Endocrine Pathology Flashcards
Define Type-1 Diabetes.
- diabetes due to lack of production of insulin
Describe type-1 diabetes
- autoimmune destruction of pancreatic beta cells leads to none, or very low, levels of insulin being produced
- this results in increased blood glucose and lack of inhibition of ketones
List symptoms of type-1 diabetes.
- polyuria
- polydypsia
- weight loss
- fever
- malaise
- usually presents in younger patients
How would you investigate type-1 diabetes?
- random blood glucose
- fasting glucose monitoring
- monitoring HbA1c-c
How would you treat type-1 diabetes?
- lifelong insulin treatment
Define Diabetic Ketoacidosis.
- increased acidity of the blood due to complications of type-1 diabetes
List signs and symptoms of diabetic ketoacidosis.
- weight loss
- polyuria
- polydypsia
- tachycardia
- hyperventilation
- impaired consciousness
- smell of ketones on breath
How would you investigate diabetic ketoacidosis?
- urine dipstick
How would you treat diabetic ketoacidosis?
- replace fluid and electrolytes
- rapid acting insulin
- monitor blood glucose
- find underlying cause
Define Type-2 Diabetes.
- diabetes due to insulin receptor resistance due to constantly high plasma glucose levels
List symptoms of type-2 diabetes.
- retinopathy
- erectile dysfunction
- arterial disease
- skin lesions
- thirst
- increase frequency or urination
- lethargy
- blurring of vision
How would you investigate type-2 diabetes?
- fasting blood glucose
- random blood glucose
- HbA1c
How would you treat type-2 diabetes?
- metformin
- IGF-1 inhibitors
- insulin
Define Cushing’s syndrome.
- increased cortisol secretion caused by either adrenal hyperplasia or and increase in circulating ACTH due to a tumour
List symptoms of Cushing’s syndrome.
- moon face
- central weight gain
- straie
- easily bruised skin
- depression
- poor libido
- growth arrest in children
- proximal muscle wastage
How would you investigate Cushing’s syndrome?
- 48hr low dose dexamethasone test
- ACTH test
- CT
- MRI
- CRH levels
How would you treat Cushing’s syndrome?
- metryapone
- tumour removal
- pituitary irradiation
Define Acromegaly.
- chronic increase in growth hormone usually due to a GH secreting pituitary tumour
List symptoms of acromegaly.
- prominent supraorbital ridge
- large tongue
- visual field defects
- spade-like hands and feet
- carpal tunnel syndrome
- headaches
- deep voice
- goitre
- lethargy
- weight gain
- breathlessness
- excessive sweating
- poor libido
How would you investigate acromegaly?
- IGF-1 levels
- GH levels
- glucose tolerance test
- MRI
How would you treat acromegaly?
- surgery
- somatostatin
- GH receptor antagonists
Define Hypothyroidism.
- a reduction in the amount of thyroxine produced, usually due to autoimmune destruction of the thyroid gland or iodine deficiency
List symptoms of hypothyroidism.
- lethargy
- weight gain
- heavy periods
- poor libido
- muscle weakness
- dry skin
- brittle hair
- constipation
How would you investigate hypothyroidism?
- thyroid function test
How would you treat hypothyroidism?
- levothyroxine
Define Hyperthyroidism.
- an increase in the amount of thyroxine produced, either due to Grave’s disease or thyroxine-secreting tumours
List symptoms of hyperthyroidism.
- anxiety
- weight loss
- light periods
- sweaty palms
- leathery skin
- diarrhoea
- tremor
- ptosis
How would you investigate hyperthyroidism?
- thyroid function test
How would you treat hyperthyroidism?
- anti-thyroid drugs
- radioiodine therapy
Define Addison’s disease.
- reduction of steroid hormones due to destruction of the supradrenal cortex
List symptoms of Addison’s disease.
- hyperpigmentation
- malaise
- fever
- anxiety
- depression
- weight loss
- confusion
- postural hypertension
How would you investigate Addison’s disease?
- short ACTH stimulation test
- CT
- U&Es
How would you treat Addison’s disease?
- steroid hormone replacement therapy
Define Phaechromacytoma.
- rare tumour of the sympathic system that releases adrenaline and noradrenaline (10% are malignant)
List symptoms of phaechromacytoma.
- anxiety
- panic attacks
- sweating
- palpitations
- headache
- hypertension
- tachycardia
- bradycardia
- hypotension
- fever
How would you investigate phaechromacytoma?
- measure metabolites
- CT
- MRI
- PET
How would you treat phaechromacytoma?
- surgery
- alpha blockers
- beta blockers
Define hyperprolactinaemia.
- increased prolactin levels due to pituitary tumour or dopamine antagonists
List hyperprolactinaemia symptoms in women.
- galactorrrhoea
- sore breasts
- skipping periods
- delayed puberty
- decreased libido
- subfertility
List hyperprolactinaemia symptoms in men.
- galactorrhoea
- decreases libido
- erectile dysfunction
- delayed puberty
- gynacomastia
How would you investigate hyperprolactinaemia?
- visual field testing
- TFTs
- anterior pituitary function test
- MRI
How would you treat hyperprolactinaemia?
- dopamine agonist
- radiotherapy
- tumour resection
Define Conn’s syndrome.
- increased aldosterone levels due to pituitary adenoma
List symptoms of Conn’s syndrome.
- hypertension
- hypokalaemia
- muscle weakness
- nocturia
- tetany
How would you investigate Conn’s syndrome?
- plasma aldosterone renin ratio
How would you treat Conn’s syndrome?
- surgery
- aldosterone antagonist (spirolactone)
Define Hypocalcaemia.
- serum calcium <2.20mmol
List causes of hypocalcaemia.
- hypoparathyroidism
- vitamin D deficiency
- pseudohypoparathyroidism
List symptoms of hypocalcaemia.
- neuromuscular irritability
- laryngospasm
- bronchospasm
- bradycardia
- papilloedema
How would you investigate hypocalcaemia?
- serum and urine creatinine
- serum calcium
- PTH levels
- parathyroid antibodies
How would you treat hypocalcaemia?
- calcium (oral or IV depending on severity)
- treat underlying cause
Define hypercalcaemia.
- serum calcium >2.60mmol
List causes of hypercalcaemia.
- parathyroid adenoma
- excessive vitamin D
- malignant disease
- calcium sparing drugs
List symptoms of hypercalcaemia.
- polyuria
- polydypsia
- nephrolithiasis
- weight loss
- nausea
- vomiting
- muscle weakness
- decreased concentration
- decreased QT intervals
How would you investigate hypercalcaemia?
- ECG
- serum calcium
- serum PTH
- renal function test
- serum alkaline phosphatase
How would you treat hypercalcaemia?
- surgery
- regular measurement of calcium
Define multiple endocrine neoplasia.
- stimultaneous or metachronous occurance of tumours involving a number of endocrine glands
Name and describe the types of multiple endocrine neoplasia.
MEN 1 - gene defect in menin, which supresses a transcription factor resulting in decreased apoptosis and oncogenesis
MEN 2a - caused be a mutation in RET proto-oncogene in extracellular domain
MEN 2b - same as MEN 2a but in intracellular domain
Define pseudoparathyroidism.
- genetic disorder that causes the target organs of PTH to not response to its stimulus
List symptoms of pseudoparathyroidism.
- obesity
- short stature
- increased PTH
- signs of hypocalcaemia
