endocrine disorders Flashcards
Addison’s disease electrolytes
hyperkalaemia, hyponatraemia, hypoglycaemia
hypotension, hyperpigmentation, lethargy
Conn’s syndrome electrolytes
hypokalaemia, hypertension, alkalosis, no similar family history, raised aldosterone
biochem presentation of vitamin b12 deficiency
low Hb, high MCV, normal platelets
what is SIADH
large amounts of ADH
> the water dilutes the sodium in the blood > hyponatraemia
> euvolaemic hyponatramia
what does ADH do
stimulates water reabsorption from collecting ducts
impact of SIADH on kidneys
high urine osmolality
high urine sodium
presentation of SIADH
headache fatigue muscle aches and cramps confusion sever hyponatraemia> seizures
causes of SIADH
infection (atypical pneumonia)
head injury > subarachnoid haemorrhage
medications (thiazide diuretics, carbamazepine)
small cell lung cancer
management of SIADH
treat the cause
correct sodium slowly
fluid resus
tolvaptan (ADH receptor blockers)
presentation of hashimotos thyroidits
goitre
TSH high
T3, T4 low
presentation of a thyroid storm
rare
severe presentation of hyperthyroidism- pyrexia, tachycardia, delirium
de quervain’s thyroiditis
presentatioin of a viral infection with fever, neck pain and tenderness, dyshpagia and features of hyperthyroidis,
treatment of de quervain’s thyroiditis
NSAIDs for pain and inflammation
BB for symptom relief
most common cause of acromegaly
pituitary adenoma
bitemporal hemianopia
loss of vision on the outer half of both eyes due to pituitary tumour compressing on optic chasm
presentation of acromegaly
headaches, visual field defects overgrowth of tissues: promients facial features, nose, tongue, jaw large hands and feet arthritis hypertrophic heart hypertension diabetes
presentation of big non functioning pituitary adenoma
compression on optic chiasm
compression on other structures (cranial nerves 3,4,6)
drugs causing increased prolactin
dopamine antagonists (metoclopramide) antipsychotics antidepressants osestrogen cocain
female presentation of raised prolactin
early galactorrhoea menstrual irregularity infertility amenorrhoea
male presentation of raised prolactin
late presentation galactorrhoea menstrual irregularity visual field abnormality anterior pituitary malfunction
prolactin investigations
serum prolactin concentration MRI pituitary visual field PFT TFT
prolactinoma treatment
dopamine agonists: cabergoline, bromocriptine, quinagolide
treatment of acromegaly
surgery
radiotherapy
medical: somatostatin analogues: sandostatin
dopamine agonists
management of a thyroid storm
supportive care anti-arrhythmic medication betablockers propylthiouracil radio-iodine
pathophysiology of pheochromocytoma
tumour of the chromaffin cells that secretes unregulated amounts of adrenaline
type of hormone is adrenaline
catecholamine
associated condition with pheochromocytoma
MEN2
diagnosis of pheochromocytoma
24 hour urine catecholamines
plasma free metanephrines
presentation of pheochromocytoma
symptoms fluctuate throughout the day anxiety headaches sweating hypertension palpitations, tachycardia, afib
management of pheochromocytoma
alpha blockers- phenoxybenzamine
bb
adrenalectomy
