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Clinical Surgery > Endocrine Disorders > Flashcards

Endocrine Disorders Flashcards

1
Q

Differential Diagnosis of Anterior Neck Swelling

A

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
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2
Q

Differential Diagnosis of Posterior Neck Swelling

A

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
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3
Q

Pathophysiology of Grave’s

A

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.

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4
Q

Symptoms and Signs of Grave’s Disease

A
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5
Q

Investigations for Grave’s

A
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6
Q

Management of Grave’s

  • Preference in Pregnancy
  • What is administered to reduce risk of thyroid storm
A
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7
Q

Types of Thyroid Cancer

  • Spread
  • Associations
A
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8
Q

Investigation of Differentiated Thyroid Cancer (History/Imaging/Biopsy)

A
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9
Q

Indications for Thyroid Surgery

A

Risk of malignancy

Hyperthyroidism - despite medical optimization

Goitre/Nodule compression symptoms

  • hoarseness
  • dysphagia
  • SOB

Cosmesis

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10
Q

Medical Management of Hyperthyroid

A

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.

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11
Q

When is total thyroidectomy indicated?

A

Total thyroidectomy is recommended if the tumor is > 4cm or there is extrathyroidal invasion

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12
Q

Complications of thyroid surgery

A
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13
Q

Hormones secreted by the Adrenal Gland

A
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14
Q

Clinical Presentation of Primary Hyperaldosteronism (aka __________)

A

Conn’s Syndrome

Commonest cause of secondary hypertension

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15
Q

Casues of Hyperaldosteronism

  • Primary
  • Secondary
A
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16
Q

Screening Investigations for Hyperaldosteronism

A
17
Q

How to determine Unilateral / Bilateral Disease in Hyperaldosteronism

A
18
Q

Medical Management of Hyperaldosteronism

A
19
Q

Causes of Hypercortisolemia

A

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
20
Q

Clinical Features of Cushing’s Syndrome

  • Catabolic Effects
  • Glucocorticoid Effects
  • Appearance
A
21
Q

Investigations for Cushing’s Syndrome

A
22
Q

Treatment of Cushing’s Disease

A

Trans-sphenoidal excision of ACTH-producing pituitary tumour

23
Q

Treatment of Adrenal Adenoma/Cancer

A
24
Q

Treatment of Ectopic ACTH

A
25
Q

Define a Pheocrhomacytoma

A

Catecholamine-secreting tumours that arise from chromaffin cells of the adrenal medulla and the sympathetic ganglia

  • 0.2% of people with hypertension
26
Q

Familial disorders associated with adrenal pheochromocytoma

A

Von Hippel-Lindau (VHL) syndrome

Multiple endocrine neoplasia type 2 (MEN2)

Neurofibromatosis type 1 (NF1)

27
Q

Pheochromocytoma rule of 10’s

A
28
Q

Clinical Presentation of Pheochromocytoma

  • Classical Triad?
A
29
Q

Investigations for Pheochromocytoma

A
30
Q

Medical Treatment of Pheochromocytoma

A
31
Q
A

Clinical Surgery (20 decks)

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