Endocrinology Flashcards
What is the endocrine system mediated by
Hormones
What kind of feedback is the endocrine system controlled by
Negative feedback
What are three basic problems with the endocrine system
Excess hormone
Reduced hormone
Physical gland enlargement
What does excess thyroxine lead to
Hyperthyroidism
What does a lack of thyroxine lead to
Hypothyroidism
What is the name given to a thyroid mass
Goitre
Does hyperthyroidism affect males or females more
females - 2-3 % of population
What is the age range for the onset of hyperthyroidism
20-40 years
What autoimmune disease results in hyperthyroidism
Graves disease
What are some symptoms on hyperthyroidism
Sweating, heat intolerance
Irritability, poor sleep, anxiety, palpitations
Excess appetite, weight loss, diarrhoee
Breathlessness
What are the signs of hyperthyroidism
Warm moist skin Tachycardia / irregular heart rate Increased BP / heart failure Fine tremor Goitre
What is exophthalmos
Protrusion on the eye balls
What is ophthalmopelgia
Paralysis of the muscles around the eye
What are exophthalmos and ophthalmoplegia signs of
Graves disease
How is hyperthyroidism diagnosed
Blood tests
Radiology sometimes
What are blood tests looking for when they are testing for hyperthyroidism
Low TSH
High T3 and T4
Auto antibodies
How is hyperthyroidism managed
Drugs - anti thyroid drugs or beta blockers
Surgery
What is the average age of diagnosis for hypothyroidism
60
Does hypothyroidism affect more men or women
Women - 2%
What are 4 causes of hypothyroidism
Auto immune
Iatrogenic
Iodine deficiency
Rarely pituitary disease
What are the symptoms of hypothyroidism
Reduced metabolism Cold intolerance Weight gain Constipation Hoarse voice Puffed face and extremities Mental slowness and poor memory Hair loss
What are the signs of hypothyroidism
Slow pulse Large tongue Deep voice Thin, dry hair / loss of eyebrows Goitre Coarsening of features
How is hypothyroidism diagnosed
Clinical exam
Blood tests
Radiology sometimes
What are the blood test for hypothyroidism testing for
High TSH
Low T4 and T3
Auto antibodies
How is hypothyroidism managed
Replacement of thyroxine with drugs - thyroxine or levothyroxine
What is a goitre
A thyroid mass
If a goitre had no associated intrinsic thyroid disease is it due to?
Iodine deficiency
If a goitre has associated intrinsic thyroid disease is it due to?
Auto immunity
How are goitres investigated?
Radiographically - ultra sound scan - radio isotope scan Fine needle aspiration Blood tests
How are goitres managed?
Treat underlying cause
Possible surgery
What are the two types of adrenal disease?
Excess corticosteroid production
Deficient corticosteroid production
What condition results from excess and deficient corticosteroid production?
Excess = cushing syndrome Deficient = Addisons disease
How is cushings syndrome managed?
Address underlying cause
Surgery possibly
What are the three causes of addison disease?
Iatrogenic - withdrawal of long term steroids
Hypothyroidism
Adrenal destruction - auto immune
What are the symptoms of acute and chronic addison disease?
Acute - usually in response to stress - infection - trauma - surgery - life threatening Chronic - general malaise
What are the signs of addison disease?
Hyper pigmentation
- buccal mucosa
- scars
- pressure points
- skin creases
How is addison disease managed?
Replacement therapy - hydrocortisone Acute addisons crisis - medical emergency - fluid replacement - glucose - hydrocortisone injection - treat infection if present
What is the name given to the condition resulting from excess growth hormone?
Acromegaly
What is acromegaly usually due to?
Pituitary gland ademona
What are the characteristic features of acromegaly ?
Large tongue Prognathism Spade like hand and feet Excess hair Thick skin Interdental separation
How is acromegaly managed?
Medically
Surgery if compressing nearby structures
May need radiotherapy
Two types of diabetes and % of population affected?
Type 1 = 10%
Type 2 = 90%
Can diabetes be asymptomatic?
Yes
DKA signs and symptoms?
Impaired consciousness
Dehydration
Ketones on breath
DKA diagnosis?
Ketone in urine
High blood glucose levels
What can cause a hypo?
Taken insulin with out glucose intake
Occasionally due to tablets
