Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Diabetes and Endocrine > Endocrine disorders > Flashcards

Endocrine disorders Flashcards

1
Q

Which drugs can be used to treat hyperthyroidism?

A

Carbimazole
Methimazole
Propylthiauracil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What risks should be explained to a patient starting on carbimazole?

A

Risks of haematological disturbances, especially neutropenia (low neutrophil count) which increases risk of infection.
Warning signs include:
- sore throat, mouth ulcers, bruising, fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the contraindications of carbimazole

A

Contraindication: Severe haematological disorders
Caution:
Pregnancy and breast feeding (Propylthiouracil is the firstline preference)
Hepatic impairment
Renal impairment (Propylthiouracil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the mechanism of carbimazole

A

Carbimazole is metabolised to methimazole. This acts by inhibiting thyroid peroxidise and thereby the production of thyroid hormones.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe the signs and symptoms of low growth hormone levels

A

Retarded growth, abnormal fat distrubution

Can potentially cause dwarfism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is growth hormone deficiency treated?

A

Treat the underlying cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Give an example of something that can cause a deficiency of growth hormone

A

Hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What condition is caused by congenital hypothyroidism?

A

Cretinism - impaired mental and physical development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the common name for autoimmune thyroiditis? What endocrine condition does this cause?

A

Hashimoto’s disease

Primary hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the signs and symptoms of hypothyroidism

A 
Low metabolic rate
Low body temperature, cold intolerance
Tiredness, lethargy
Weight gain
Dry skin, hair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What tests should be done if hypothyroidism is suspected?

A

TFTs - FT3, FT4, TSH

Serology for TPO autoantibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is hypothyroidism treated?

A

Give oral Levothyroxine (T4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the signs and symptoms of hypocalcaemia

A 
SPASMODIC:
Spasms (e.g. Trousseau’s sign)
Paraesthesiae / Prolonged QTc interval / Papilloedema
Anxious, irritable, irrational
Seizures
Muscle tone increase in smooth muscle – colic, wheeze, dysphagia
Orientation impaired, confusion
Dermatitis
Impetigo herpetiformis
Cardiomyopathy / Cataract
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What tests should be done in a patient with suspected hypocalcaemia?

A 
Blood test for serum calcium level
PTH level
ECG
FBC, U&E, albumin
Vitamin D, magnesium, phosphate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is hypocalcaemia managed?

A

Oral or IV calcium (depending on severity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What disease causes low levels of aldosterone and cortisol?

A

Addison’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe the symptoms of aldosterone deficiency

A 
Polyuria
Hypovolaemia
High serum potassium
Low serum sodium
(Can lead to hypotension)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe the symptoms of cortisol deficiency

A 
Fatigue, nausea, weight loss, irritability, depressions
Hyperpigmentation
Buccal pigmentation
Hypotension
Hypoglycaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What tests should be done in a patient with suspected adrenal insufficiency?

A 
Routine bloods
Random cortisol (<700 nmol/l)
Short synacthen test
ACTH levels
Adrenal antibodies
20
Q

How is Addison’s disease treated?

A

Give oral glucocorticoid (hydrocortisone) and oral mineralcorticoid (fludrocortisone) replacement

21
Q

What is a life-threatening complication of Addison’s disease? Describe the clinical signs/symptoms.

A

Addisonian crisis

Hypotension, tachycardia

22
Q

What causes Addisonian crisis?

A

Addisonian crisis happens in patients with chronic adrenal insufficiency when subject to an intercurrent illness or stress, e.g. burns, infection, pregnancy, allergy, MI.

23
Q

Explain why patients in Addisonian crisis become hypotensive

A

Low aldosterone: Sodium (and therefore water) are not sufficiently reabsorbed by the kidney, so are excreted, which leads to hypovolaemia and therefore hypotension.
Low cortisol: cortisol has a permissive effect on catecholamine action, therefore low cortisol levels mea that catecholamines do not work as effectively. This prevents the blood vessels from constricting enough to raise the blood pressure, so exacerbate the hypotension.

24
Q

Explain why patients in Addisonian crisis become tachycardic

A

Tachycardia is to compensate for the low blood pressure (caused by hypovolaemia) to maintiain sufficient cardiac output.

25
Q

How is Addisonian crisis managed?

