Endocrine Disorders Flashcards
Differential Diagnosis of Anterior Neck Swelling
Lymphadenopathy
Goitre
- Moves on swallowing
Thyroid Nodule
Branchial Cyst
- At the anterior border of SCM
- Presents in those under twenty years old
- Contains cholesterol
Dermoid Cyst
- In the midline.
- Presents in those under twenty years old
Carotid Body Tumours
- Strong pulsation
- ‘Goblet’ sign on angiography
Thyroglossal Cyst
- Embryological remnant
- Always midline
- Moves with protrusion of the tongue
Differential Diagnosis of Posterior Neck Swelling
Lymphadenopathy
Cervical Rib
- Subclavian Steel
Pharyngeal Pouch
- Dysphagia/Bad Breath
- BEWARE on endoscopy
Cystic Hygroma
- Benign proliferation of lymph vessels
- Presents in infancy
- Transluminates brightly
Pathophysiology of Grave’s
Grave’s disease is caused by autoantibodies that bind to the thyrotropin receptor (TSHR-Ab), stimulating growth of the thyroid and overproduction of thyroid hormone. This can lead to thyrotoxicosis.
Symptoms and Signs of Grave’s Disease
Investigations for Grave’s
Management of Grave’s
- Preference in Pregnancy
- What is administered to reduce risk of thyroid storm
Types of Thyroid Cancer
- Spread
- Associations
Investigation of Differentiated Thyroid Cancer (History/Imaging/Biopsy)
Indications for Thyroid Surgery
Risk of malignancy
Hyperthyroidism - despite medical optimization
Goitre/Nodule compression symptoms
- hoarseness
- dysphagia
- SOB
Cosmesis
Medical Management of Hyperthyroid
Carbimazole (Methimazole pro-drug) restores serum thyroid levels in 4-8 weeks
Beta-adrenergic blocking drugs, such as propranolol, rapidly control the symptoms of thyrotoxicosis
In patients who are undergoing a thyroidectomy for hyperthyroidism, potassium iodine (Lugol’s iodine) is given for ten days pre-operative to reduce the vascularity of the gland.
When is total thyroidectomy indicated?
Total thyroidectomy is recommended if the tumor is > 4cm or there is extrathyroidal invasion
Complications of thyroid surgery
Hormones secreted by the Adrenal Gland
Clinical Presentation of Primary Hyperaldosteronism (aka __________)
Conn’s Syndrome
Commonest cause of secondary hypertension
Casues of Hyperaldosteronism
- Primary
- Secondary
Screening Investigations for Hyperaldosteronism
How to determine Unilateral / Bilateral Disease in Hyperaldosteronism
Medical Management of Hyperaldosteronism
Causes of Hypercortisolemia
Cushing’s Syndrome is usally due to:
- Corticotropic (ACTH) producing pituitary tumor (Cushing’s Disease)
- Ectopic ACTH secretion
- Cortisol secretion by an adrenal adenoma/carcinoma
Clinical Features of Cushing’s Syndrome
- Catabolic Effects
- Glucocorticoid Effects
- Appearance
Investigations for Cushing’s Syndrome
Treatment of Cushing’s Disease
Trans-sphenoidal excision of ACTH-producing pituitary tumour
Treatment of Adrenal Adenoma/Cancer
Treatment of Ectopic ACTH
Define a Pheocrhomacytoma
Catecholamine-secreting tumours that arise from chromaffin cells of the adrenal medulla and the sympathetic ganglia
- 0.2% of people with hypertension
Familial disorders associated with adrenal pheochromocytoma
Von Hippel-Lindau (VHL) syndrome
Multiple endocrine neoplasia type 2 (MEN2)
Neurofibromatosis type 1 (NF1)
Pheochromocytoma rule of 10’s
Clinical Presentation of Pheochromocytoma
- Classical Triad?
Investigations for Pheochromocytoma
Medical Treatment of Pheochromocytoma