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Y3 Clinical Case Revision > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

thyroid anatomy

A

art: inf / sup thyroid arteries
glandular prox: parathyroid glands = posterior
nervous prox: recurrent laryngeal nerve = lateral

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2
Q

thyroid function

A

=> T4/T3 (iodinated)

=> calcitonin

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3
Q

hyperthyroidism presentation

A 
most commonly in adult women
weight loss + ^ appetite
HTN
palpitations / ^ HR / AF
warm peripheries
pruritus 
anxiousness / irritability 
insomnia
diarrhoea
lid lag
lid retraction only in Grave's disease
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4
Q

lid retraction pathophysiology

A

inflammation of orbital fatty tissues in the orbit due to autoimmune destruction

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5
Q

Grave’s disease pathophysiology

A

TSH receptor stimulating autoantibodies (TSHrAb)

> ^ thyroid stimulation > ^ => T4 /T3

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6
Q

hyperthyroidism investigations

A 
^ T4 / T3 
v TSH
TPO antibodies
TSHrAb
thyroid USS
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7
Q

hyperthyroidism treatment

A

symptomatic = bisoprolol
carbimazole
definitive = radioactive iodine / thyroidectomy

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8
Q

carbimazole side effects

A

generalised rash
bone marrow suppression
> pancytopenia = unexplained sore throat / fever

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9
Q

primary hypothyroidism pathophysiology

A

Hashimoto’s = autoimmune pathology

TPO Ab regulated

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10
Q

primary hypothyroidism investigation

A

v T4 / T3 & ^ TSH

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11
Q

secondary hypothyroidism pathology

A

hypo-pituitary system pathology / dysfunction

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12
Q

secondary hypothyroidism investigations

A

-/v TSH & v T4 / T3

pituitary function / head CT

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13
Q

hypothyroidism presentation

A 
fatigue
bradycardia
cold intolerance 
weight gain / ^ BMI
myxoedema 
skin thickening 
constipation
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14
Q

hypothyroidism treatment

A

thyroxine replacement

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15
Q

v T4 even with thyroxine treatment? consider:

A

malabsorption (Coeliac’s, iron supplements etc.)
poor adherence
under replacement

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16
Q

thyroxine treatment side effects

A 
over replacement (hyperthyroidism)
osteoporosis (> ^ => calcitonin)
17
Q

subclinical hypothyroidism

A

normal T4 / T3
v TSH
if asymptomatic = no treatment (just regular blood tests / f/u)

18
Q

glucocorticoid example

A

cortisol

19
Q

hypopituitary adrenal negative feedback cycle

A

stress / v cortisol / ^ CRH (from hypothalamus) + pituitary => ACTH
ACTH + adrenal glands => cortisol
cortisol - pituitary / hypothalamus

20
Q

cortisol function

A

^ serum glucose
regulates metabolism
v inflammation
^ memory formation

21
Q

cortisol fluctuation

A

^ @ 0800

v @ 0000

22
Q

adrenal androgens example

A

testosterone

controlled by fluctuations of ACTH

23
Q

mineralocorticoids example

A

aldosterone

24
Q

RAAS negative feedback system

A

v blood volume / v GFR / hypOna / hypERka + kidneys (juxtaglomerular cells) => renin
renin + conversion of angiotensinogen > angiotensin I
lungs => ACE + conversation of Ag I > Ag II
Ag II + adrenals => aldosterone
aldosterone + ^ K loss / ^ Na retention

25
Q

Addison’s disease pathophysiology

A

autoimmune destruction of the adrenal glands

> v glucocorticoids / mineralocorticoids / ^ ACTH

26
Q

primary hypoadrenalsim name

A

Addison’s disease

27
Q

Addison’s crisis

A

= fatigue, low blood pressure, weakness

req IV fluids + hydrocortisone

28
Q

Addison’s disease presentation

A 
weakness / fatigue  
anorexia / nausea
weight loss
^ ACTH > hyperpigmentation
hypoglycaemia
29
Q

Addison’s disease investigations

A 
hypOna / hypERk / hypoglycaemia
^ urea
anaemia 
0900 cortisol ^
^ ACTH
30
Q

Addison’s disease treatment

A

steroids: hydrocortisone / prednisolone
mineralocorticoids: fludrocortisone
at times of illness - double dosing / IV dosing (n/v)
steroid emergency card + medical alert jewellery + endocrine emergency contact card

31
Q

secondary hypoaldosteronism cause

A

renin insufficiency

32
Q

impaired glucose tolerance definition

A

Fasting glucose <7mmol/L

2h glucose 7.8-11mmol/L

33
Q

complications in acromegaly

A

children > gigantism

adults > macroglossia => obstructive sleep apnoea

34
Q

lithium toxicity complications

A

nephrogenic DI => low osmolality urine + polyuria

primary hypothyroidism

35
Q

SIADH presentation

A

oliguria

36
Q

which region of the adrenal glands produce mineralocorticoids

A

zona glomerulosa

37
Q

which region of the adrenal glands produce androgens

A

zona reticularis

38
Q

which region of the adrenal glands produce glucocorticoids

A

zona fasciculata

Y3 Clinical Case Revision (17 decks)

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