Endocrinology Flashcards
What is the endocrine system controlled by?
Negative feedback
What are the main problems re. The endocrine system
Excess hormones
Reduced hormones
Physical gland enlargement
What does the pituitary gland do?
Produces thyroid stimulating hormone and regulating hormone which act on the thyroid gland
Name two thyroid diseases resulting in thyroxine excess
Hyperthyroidism
Thyrotoxicosis
What disease causes lack of thyroxine?.
Hypothyroidism
What cause thyroid mass?
Goitre
Who is hyperthyroidism likely to effect?
2-3% of women compared to 0-2% men
Younger age group- 20-40
What is an autoimmune disease of hyperthyroidism?
Graves’ disease
What are symptoms of hyperthyroidism?
Sweating,heat intolerance Irratabiltiy Poor sleep Anxiety Palpitations Excess appetite Weight loss Diarrhoea Breathlessness
What are signs of hyperthyroidism ?
Warm, moist skin Tachycardia Increased bp Fine tremor Goitre Pre tibial myxoedema
What other symptoms can be evident re. Graves’ disease?,
Side effect of the eyes Exophthalmos Ophthalmoplegia Lid lag Loss of visual activity
What can aid a diagnosis of hyperthyroidism?
Clincal
Blood test
Radiology
What would appear in blood test re. Hyperthyroidism?
Low TSH
High T3 and T4
Autoantibodies
How is hyperthyroidism managed?
Anti thyroid drugs- carbimazole, prophylhiouracil
Beta blockers re. Symptoms
Surgery- thyroid or eye
Radioactive iodine
When is radioactive iodine conteaindicated?
Pregnancy or breast feeding
What is the mean age of diagnosis re. Hypothyroidism?
60
What are the causes of hypothyroidism?
Auto immune
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- poor memory Hair loss
What are signs of hypothyroidsim?
Slow pulse Large tongue Thin, dry hair Loss of eyebrows Goitre Coarsening of features
What would be present in blood tests of hypothyroidism?
High TSH
Low t4 and t3
Autoantibodies
What are the causes of goitre?
Simple cysts- adenoma Iodine deficiency Autoimmune Toxic multi nodular Malignant- rare
What can goitre cause?
Dysphagia
Breathing difficulties
What is the managemen of goitre?
Radiology
Fine needle aspiration
Blood tests
What are the side effects of anti thyroid drugs?
Neutropenia
Taste disturbances
Name two types of adrenal disease
Cushings syndrome
Addison’s disease
What are the presenting factors of Cushing’s syndrome?
Excess corticosteroids
Excess adrenocorticotrophic hormone
Can cause adrenal adenomas, carcinomas
What are symptoms to Cushing’s disease?
High bp
Diabetes
Prone to infections
What is Addison’s disease a result from?
Withdrawal from long term steroids
Hypopituitarism
Adrenal destruction- auto immune disease
What are symptoms of chronic addisons?
General malaise Hyperpigmentation- Buccal mucosa Scars Pressure points Skin creases
What are symptoms of acute addisons?
In response to stress---- Shock Vomitting Abdominal pain Confusion Hypoglycaemia
Management of addisons?
Replacement therapy- hydrocortisone 2x daily
Fluorocarbons one
What is the management of acute addisons?
Fluid replacement
Glucose
Hydrocortisone injections
999
What considerations dentally re. Cushing’s?
Poor wound healing
Oral infections
Dose increase re tx
What are the characteristics of acromegaly?
Large tongue
Interdental separation
Prognathism
Large spade like hands and feet
What is the endocrine system mediated by?
Hormones
