Endocrinology from PANCE Pearls Flashcards
What is Hyperthyroidism and what does it do in your body
High T3/T4 Increases Metabolism Increases glucose absorption from GI Catabolic effect on muscle mass Increased CO and RR Increased Catecholamine levels Increased Oxygen Consumption
What is the most common cause of Hyperthyroidism
Graves
Autoimmune
Antibodies against TSH receptor
What is a common cause of Hyperthyroidism in the elderly
Toxic Nodular Goiter
Leads to thyrotoxicosis (Increased T3/T4)
Sx of Hyperthyroidism
Anxiety, Emotional Lability, Weight loss, Weakness, Tremor, Palpitations, Heat Intolerance, Warm, Moist Skin, Thin Hair, Tachycardia, Fine Resting Tremor, Hyper-reflexia
What is a unique sx seen in Graves
Exophthalmos
Proptosis, Lid Lag, Eyes Bulging
Dx of Hyperthyroidism
Low TSH
High T3/T4
If graves, see TSH Ig Antibodies
Tx of Hyperthyroidism
Anti-Hormonal Therapy: PTU (propylthiouriacil) or Methimazole Radiactive Iodine destroys gland
Which of the tx for Hyperthyroidism can be used during pregnancy
PTU
What drugs can you use to curb sx of Hyperthyroidism
Beta Blockers: Propranolol, decreases HR and BP
Glucocorticoids prevent conversion of T4 to T3
Dx of TSH secreting pituitary adenoma
High TSH
High T3/T4
MRI to look for pituitary mass
Tx of TSH secreting pituitary adenoma
Transphenoidal surgery to remove pituitary tumor
What is Hyperparathyroidism
Overactive Parathyroid glands that lead to increased calcium absorption
What is primary Hyperparathyroidism and what causes it
Excess inappropriate PTH production
Parathyroid Adenoma is the most common cause
What is secondary Hyperparathyroidism and what causes it
Increased PTH due to hypocalcemia or Vitamin D deficiency
Chronic Kidney Failure is the most common cause
Sx of Hyperparathyroidism
Bones, Stones, Groans and Psychic Groans
Bone pain, Kidney stones, Abdominal Pain Constipation, Depression and Confusion
Dx of Hyperparathyroidism
Increased PTH Hypercalcemia Decreased Phosphate Check 24 hour urine calcium excretion Osteopenia on bone scan
Tx of Hyperparathyroidism
Surgery
Parathyroidectomy
Vitamin D/Calcium supplement if secondary
What is Hypoparathyroidism
Due to low PTH or Insensitivity to its action