruising, acne, hirsutism, weakness, abnormal menses, depression
what do you get when you have mineralocorticoid excess?
aldosteronism
what is the most common cause of primary aldosteronism?
adrenal adenomas aka CONN’S SYNDROME
what is the clinical hallmark of aldosteronism?
HTN with low potassium (sodium usually normal)
what is a pheochromocytoma?
a catecholamine-producing tumor derived from the sympathetic or parasympathetic nervous system
what are the classic signs of a pheochromocytoma?
palpitations, headache, profuse sweating; dominant sign= HTN (often episodic)
