Endocrinology Flashcards
Posterior lobe hormones
ADH (vasopressin)
Oxytocin
Pituitary adenoma
Classic : bitemporal hemianopsia
Elaine had this
Prolactinoma
Galactorrhea
Menstrual irregularity or amenorrhea
Infertility
MRI to make diagnosis
Prolactin > 200
Tx: dopamine agonist - cabergoline
Acromegaly
Insidious course
High growth hormone for several years
First test for diagnosis: “IGF-1” ***
Then confirm lesion on MRI
Tx: surgical resection
Dwarfism
Mutation of FGFR3
Diabetes insipidus
Failure to secrete ADH (concentrator of urine)
Polydipsia
Polyurea
Persistent thirst with dilute urine
Dx: 24 h urine, water deprivation test and desmopressin test
**LITHIUM side effect ***
DI treatment
Central: desmopressin
Nephrogenic: thiazides
Pituitary gland – anterior lobe hormones
Growth hormone Prolactin TSH LH FSH ACTH
Subacute thyroiditis
Dequervains thyroiditis
40-50 yo woman usually
With recent viral illness (trigger)
Hallmark: neck pain with or without fever- tender thyroid
Thyrotoxic symptoms
Tx: NSAIDs first line
Hyperthyroidism
Graves’ disease
Toxic multinodular goiter
Toxic adenoma
Low TSH and high T4 and T3
Treatment
Methimazole or propylthiouracil
Radioactive iodine
Graves’ disease classic findings on exam
Exophthalmos
Pretibial myxedema
Hypothyroidism
Hashimoto’s thyroiditis
High TSH, low T4
Thyroid cancer
Pt with childhood neck radiation
With rapidly growing nodule and hoarse voice, neck lymphadenopathy.
Thyroid nodule – what testing?
TSH first
If normal TSH – Ultrasound
If TSH low– thyroid scan
FNA biopsy for all is most accurate
Primary hyperparathyroidism
Bones, stones, groans, psychic moans and fatigue overtones
Hallmark is hypercalcemia
High PTH level 24 urine for calcium and creatinine DEXA scan Vitamin d screening Tx: observation or If severe - meds and surgery
