Endocrine Disorders Flashcards
What can we do to investigate endocrine disorders?
Measure hormone levels
Is endocrine tissue functional- dynamic tests of endocrine function
What are the levels of thyroid hormone in primary hypothyroidism?
Low
What are the levels of thyroid hormone in secondary hypothyroidism?
Low
What are the levels of thyroid hormone in primary hyperthyroidism?
High
What are the levels of thyroid hormone in secondary hyperthyroidism?
High
What are the levels of TSH in primary hypothyroidism?
High
What are the levels of TSH in secondary hypothyroidism?
Low
What are the levels of TSH in primary hyperthyroidism?
Low
What are the levels of TSH in secondary hypothyroidism?
Low
What are the levels of TSH in secondary hyperthyroidism?
High
What are the types of disorders of adrenocortical function?
Adrenal steroids
Adrenal hyperfunction
Adrenal insufficiency
What are the adrenal hyperfunction diseases?
Excess cortisol (cushings) and aldosterone (conn’s)
What are the adrenal insufficiency diseases?
Hypocortisolism
Lack of aldosterone and cortisol (Addisons)
What is aldosterone secretion activated by?
RAAS
What is useful in the diagnosis of primary hyperaldosteronism?
Plasma aldosterone : renin ratio
What are the functions of cortisol?
Immunosuppressant
Blood pressure
Preserve plasma glucose
Promotes lipolysis and gluconeogenesis
What is the most common cause of cushings?
Iatrogenic
What do exogenous glucocorticoids activate?
Cortisol receptor
What will glucocorticoids do at high doses?
Shut down HPA
What happens to the adrenal cortex with lack of ACTH stimulation?
Atrophies
What is an adenoma?
ACTH secreting pituitary tumour or ectopic ACTH source
What is the name of primary adrenal insufficiency?
Addisons
What does primary adrenal insufficiency cause?
Insufficient cortisol and aldosterone
What are secondary adrenal insufficiencies called?
Pituitary or hypothalamic disease
What does secondary adrenal insufficiency cause?
Insufficient cortisol
What are the lab features of addisons?
Hypotension
Normal/low Plasma sodium conc
Normal/high plasma potassium conc
High ACTH
What may addisons be unmasked by?
Significant stress or illness
What are the symptoms of addisons?
Anorexia Weakness/fatigue Hyperpigmentation GI symptoms Salt cravings Postural dizziness Vitiligo Muscle or joint pain
What is addisons hallmarked by?
High ACTH and low cortisol
What are the tests for addisons?
ACTH stimulation test
