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Priority 1 > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Secondary and tertiary causes of hypothyroidism

A

Secondary:
Hypopituitarism
Impaired TSH synthesis

Tertiary:
Hypothalamic damage (tumours, surgery, radiotherapy)
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2
Q

Causes of hyperthyroidism

A 
Primary (high T3/4, low TSH):
Graves disease
Toxic multinodular goitre
Toxic adenoma
Exogenous (iodine excess)
Ectopic thyroid tissue
Thyroid follicular carcinoma
Drugs (amiodarone, lithium)
Postpartum

Secondary (high T3/4, high TSH):
TSH-secreting pituitary tumour

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3
Q

Signs and symptoms of insulinoma

A

Hypos when ordinarily would be fine
Whipple’s triad
CNS and GI phenomena

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4
Q

Presentation of hypothyroidism

CHAMPS

A

C - change in bowels (constipation)
H - hair loss
A - appetite / weight (decrease in appetite, weight gain)
M - menstruation (increase, menorrhagia)
P - prefers temperature (hot - cold intolerance)
S - skin changes (cold, dry, loss of outer 1/3 eyebrows)

Plus:
Tired, sleepy, lethargic, low mood, hoarse voice, decreased memory/cognition, dementia, myalgia, cramps, weakness, poor libido

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5
Q

Thyroid pathology

A

Hypothalamus (TRH)->
Anterior pituitary (TSH) ->
Thyroid gland (T3 & T4)
Peripheral conversion of T4 to T3

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6
Q

What is insulinoma?

A

Benign islet cell tumour, sporadic or MEN

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7
Q

Complications of hyperthyroidism

A 
HF
Angina
AF
Osteoporosis
Exophthalmos
Gynaecomastia 
Thyroid storm
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8
Q

Conditions associated with hypothyroidism

A 
Other autoimmune (T1DM, Addison's, PA)
Downs and Turners
CF
Primary biliary cirrhosis
Ovarian hyper-stimulation
POEMS syndromes
Pregnancy problems
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9
Q

Investigations in thyroid disease

A 
T3/4
TSH
T3/4 ratio
Hyperglycaemia
Hypercalcaemia
Elevated ALP
Leukocytosis
Elevated liver enzymes
Cortisol raised
Thyroid antibodies
Radioiodine uptake scans
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10
Q

3 types of thyroid cancer

P, F, M

A 
Papillary (60%)
Follicular (25%)
Medullary (5%)
Lymphoma (5%)
Anaplastic (rare)
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11
Q

Management of hyperthyroidism

A 
Decreasing T4->T3 conversion
Propranolol - symptomatic relief 
Potassium perchlorate - used in amiodarone-induced thyrotoxicosis
Radioiodine ablation
Thyroidectomy
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12
Q

Lumps in the thyroid

A

Diffuse goitre (endemic, congenital, secondary to goitrogens, acute thyroiditis, physiological, autoimmune

Nodular goitre (multinodular, fibrotic)

Solitary thyroid nodule (cyst, adenoma, malignancy)

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13
Q

Signs of Graves disease

A

Eye disease: exophthalmos, ophthalmoplegia
Pretibial myxoedema
Thyroid acropachy

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14
Q

Primary causes of hypothyroidism

A 
Hashimotos
Primary atrophy hypothyroidism
iodine deficiency
Post-thyroidectomy/radioiodine
Drugs induced (anti-thyroid drugs)
Subacute thyroiditis
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15
Q

Classification of hyperlipidaemia

A

Primary:
Idiopathic
Familial

Secondary: 
Hypothyroidism
Diabetes
Renal disease
Liver disease
Alcohol
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16
Q

Targets of thyroid treatments

A 
Stop hormone synthesis
Release
Conversion from T4->T3
Control symptoms
Control systemic decompensation with supportive therapy
17
Q

What is a thyroglossal cyst?

A

Embryological remnant
Fluctuating swelling in/near midline
Moves upwards when patient protrudes tongue (attached to tract of thyroid)
Moves on swallowing (attached to larynx)

18
Q

Signs and symptoms of hypoglycaemia

A

Whipple’s triad:
During starvation
Hypoglycaemia
Relieved by sugar

Autonomic/early:
Sweating, anxiety, tremor, palpitations, dizziness

Neuroglycopenic/later:
Confusion, personality changes, drowsiness, visual troubles, seizures, coma

19
Q

Presentation of hyperthyroidism

CHAMPS

A 
C - change in bowels (diarrhoea)
H - hair loss
A - appetite / weight
M - menstruation 
P - preferred temperature (heat intolerance)
S - skin changes (sweaty, clammy)

Plus:
Overactive, palpitations, tremor, anxious, irritable, labile emotions

20
Q

Causes of hypoglycaemia

A

DIABETIC
High insulin:
Increased activity, missed meal, overdose of medication

NONDIABETIC: EXPLAIN
Exogenous drugs
Pituitary insufficiency
Liver failure
Addison's
Islet cell tumours
Non-pancreatic neoplasms
Post-prandial - dumping syndrome
21
Q

Investigations for thyroid lumps

A 
T3 & T4
Thyroid autoantibodies
CXR
USS thyroid
Radionuclide scans
FNA and cytology
CT/MRI
22
Q

Subclassfication of hyperlipidaemia

1LP, 2LD, 3 with E, 4 gets more

A

1 - Familial, LPL deficiency, increased triglycerides

2 - LDL receptor deficiency, increased LDL

3 - ApoE deficiency

4 - VLDL, increased VLDL, pancreatitis

23
Q

Define hypoglycaemia

A

<4mmol/L

<2.2 serious

24
Q

Presentation of hyperlipidaemia

A

Incidental finding:
Opportunistic shock
Health screening
Investigation of chest pain)

Presentation with clinical sequelae:
MI
Acute pancreatitis
Xanthelasma
Corneal arcus
Tendon xanthomata

Priority 1 (17 decks)

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