Endocrine I Flashcards
Signs and sx of hypocalcemia
Hypoparathyroid/Hypocalcemia Signs & Symptoms:
Neuropsych: Seizures, dementia, anxiety, depression, ect
Neuromuscular: Paresthesia around mouth and fingers/toes, muscle stiffness, myalgia and spasms
CV: CHF, hypotension, prolongation of QT interval
Autonomic: Biliary colic, bronchospasm, diaphoresis
Other: Cataracts, dry coarse skin,
what is chvostek’ sign?
tap onto the facial n anterior to the lip and you’ll get the spasming of lip
what is trousseu’s sign?
put the bp cuff around the arm
hold it for a few min
get some spasming of the arm
what is the most common cause of hypocalcemia?
hypoparathyroidism
causes of hypoparathyroidism
-Surgical removal of glands during thyroidectomy, DiGeorge Syndrome, and hereditary autoimmunity syndrome.
what is primary hyperparathyroidism predominantly caused by?
1° hyperparathyroidism(causes high PTH)
Adenomas (MC 80%) – may be associated with MEN 1
Multiple endocrine neoplasia (MEN)–endocrine gland(s) overactive or forms a tumor.
what is secondary hyperparathyroidism predominantly caused by?
Renal failure, vit D def, malabsorption
low calcium causes high PTH
Sx of hyperparathyroidism
Symptoms:
CNS: Lethargy, weakness, confusion, coma
Renal: Polyuria, dehydration, nocturia, renal stones, renal
failure
GI: Constipation, nausea, anorexia, gastric ulcer, pancreatitis
Cardiac: Syncope from arrhythmias
Stones (renal or biliary calculus)
Bones (bone pain)
Groans (abdominal pain, nausea and vomiting)
Thrones (polyuria) resulting in dehydration.
Psychiatric overtones (Depression 30–40%, anxiety, cognitive dysfunction, insomnia, coma
what is secreted by the thyroid? what is the active form?
Synthesizes, stores and secretes thyroid hormone
(T4 and T3)
• Thyroxine (T4 – contains four atoms of iodine) and
tri-iodothyronine (T3- contains three atoms of
iodine)
• T4 (inactive form) –> T3 (active form)
what TSH levels expected to be in both hypo and hyper thyroidism?
Thyroid stimulating hormone (TSH) is secreted by
pituitary and in response the thyroid will secreted
T4 and T3
• Therefore there is a negative feedback
– Hypothyroidism (low thyroid) TSH is high in response to low T4,
low T3
– Hyperthyroidism (high thyroid) TSH is low in response to high
T4, high T3
what causes hypothyroidism
Causes:
Hashimoto’s thyroiditis – Autoimmune (most common cause of hypothyroidism)
Medications (i.e. lithium) can sometimes cause hypothyroidism
Pregnancy (during or after) – can recur with subsequent pregnancies
Treatment for hyperthyroidism
Thyroidectomy
Sx of hypothyroidism
Symptoms: Constipation Depression Fatigue Pale, dry skin Sensitivity to cold Elevated cholesterol levels Dry, brittle nails and hair Weight gain
what causes hyperthyroidism
Causes:
Graves’ Disease – autoimmune (most common cause of hyperthyroidism)
Toxic nodular or multinodular goiter
Thyroiditis (autoimmune or viral)
Excessive consumption of iodine or meds (like amiodarone) that contain iodine
Pregnancy or first year after birth (some women)
Sx of hyperthyroidism
Symptoms: Fatigue or muscle weakness Hand tremors Mood swings Nervousness or anxiety Rapid heart rate Heart palpitations or irregular heartbeat Skin dryness Trouble sleeping Weight loss Increased frequency of bowel movements Light or missing periods Irritability Thinning of hair Heat intolerance
what are the causes of primary addison’s disease?
Adrenal Insufficiency (Cortisol Underproduction) Primary (account for 90% of cases) About 70% are autoimmune About 20% due to TB Other causes: Chronic infections, surgical removal, cancer cells affecting adrenals
what are the causes of secondary addison’s disease?
Secondary due to lack of ACTH
Suddenly stopping exogenous glucocorticoids (like
prednisone)
Surgical removal of ACTH-producing tumors from
pituitary
Pituitary gland suddenly stops producing ACTH
(as in cancerous processes)
Sx of addison’s disease
Symptoms: Skin darkening, especially on scars, skin folds, pressure points, mucus membranes N/V/D in about 50% of cases Salty food craving Hypotension Chronic worsening fatigue and muscle weakness Weight loss, loss of appetite Irritability Hypoglycemia (uncommon in adults) Menstrual irregularities
Addisonian Crisis/Acute Adrenal Insufficiency
- Usually appears at time of stress (illness, surgery, etc.)
- Sudden penetrating pain of back, extremities, vomiting, diarrhea
- If left untreated, could lead to death
what is cushing’s syndrome?
Cushing Syndrome - (Adrenal (Cortisol) Overproduction)
Cushing’s disease is named after Henry Cushing, first described in 1932.
- Affects women more than men ( Female>Male)
- Cushing’s syndrome has both endogenous and exogenous causes
- Cushing’s disease is the most common cause of endogenous form
Sx of cushing’s
Symptoms (how they feel): Fatigue and sleeping problems Headaches Backaches Swelling Irritability Repeated infections and poorly healing wounds Acne Hair loss
signs of cushing’s
Signs (what you see):
-A round (moon-shaped) and/or red face
-Purplish streaks across the skin (“striae”)
-Unusual buildup of fatty tissue between the
shoulder blades (called “buffalo hump”)
-Unusual buildup of fatty tissue in the abdominal
area with thin arms and legs
-Easy bruising
-Excess facial/body hair growth (called
“hirsutism”) in women
what is hyperprolactinemia? what are the clinical presentations?
Hyperprolactinemia
• Most common pituitary adenoma
• Common clinical presentation:
– Galactorrhea (milk discharge from breast), menstrual abnormalities,
hypogonadism, erectile dysfunction, infertility
– If mass is very large then vision issues and headaches
