Endocrine Hx and Exam Flashcards
T/F: the thyroid regulates body’s metabolism and has NO effect on calcium levels
True
[Parathyroid glands regulate calcium levels and have no effect on body’s metabolism]
Viscerosomatic reflex for thyroid and parathyroid
T1-T4
Where/what enzyme converts vit D to active form?
Kidney - 1 alpha hydroxylase
What is the most common cause of hypocalcemia?
Hypoparathyroidism
Cuases of hypoparathyroidism
Surgical removal of glands during thyroidectomy
DiGeorge syndrome
Hereditary autoimmunity syndrome
Signs/symptoms of hypoparathyroidism: neuropsych
seizures, dementia, anxiety, depression, extrapyramidal symptoms like parkinsonism
Signs/symptoms of hypoparathyroidism: neuromuscular
Paresthesia around mouth and fingers/toes, muscle stiffness, myalgia and spasms
Signs/symptoms of hypoparathyroidism: CV
CHF, hypotension, prolonged QT interval
Signs/symptoms of hypoparathyroidism: autonomic
Biliary colic
Bronchospasm
Diaphoresis
Signs/symptoms of hypoparathyroidism: other
Cataracts Dry coarse skin Hyperpigmentation Eczema Steatorrhea
Test for hypoparathyroidism (hypocalcemia)
Chvostek sign
Trousseau’s sign
Primary hyperparathyroidism most common cause
Adenomas (may be associated with MEN1)
[other causes are hyperplasia, carcinoma]
Secondary hyperparathyroidism
Low calcium causes high PTH
About 90% of hypercalcemia is caused by
Hyperparathyroidism or malignancy
CNS, Renal, GI, and Cardiac symptoms of Hyperparathyroidism
Lethargy, weakness, confusion, coma
Polyuria, dehydration, nocturia, renal stones, renal failure
Constipation, nausea, anorexia, gastric ulcer, pancreatitis
Syncope from arrhythmias
Stones Bones Groans Thrones Psychiatric overtones
Hyperparathyroidism
Biologically active thyroid hormone
T3
MCC of hypothyroidism
Hashimoto’s thyroiditis
[others include lithium medications, pregnancy, tx for hyperthyroidism, or thyroidectomy]
Symptoms of hypothyroid
Constipation Depression Fatigue Pale/dry skin Sensitivity to cold Elevated cholesterol Dry brittle nails and hair Weight gain
MCC of hyperthyroidism
Grave’s disease
[others: toxic nodular goider, thyroiditis, excess consumption of iodine or amiodarone, pregnancy]
Classic grave’s sign
Exophthalmos “proptosis”
USPSTF recommendation for thyroid screen
Grade I = insufficient evidence; no recommendation
Primary vs. secondary addisons disease (adrenal insufficiency)
Primary = adrenal problem
Secondary = due to lack of ACTH
Symptoms of addison’s disease
N/V/D in about 50% of cases
Salty food craving
Hypotension
Skin and oral hyperpigmentation
What causes addisonian crisis (acute adrenal insufficiency), what are symptoms
Times of stress (illness, surgery, etc)
Sudden penetrating pain of back, extremities, vomiting, diarrhea
Most common cause of endogenous form of cushing syndrome
Cushing’s disease
Difference between addisons, cushing’s disease, and cushing’s syndrome
Addisons = adrenal insufficiency
Cushing’s disease = adrenal overproduction of cortisol d/t tumor, MCC of cushing’s syndrome
Cushing’s syndrome = adrenal overproduction d/t endogenous or exogenous cause
When cushing’s syndrome is caused by a _______ tumor, it is called cushing’s disease
Pituitary tumor
Symptoms of cushing syndrome
Fatigue and sleeping problems
Headaches
Backaches
Swelling
Irritability
Repeated infections, poorly healing wounds
Acne, hair loss
Signs of cushings
Round face
Abdominal striae
Buffalo hump
Easy bruising
Excess facial hair
Acanthosis nigracans may indicate what condition
Diabetes
54 y/o female presents with tingling of toes and lips. She also notes muscle spasms. PMH includes hyperthyroidism with thryoidectomy 9 months ago. She is now on thyroid replacement meds. Current TSH is 4.9 (normal is 0.5-5) what is the cause of her sx?
A. Hypothyroidism B. Hyperthyroidism C. Hypoparathyroidism D. Hyperparathyroidism E. Cushing syndrome
C. Hypoparathryroidism
