endocrine conditions

Question 1

hyperthyroidism

Answer 1

• too much thyroid hormone produced=
• increased BMR (basal metabolic rate)
• increase SNS

signs and symptoms

• weight loss but increased appetite
• anxious
• irritable
• restless
• heat intolerance
• palpitations/ tachycardia
• warm, moist skin
• tremors, muscle weakness

most common causes

• grave diseases
• IgG antibodies mimic TSH

treatment

• anti-thyroid drugs
• radioactive iodine
• thyroidectomy

Question 2

hypothyroidism

Answer 2

• not enough thyroid hormone produced=
• decreased BMR

Signs and symptoms

• Increased weight gain
• Lethargic, mental slughishness
• Cold intolerance
• Bradycardia
• Cold, dry, brittle skin/ hair
• Decreased reflexes, muscle weakness

Causes

• Thyroiditis (hashimotos disease)
• Iodine deficiency
• Congenital
• Thyroid treatments

Treatments
- Synthetic thyroid hormone (T4)

Question 3

Cushings syndrome

Answer 3

• Increased cortisol=
• Increase in gluconeogenesis, protein and lipid breakdown
• Decreased immunity
• Affects on N.S functioning

Pathology

• Increased Breakdown of bone, muscle, skin which leads to
• Muscle wasting
• Thin extremities
• Increased risk of fractures, osteoporosis
• Thin skin, easily bruised- stretch marks
• Altered fat distribution- face, neck, back shoulders, abdomen
• Hyperflycemia- hyperinsulinaemia
• Hypertension via vasoconstriction
• Inhibits GnRH- affects gonadal function
• Immune suppression
• Decreased neuronal function

Causes

• Medications (steroids)- cortisol mimic
• Increase in ACTH (pituitary adenoma) - cushings disease
• Ectopic ACTH production
• Adrenal tumours

Treatment

• Gradual withdrawal of steroids
• Remove tumour
• Steroid inhibitors

Question 4

Addison’s disease

Answer 4

• Decreased aldosterone, decrease cortisol, decreased gonadocorticoids (adrogens)

Pathology:

• Fatigue
• Muscle weakness
• Weight loss, anorexia (decreased/ loss of appetite)
• Nausea, vomiting, diarrhea
• Decreased sodium levels, increased potassium levels
• Hypotension
• Hypoglycemia (decreased glycogenolysis, decreased gluconeogenesis)
• Hyperpigmentation- decreased cortisol- increased ACTH- stimulates melanocytes

Causes

• Autoimmune adrenalitis
• Infections (TB)
• Metastasis of cancer to adrenal gland
• Adrenal trauma and hemorrhage
• Adrenal hyperplasia

Treatment
- Glucorticoid and mineralcorticoid replacement

Addisons adrenal crisis:

• life threatening
• Hypovolemic shock and hypoglycemia
• Often precipitated by stress/ illness