Endocrine exam Flashcards
Causes of diffuse goitre
Idiopathic Puberty, pregnancy, post-partum Grave's disease Thyroiditis Simple goitre Iodine excess, drugs Inborn errors of thyroid hormone synthesis
Causes of thyrotoxicosis
Primary- Grave’s disease, toxic adenoma/MNG, Hashimoto’s, iodine-induced, excess TH replacement, post-partum thyroiditis, amiodarone
Secondary- pituitary/ectopic TH-secretion, hydatiform mole, choriocarcinoma, struma ovarii, factitious
Grave’s disease
Visual eye signs
Hyperthyroidism with goitre
Pretibial myxedema
Causes of hypothyroidism
Primary- idiopathic atrophy, treatment (surgery, radioactive iodine), agenesis, unresponsiveness to TSH, chronic thyroiditis, drugs, iodine-induced, inborn errors
Secondary- pituitary lesions
Tertiary- hypothalamic lesions
Causes of anaemia in hypothyroidism
Chronic disease
Folate deficiency secondary to bacterial overgrowth
Pernicious anaemia associated with myxoedema
Fe deficiency in women due to menorrhagia
Haemolysis secondary to hypercholesterolaemia induced spur cell anaemia
Neurological associations of hypothyroidism
Nerve entrapment- carpal tunnel Delayed relaxation phase of ankle jerk Nerve deafness Peripheral neuropathy Proximal myopathy Hypokalaemic periodic paralysis Cerebellar syndrome Psychosis Coma
Causes of panhypopituitarism
Chromophobe adenoma Space occupying lesions Iatrogenic- surgery, radiation Sheehan's syndrome Head injury Idiopathic
Activity in acromegaly
Skin tag number
Excessive sweating
Presence of glycosuria
Increasing visual field loss/CN III, IV, VI, V palsies
Enlarging goitre
HTN
Symptoms of headache, increasing ring size, shoe size
Causes of angioid streaks
Paget’s disease, lead poisoning, pseudoxanthoma elasticum
Acromegaly
Sickle cell anaemia
Hyperphosphataemia
Causes of Addison’s disease
Iatrogenic
Autoimmune adrenal disease
Polyglandular syndromes- hypoparathyroidism, T1DM, Hashimoto’s, Graves
TB, histoplasmosis
Infiltration
Demyelinating disease- adrenoleukodystrophy
Drugs- heparin, ketoconazole, HIV infection
Features of autonomic neuropathy
Postural hypotension Loss of sinus arrhythmia Valsalva manoeuvre causes no slowing of pulse Loss of sweating Erectile dysfunction Nocturnal diarrhoea Urine retention, incontinence
Features of non-proliferative diabetic retinopathy
Dot haemorrhages in inner retinal areas Blot haemorrhages in superficial nerve fibre layers Hard exudates Soft exudates (cotton wool spots) Microaneurysms Dilated veins
Features of proliferative diabetic retinopathy
New vessels Vitreous haemorrhage Scar formation Retinal detachment Laser scars
Causes of hirsutism
Constitutional
PCOS
Adrenal- Cushing’s syndrome, CAH, virilising adrenal tumour
Ovarian
Drugs- phenytoin, androgen, glucocorticoids
Other- acromegaly, porphyria cutanea tarda
