endocrine conditions Flashcards
hypothyroid disease
=a condition in which the thyroid gland does not produce enough hormones, leading to an imbalance in the body’s metabolism
caused by: Autoimmune disease (Hashimoto’s thyroiditis), Surgery to remove the thyroid gland, Radiation treatment for neck or upper chest cancers, Congenital hypothyroidism, Certain medications, Pituitary gland disorders
patho: In hypothyroidism, the thyroid gland does not produce enough hormones, leading to a decrease in metabolism.
This leads to an accumulation of metabolic waste products in the body and a reduction in the production of energy
pop: 5% of general pop
risk factors: Are a woman, Have a family history of thyroid disease, Have an autoimmune disease, such as type 1 diabetes or celiac disease, Have received treatment for hyperthyroidism, Received radiation to your neck or upper chest, Have had thyroid surgery.
s&s: Fatigue, Weight gain, Cold intolerance, Constipation, Dry skin, Joint pain, Depression, poor memory, Heavy or irregular menstrual periods
management: Hormone replacement therapy with levothyroxine, a synthetic form of the thyroid hormone thyroxine, to restore normal hormone levels, Regular monitoring of hormone levels through blood tests, Adjustment of hormone dosage based on results of blood tests, Healthy lifestyle, including a balanced diet and regular exercise, Avoidance of certain medications that can interfere with hormone replacement therapy
hyperthyroid disease
=a condition in which the thyroid gland produces an excessive amount of hormones, leading to an overactive metabolism
caused by: Graves’ disease (most common cause), Tumors of the thyroid gland, Excessive intake of iodine, Taking too much thyroid hormone medication
patho: The overproduction of thyroid hormones causes an increase in the metabolism of cells in the body, leading to a wide range of symptoms.
Graves’ disease is an autoimmune disorder that causes the production of antibodies that stimulate the thyroid gland, leading to hyperthyroidism.
pop: Common in women in 20’s and 30’s
risk factors: A family history of thyroid disease, particularly Graves’ disease, A personal history of certain chronic illnesses, including pernicious anemia and primary adrenal insufficiency, A recent pregnancy, which raises the risk of developing thyroiditis. This can lead to hyperthyroidism
s&s: Increased appetite
-Weight loss, Rapid or irregular heartbeat, Sweating, Nervousness and irritability, Heat intolerance,Tremors, Fatigue
management: Antithyroid medications to slow down the production of thyroid hormones, Radioactive iodine to shrink the gland and reduce hormone production, Surgery to remove part or all of the gland, Beta-blockers to control symptoms such as rapid heartbeat and tremors, Hormonal replacement therapy with levothyroxine to replace the thyroid hormones after treatment
cushing’s disease
=a syndrome that is caused by having an excess of cortisol hormone in your body. Cortisol helps the body respond to stress, regulate blood glucose and reduce inflammation
caused by: spontaneous Cushing’s- small benign tumour on pituitary gland, or on the adrenal gland
taking oral corticosteroid medication (could be injection too)
patho: caused by adrenal glands excrete too much cortisol.
the pituitary gland produces ACTH which travels to the adrenal glands causing them to produce too much cortisol
exogenous Cushing’s= high doses over time of corticosteroid medications (e.g. prednisone)
may be necessary to treat inflammatory diseases e.g. RA, lupus or asthma
pop: far more women than men
ages 30-40
risk factors: people who are overweight, people with uncontrolled type 2 diabetes, people with high blood pressure
s&s: excessive and sudden onset of weight around trunk with arms and legs unchanged and thin, weak muscles (especially legs), moon face (appears redder and rounder), weaker bones due to steroid induced osteoporosis, higher blood pressure, easier to bruise, Red/ purple stretch marks, Irregular periods, Excessive hair growth, Reduced libido, General feeling of unwell, Mood swings
management: reduce corticosteroid use.
If it’s due to a tumour then must remove the tumour or the affected gland itself with surgery
radiation therapy to fully remove tumour
Medications: to control excessive production of cortisol such a ketoconazole, mitotane and metyrapone
addisons disease
=Uncommon illness, where the adrenal glands don’t make enough cortisol, or aldosterone
caused by: TB is the most common cause of Addison’s disease worldwide, but its rare in the UK.
In Addison’s disease, reduced cortisol levels lead, through feed-back, to increased CRH and ACTH production, the latter being directly responsible for the hyperpigmentation.
When 90% of the adrenal cortex is destroyed, your adrenal glands will not be able to produce enough of cortisol and aldosterone.
Once the levels of these start decreasing, you’ll experience symptoms of Addison’s disease.
Other possible causes of Addison’s disease: Infections, A haemorrhage, Cancer, Amyloidosis, Surgical removal of both glands, Adrenoleukodystrophy, Certain treatments needed for cushings syndrome
patho: There is a destruction of the entire adrenal cortex. So glucocorticoid, mineralocorticoid and sex steroid production are all reduced.
If there is a problem with the immune system, it can start to attack your own healthy tissues. So Addison’s disease can develop if your immune system starts attacking the adrenal cortex.
pop: Can affect anyone and can be life threatening
risk factors: Cancer, Taking anticoagulants (blood thinners), Have chronic infections like TB, Had surgery to remove any part of your adrenal gland, Autoimmune disease like type 1 diabetes or Graves’ disease
s&s: Symptoms usually happen slowly, often over months, Extreme fatigue, Weight loss and loss of appetite, Areas of darkened skin, Weakness, Fever, Anorexia, Nausea/vomiting, Diarrhoea, Abdominal pain, Constipation, Depression, Confusion, Myalgia, Joint or back pain, Loss of weight, General wasting, Pigmentation, especially new scars and palmar creases
management: Acute hypoadrenalism needs urgent treatment.
Long term treatment is with replacement glucocorticoid and mineralocorticoid; tuberculosis must be treated if present or suspected.
