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PCM Midterm Spring 2020 > Endocrine Topics 2 > Flashcards

Endocrine Topics 2 Flashcards

1
Q

Primary vs Secondary vs Tertiary Disease

A

primary: inhibits downstream gland
secondary: pituitary gland
tertiary: hypothalamus dysfunction

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2
Q

Causes of Endocrine Dysfunction

A

Hormone excess
Hormone deficiency
Hormone Resistance

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3
Q

Endocrine Testing and Treatment

A

Testing
-Suppression test: assess endocrine hyperfunction
-Stimulation test: assesses endocrine hypofunction
Treatment
-Replacing deficient hormone
-Suppressing excessive hormone production

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4
Q

Causes of Hyperfunction Dysfunction

A
  • Benign: Pit adenomas, hyperPTHism
  • Malignant: cancer
  • Ectopic: SIADH, Ectopic ACTH
  • Multiple endocrine neoplasia (MEN): MEN1 MEN2
  • Autoimmune: Grave’s
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5
Q

Causes of Hypofunction Dysfunction

A
  • Autoimmune: Hashimoto, Type 1 DM, Addisons
  • Nutritional Deficiency
  • Hormone mutations
  • Enzyme defects
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6
Q

Causes of Hormone Resistance Dysfunction

A
  • Signaling pathway: Type 2 DM, Leptin resistance

- Receptor mutations

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7
Q 
Testing for 
Hypothyroidism
Graves
Thyroid Nodules and Neoplasia
Hyperparathyroidism
A

Hypothyroidism: TSH, confirm with free T4
Graves: TSH, free T4
Thyroid Nodules and Neoplasia: biopsy
Hyperparathyroidism: Serum Ca, PTH if Ca elevated

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8
Q

Hyperthyroidism and HPI

A

-Weight loss
-Anxiety
-Heat Intolerance (feels hot)
-Palpitations
-Tremor
-increased appetite
-Exophtalmos & proptosis (graves)
-

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9
Q

Potential Causes of Hyperthyroidism

A
  • Graves
  • Toxic multinodular goiter
  • Subacute (de Quervain’s) thyroiditis
  • Initial phase of Hashimoto
  • Jod-Basedow phenomenon: due to high I2 intake, Amiodarone, radiocontrast_
  • Amiodarone-induced
  • “Subclinical”
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10
Q

Hyperthyroid differentials

A
  • anxiety
  • Cancer
  • Exopthalmos due to orbital tumor
  • Acute psych disorders
  • High estrogen states
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11
Q

Hypothyroid HPI

A
  • Fatigue
  • weight gain
  • Cold intolerance
  • Impaired memory
  • Depressed
  • diminished sweating
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12
Q

Hypothyroid Causes

A
  • Hashimoto
  • I2 deficiency
  • Severe illness
  • Drugs: Lithium, amiodarone
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13
Q

Hypothyroidism Differentials

A
  • Depression
  • Chronic Fatigue Syndrome
  • Heart failure
  • Anemia
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14
Q

Parathyroid (classical primary hyperparathyroidism)

A
  • NO effect on metabolism
  • Classical primary hyperparathyroidism
  • Increased Ca and PTH
  • “Bones, Stones, Abdominal Moans, Psychic Groans”
  • Decreased bone density, kidney stones, abdominal pain, depressed, fatigued
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15
Q

PTH and Ca

A

Kidney
-1-alpha hydroxylase converts to active Vit D
Intestine
-Vit D increases amount of Ca absorbed

  • When Ca serum low–>Increase PTH–>Increase Ca reabsorb into bone, kidney, intestine
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16
Q

2 Tests for Hypocalcemia

A
  1. Trousseau’s Sign: spasm when inflating blood pressure cuff
  2. Chvostek’s Sign: contraction of facial muscle when tapping on the nerve
17
Q

Signs of Excess PTH

A
  • hypercalcemia
  • bone disease
  • Proximal renal tubular acidosis
  • Hyperuricemia and gout
18
Q

Clinical Signs of HyperCalcemia

A
  • Muscle weakness
  • Bone pain
  • Polyuria & Polydipsia
  • Nephrogenic Diabetes Insipidus
  • Nausea, vomitting
  • Bradycardia
  • Hypertension
  • Confusion
19
Q

Primary Hyperparathyroidism Symptoms and Causes

A

Symptoms
-Associated with Nephrolithiasis and bone disease
-anorexia, nausea, constipation, polydipsia, polyuria
Causes
-PT adenoma, hyperplasia, carcinoma, MEN, chronic renal failure

20
Q

Differentials Of HPTH

A
  • Hypercalcemia of malignancy
  • Vit D intoxication
  • Hyperthyroidism
  • FHH
21
Q

Hypoparathyroidism: Hypocalcemia Causes and Symptoms

A 
Causes
-gland removal
-hypoparathyroidism 
Symptoms: 
Neuropsych: seizures, dementia, anxiety
Neuromuscular: paresthesia round mouth/fingers, muscle stiffness
CV: CHF, hypotension
Autonomic: Bronchospasm
Other: Cataracts, dry coarse skin, hyperpigmentation
22
Q

Cushings Syndrome Cause and presentation

A 
Cause: overproduction of cortisol or ingestion of exogenous
Presents: HTN, Central Obesity, Weakness, Ecchymosis, Hirsutism, Depression, Striae
SIGNS:
-moon shaped face
-striae: purple streaks
-Buffallo hump
-Fatty tissue in abdomen 
-hirsutism in women
23
Q

Differential of Cushings

A
  • Chronic alcoholism
  • DM
  • Depression
  • Obesity due to other causes
  • Primary hyperaldosteronism
24
Q

Adrenal Insufficiency Causes

A 
Primary (Addisons)
-Autoimmune
-Surgical removal
-Infection
-Hemorrhage
Secondary
-Pituitary failure
-exogenous sterioids
25
Q

HPA Axis

A 
Hypothal
    l
Pituitary gland
    l 
Adrenal gland
26
Q

Addisons Disease

A

Hyperpigmentation because of increase in ACTH

27
Q

Pituitary Disorders

A

-Hypopituitarism> decreased secretion of pituitary hormones, majority due to pituitary adenoma
-can also be caused by hypothalamic diseases
-if due to sellar mass, often have headaches, visual loss, diplopia
-

PCM Midterm Spring 2020 (9 decks)

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