A

IV 0.9% saline
Oral hydrocortisone 20mg
Fludrocortisone

26
Q

What conditions are caused by excess growth hormone?

A

Gigantism (before fusion of epiphyseal plate)

Acromegaly (after fusion of epiphyseal plate)

27
Q

Describe the signs and symptoms of acromegaly

A

Enlarged hands, feet, jaw (causes spacing-out of teeth), tongue, thick/course facial features
Cardiac symptoms
Thick, oily skin

28
Q

What is the most common cause of acromegaly? How is this treated?

A

Pituitary adenoma

Transphenoidal surgery to remove pituitary tumour
Radiotherapy of pituitary tumour
Somatostatin (GHIH) analogues, dopamine agonists

29
Q

Give an example of a disease that causes hyperthyroidism

A

Grave’s disease

30
Q

Describe the signs and symptoms of hyperthyroidism

A 
High metabolic rate
High body temperature, heat intolerance
Anxiety, irritability
Weight loss
Sweaty palms
Palpitations
Exophthalamos/proptosis
Eyelid retraction
31
Q

What tests should be done in a patient with suspected hyperthyroidism?

A

TFTs - FT3, FT4, TSH

TSH-receptor antibodies (test for Grave’s)

32
Q

How is Grave’s disease treated?

A 
Antithyroid drugs
 - carbimazole
 - methimazole
 - propylthiouracil
Radioiodine
Surgery (thyroidectomy)
33
Q

Describe the signs and symptoms of hypercalcaemia

A

stones, bones, (abdominal) moans, and psychic groans
Renal stones, gallstones
- renal dysfunction, polyuria
Bone pain, osteoporosis, arthritis, muscle weakness
Nausea, vomiting, anorexia, constipation, pancreatitis
Confusion, depression, fatigue

34
Q

What tests should be done in a patient with suspected hypercalcaemia?

A

Bloods - serum calcium, PTH,

FBC, U&E, albumin, vitamin D, magnesium

35
Q

How is hypercalcaemia treated?

A

Rehydration (fluids)
IV bisphosphonates
Surgery

36
Q

What disease is associated with high aldosterone levels?

A

Conn’s syndrome

37
Q

What are the signs and symptoms of Conn’s syndrome?

A

Water retention (and sodium retention)
Increased body weight
Low blood potassium level

38
Q

Describe the signs and symptoms of Cushing’s syndrome

A

Tissue breakdown - weakness of skin, bone and muscle
Sodium retention - can lead to hypertension and heart failure
Insulin antagonism - causes glucose intolerance, hyperglycaemia
Hyperlipidaemia
Weight gain, acne, bruising, moon face, purple striae, hirsutism
Suppressed immunity

39
Q

What tests should be done in a patient with suspected Cushing’s syndrome?

A

24-hour urinary free cortisol

Dexamethasone suppression test

40
Q

Explain the principle of the dexamethasone suppression test

A

Used to test for cushing’s syndrome
In normal subjects, dexamethasone suppresses ACTH and therefore cortisol secretion. In Cushing’s syndrome, there is incomplete suppression.

41
Q

How is Cushing’s syndrome treated?

A

Treat the underlying cause, e.g. surgical removal of tumour

Medical therapy: metyrapone or ketoconazole

42
Q

What can cause excess catecholamines in the blood?

A

Phaeochromocytoma: a catecholamine-secreting tumor of chromaffin cells typically located in the adrenals.

43
Q

Describe the symptoms/signs caused by a phaeochromocytoma

A

Hypertension
High blood glucose level
Postural hypotension
Paroxysmal attacks; sweating, headache, palpitations, tremor, pallor, anxiety/fear

44
Q

What tests should be done in a patient with a suspected phaeochromocytoma?

A

24 hour urine (metanephrines - metabolites of adrenaline)
Plasma free metanephrine
Imaging to locate tumour
Genetic testing

45
Q

How is a phaeochromocytoma treated?

A

Surgery to resect the tumour

Antihypertensive medication

46
Q

What is precocious puberty?

A

Onset of sexual maturation before age 8 in girls or age 9 in boys. Two types:

  • Gonadotropin-releasing hormone (GnRH)–dependent (central precocious puberty)
  • GnRH-independent (peripheral sex hormone effects)

Diabetes and Endocrine (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions