Endocrinology Flashcards
what is a simple colloid goitre a result of?
iodine deficiency
what is the overall effect of PTH?
increases calcium and decreases phosphate
albumin is usually normal or low
as PTH increases bone turnover by stimulating osteoclast activity, ALP is usually elevated
what symptoms does high calcium cause?
weak, tired, depressed
what is secondary hyperparathyroidism caused by?
decreased vit D intake or chronic renal failure
the resulting reduction in calcitrol causes hypocalcaemia and raised PTH secondary to this
what causes primary hyperparathyroidism?
parathyroid adenoma or MEN syndromes
what are the results for bone metastases with regards to calcium and phosphate?
hypercalcaemia, normal or low albumin, and raised ALP, phosphate elevated or normal
what are the results of vit D excess?
hypercalcaemia, hyperphosphataemia, ALP usually normal
what are the results of myeloma with regards to calcium and phosphate and ALP?
hypercalcaemia, hyperphosphataemia, and normal ALP
what is the classic triad of Grave’s disease?
pretibial myxoedema, thyroid ophthalmopathy, thyroid acropachy
which variant of endocrine malignancy has the worst prognosis?
anaplastic thyroid cancer - 50% of thyroid cancer mortality
which variant of endocrine malignancy carries a relationship with MEN?
medullary - they originate from parafollicular thyroid cells and secrete calcitonin
which variant of endocrine malignancy mainly spread via blood?
follicular
fine needle aspiration cytology does not suitably discern whether which endocrine variant malignancy is malignant or not?
follicular - excisional biopsy is required
which variant of endocrine malignancy occurs in iodine-rich areas of the thyroid gland?
papillary
what is the result of elevated cortisol levels with regards to calcium and phosphate and PTH?
hypocalcaemia and hyperphosphataemia and secondary hyperparathyroidism
a 19 yea old man is brought to the ED unconscious. the patient’s breath smells of fruit punch. the patient was holding a glass containing clear liquid and the ambulance attendance had noted a syringe on the patient’s coffee table and a pool of vomit near the patient. what is the diagnosis?
diabetic ketoacidosis - acetone on the breath suggests ketoacidosis
excessive thirst explains the empty glass of water and the syringe is most likely insulin
what is acromegaly and what are its 2 associations?
hypersecretion of growth hormone and a/w insulin resistance and diabetes
what is psammoma calcification diagnostic for?
papillary thyroid cancer
why is there hyperpigmentation in Addison’s?
there is an increase in ACTH which causes hyperpigmentation as it has the same precursor as melanocytes-stimulating hormone
what is another name for primary hyperaldosteronism?
Conn’s syndrome
what is the clinical presentation of Conn’s syndrome?
HARPS:
hypertension, aldosterone is raised, renin is lowered, potassium is decreased, sodium raised
what is the most common cause of Addison’s disease?
autoimmune destruction
how is the dose of levothyroxine changed in pregnaancy?
increase does of levothyroxine and refer to specialist
which quadrants do craniopharyngiomas and pituitary adenomas affect?
cranio > inferior temporal
pituitary > superior temporal
which test is used for Addison’s?
synacthen test - cortisol level is measured before and after ACTH admin - failure of cortisol to increase after admin suggests Addison’s
what is the investigation for growth hormone deficiency?
insulin tolerance test
