Endocrine, Metabolic - Lecture 8 Flashcards
7 common presenting symptoms & possible reasons why…..
fatigue - consider anaemia, thyroid dysfunction, Addisons,hypopituitarism
hypoglycaemia - Addisons, hypopituitarism,liver failure
sweating - endocrine could be thyrotoxicosis, acromegaly
altered consciousness - hypoglycaemia, Addisons, hypopituitarism - prob. cardiac or neurological though
hypertension - endocrine disorders: hypokalaemia, Cushings
Hirsutism - hyperandrogenism, polycystic ovarian syndrome
obesity - hypothyroidism, Cushings
Pituitary dysfunction - hypopituitarism
Sequence of loss & symptoms
growth hormone - fatigue
gonadotropin - amenorrhea, erectile dysf. reduced libido, infertility
thyroid-stimulating-hormone - facial puffiness, hoarse voice, bradycardia, cold intolerance
adrenocorticotropic hormone - addisons (hyper pigmentation of skin/mucous, weakness, fatigue, weight loss,
decrease of appetite & hyperphagia too
Discuss diabetes insipidus - presents with…….
why does it occur? (physiology)
polydipsia (excessive thirst) - may produce 3-30L of urine
polyuria with nocturia (similar to mellitus but WO disturbed insulin regulation
So - may develop dehydration & hypovolemia
impaired production of ADH by post. pit.
Hyperpituitarism
(hyperfunction of ant. pit. almost always selective)
Over production & symptoms
increased GH - gigantism - (acromegaly in adults)
increased prolactin - increase in lactation in both sexes
increase in ACTH - Cushings disease
increase in TSH - rare, hyperthyroidism
Gigantism/acromegaly
Presents as…….
enlarged supra orbital ridges, prominent jaw, distinct facial expressions
teeth widen, lower jaw protrudes
skin is thick & greasy, perspire a lot
hands & feet are broad & spadelike - Warren
arthritis, HAs, cardiac disease
Susceptible to a range of paths
Hyperthyroidism - what is it?
Comes from two things……
increased synthesis & secretion of thyroid hormones due to thyroid stimulators in the blood
or an
increase in release of thyrois hormones due to destruction of thyroid tissue
Graves disease
(leading cause of hyperthyroidism)
Caused by & characterised by…….
autoantibody effects on the thyroid receptor for TSH
goiter exopthalmos (bulging eyes) increased heartbeat muscle weakness disturbed sleep irritability
Hyperthyroidism
9 signs/symptoms……….
(elderly may present atypically, another presentation is a thyroid storm - sudden onset of symptoms)
palpitations tremor weight loss increase in appetite increase in bowel frequency hot/sweaty hyperactive (mood) decreased tolerance for exercise light/infrequent menstruation
Hypothyroidism
8 signs/symptoms………………….
weight gain decreased appetite decrease in bowel frequency cold/dry skin depressed (mood) decrease exercise tolerance heavy menstruation muscle weakness, muscle & joint pain
Hashimotos Thyroiditis……….what is it & presentations?
autoimmune condition resulting in inflam. of thyroid
fullness in the throat, painless enlargement of thyroid
Hyperparathyroidism leads to hypercalcaemia - what are the symptoms & what can it lead to?
polyuria
abdo pain
nausea, vomiting, muscle weakness
can lead to osteoporosis, peptic ulcers, pancreatitis
Hypoparathyroidism leads to hypocalcaemia - what are the symptoms & what can it lead to?
muscle irritability, tetany
paraesthesias of the lips, tongue, fingers, feet, spasm of facial muscles
chronic - dry scaly skin, brittle nails, course hair
Addisons disease/adrenal sufficiency - who gets it, what is it, signs/symptoms
MUST KNOW
Rare
Women 30-50
Adrenal insufficiency due to the destruction or dysfunc. of entire adrenal cortex. It affects glucocorticoid and mineralocorticoid function
Signs/symptoms - weakness, fatigue and orthostatic hypotension with brown skin pigmentation, of decreased cold tolerance, anorexia, nausea, vomiting and diarrhoea
May have an adrenal crisis - profound weakness/lethargy, severe abdominal or lower back pain, hypotension and, finally, renal failure
Cushings syndrome - who gets it, what is it, signs/symptoms
MUST KNOW
Female/Male: 5:1 - 25-40 years
results from chronically high levels of corticosteroids
When due to excess ACTH production, it is known as Cushing’s Disease
Signs/symptoms - Central obesity (limbs remain thin)
Supraclavicular/dorsal cervical fat pads (“Buffalo hump”)
Muscle wasting/weakness
Thin skin (bruising easily) with purple striae
Associated pathologies:
Hypertension, renal stones, osteoporosis, glucose intolerance, reduced infection resistance and mental disturbance
Diabetes Mellitus - classic triad of symptoms
weight loss
thirst (polydipsia)
polyuria (often with nocturia)
