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PCM2 Midterm > Endocrine Disorders Part 2 > Flashcards

Endocrine Disorders Part 2 Flashcards

1
Q

What are the 3 main causes of endocrine dysfunction?

A

1) Hormone excess
2) hormone Deficiency
3) Hormone Resistance

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2
Q

How to measure hormone levels?

A
  • immunoassays

- plasma and primary samples

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3
Q

What two ways to test endocrine function?

A

1) suppression test = assess hyper function

2) stimulation test = assess hypo function

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4
Q

Treatment of hormone abnormalities?

A
  • replacing deficient hormone

- suppressing excessive hormone production

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5
Q

Clinical presentation of hyperthyroidism?

A
  • weight loss
  • diaphoresis
  • palpitations
  • heat intolerance
  • amenorrhea
  • tremor
  • increased appetite with weight loss
  • proximal muscle weakness
  • frequent bowel movements
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6
Q

Causes of hyperthyroidism?

A
  • graves
  • goiter
  • adenoma
  • deQuervain thyroiditits
  • hashimoto (initial phase)
  • AMIDARONE (beta blocker)
  • clinically euthyroid
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7
Q

Differential for hyperthyroid?

A
  • anxiety/panic
  • mania
  • cancer/pheochromocytoma
  • exophthalmos due to orbital tumor
  • atrial fib
  • high estrogen (pregnancy)
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8
Q

Clinical presentation of hypothyroidism?

A
  • fatigue
  • weight gain
  • anorexia
  • dry,coarse skin
  • cold intolerance
  • weak
  • impaired memory
  • depressed
  • brittle hair
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9
Q

Causes of hypothyroidism?

A
  • hashimotos
  • I- deficiency
  • deQuervains thyroiditis
  • severe illness
  • drugs (amiodarone)
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10
Q

Differential for hypothyroidism?

A
  • depression
  • chronic fatigue syndrome
  • HF
  • irregular vaginal bleeding due to other causes
  • anemia
  • amyloidosis (think tongue, macroglossia)
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11
Q

Describe a thyroid examination?

A

posterior approach

  • palpate for thyroid cartilage
  • move down
  • use finger tips to feel thyroid on side of trachea and push SCM out of way
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12
Q

Main role of Parathyroid?

A

blood calcium levels with no effect on metabolism

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13
Q

Describe Primary Hyperparathyroidism?

A
  • bones, stones, and groans
  • > too much PTH released, high blood Ca levels
  • nephrolithiasis, osteoporosis, irritable (prolonged PTH exces)
  • anorexia, nausea, constipation, polydipsia, polyuria (due to hypercalcemia)
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14
Q

Role of Kidney in consort with PTH?

A

Kidney contains 1A-OH which converts 25oh-vit D to active form of 1,25OH vit D

-this Vit D will cause increase absorption of Ca from intestine

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15
Q

Assessing Hypocalcemia?

A

-trosseau’s and Chvostek’s sign

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16
Q

Causes of Primary Hyperparathyroidism?

A

adenoma, hyperplasia, carcinoma (rare)

  • multi. endocrine neoplasia
  • chronic renal failure (secondary, or tertiary form of HPTH)
17
Q

Differential for hyperPTH?

A
  • hypercalcemia of malignancy
  • multiple myeloma
  • familial hypocalcuric hypercalcemia
  • vitamin D intoxication
  • sarcoidosis
  • hyperthyroidism
18
Q

Causes of hypoparathyroidism (hypocalcemia)?

A
  • surgical removal of para glands during thyroidectomy
  • DiGeorge Syndrome
  • heridetary autoimmunity syndrome
19
Q

Signs and symptoms of hypoparathyroidism?

A

1) neuropsych = seizures, dementia, anxiety, depression
2) neuromuscular = paresthesia around mouth and fingers/toes, muscle stiff, myalgia and spasms
3) CV : CHF, hypotension, prolonged QT interval
4) Autonomic = Hilary colic, bronchospasm, diaphoresis
5) cataracts, dry,coarse skin, hyperpigmentation, eczema, steatorrhea

20
Q

Cushings Syndrome vs Cushing’s Disease

A 
Syndrome = cortisol excess
Disease = Cushing's syndrome secondary to pituitary ACTH hyper secretion
21
Q

What causes Cushing’s syndrome and how does it clinically present?

A

-caused y overproduction of cortisol or ingestion of exogenous corticosteroids

presnets w.:
-HTN, central obesity, hirsutism, depression, striae, ecchymosis

22
Q

Signs of Cushing’s syndrome?

A
  • round,moon face
  • flushed face
  • purple striae
  • buffalo hump
  • visceral obesity
  • easy bruising
  • faical hair growth in women
23
Q

Differential for Cushing’s?

A
  • chronic alcoholism (pseudo-bushings)
  • diabetes
  • depression
  • osteoporosis
  • obesity due to other causes
  • primary hyperaldosteronism
  • anorexia nervosa w/ high free urinary cortisol
24
Q

causes of Adrenal Insufficiency?

A

1) primary = autoimmune, surgical removal/trauma, infection (HIV patient w/ TB), metastatic CA, adrenal hemorrhage, congenital adrenal hyperplasia, hemochromatosis/amyloidosis
2) secondary = pituitary failure, exogenous steroids

25
Q

What are the clinical manifestations of adrenal insufficiency?

A

1) hyperpigmentation
2) weakness
3) fatigure
4) anorexia
5) nauseas/vomiting
6) hypotension
7) salt craving
8) syncope

8gum issues, hands lose color (hypo pigmentation) , dark elbows and low back

26
Q

Clinical feature of Addison’s?

A

hyperpigmentation of hands and oral mucosa

27
Q

What are some differentials for adrenal insufficiency?

A

-hypotnesion from other causes (acutely)
-hyperkalemia (renal failure)
(rnhabdomylosis acute)
-occult cancer
-other acute : SIADH, cirrhosis, ab pain

PCM2 Midterm (6 decks)

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