Endocrinology- micellaneous Flashcards
Acromegaly
- Definition
- Causes
- Signs and symptoms
Definition
- Excess GH in adults
Causes
- Pituitary tumour stimulating XS GH release (pituitary somatotroph adenoma)
- Ectopic production of GH or GHrH.
Symptoms
- Coarse facial features
- Acroparaesthesia
- Amenorrhea
- Snoring
- Arthralgia
- Sweating
- Hypertension
- Diabetes
- Decreased libido
Function of GH
Stimulates bone and soft tissue growth
- Via IGF-1
Acromegaly investigations
Bloods
- Hyperglycaemia
- Hypercalcaemia (bone turnover)
- Hyperphosphataemia (bone)
GH glucose test
What is the most common type of thyroid cancer?
Papillary carcinoma (75%)
Papillary carcinoma of the thyroid typically metastasises via…
Lymphatics
What population of people does thyroid papillary carcinoma typically affect?
Younger women (35-40)
What thyroid cancer has the worse prognosis
Anaplastic carcinoma
Medullary carcinoma of the thyroid arises from what cells/ tissue?
Parafollicular C cells
Medullary carcinoma of the thyroid produces what 2 things?
Calcitonin
CEA
What thyroid cancer is associated with the MEN2A and 2B syndrome
Medullary carcinoma
Follicular carcinoma of the thyroid spreads via ______ and is most likely to metastasise to what areas?
Spreads via blood (haematogenically)
- Metastasises to BLL (bone, liver, lung)
What is the 2nd most common type of thyroid cancer?
Follicular carcinoma
Anaplastic carcinoma of the thyroid typically affects what population of people?
Older people (60+)
Risk factors of thyroid cancer
Exposure to ionising radiation (i.e. neck radiotherapy)
Family history of thyroid disease
Female
Previous thyroiditis
MEN2 syndrome
Serum _____ is typically elevated in medullary carcinoma of the thyroid
Calcitonin
Indications of 2-week referral for thyroid cancer
Unexplained thyroid lump/ nodule
Thyroid mass with unexplained voice hoarseness/ voice changes
Thyroid mass with supraclavicular/ cervical lymphadenopathy
Unexplained painless thyroid mass increasing rapidly in size
Thyroid nodule with compression signs
Presentation of a thyroid cancer
Hard, non tender thyroid nodule
Cervical lymphadenopathy (especially in papillary)
Voice hoarseness/ stridor
What thyroid cancer typically grows rapidly?
Anaplastic carcinoma
What are the three phases of de Quervain thyroiditis?
- Transient thyrotoxicosis (4-6 weeks)
- Transient hypothyroidism (2-6 months)
- Euthyroidism
What are the biochemical findings in de Quervain thyroiditis
Thyrotoxicosis phase
- Raised T3 and T4
- Raised ESR, CRP
- Reduced thyroid radioiodine uptake
Hypothyroid phase
- Low T3, T4
- May show thyroid peroxidase antibodies
What are the histological findings of de Quervain thyroditis
Giant cell granulomatous inflammation
de Quervain thyroiditis is typically triggered by…
Viral upper respiratory tract infection
What are the conditions included in Multiple endocrine neoplasia, Type 1 (MEN1 syndrome)
3Ps
Pituitary adenoma
Parathyroid hyperplasia
Pancreatic tumours
What are the conditions included in Multiple endocrine neoplasia, Type 2A (MEN2A syndrome)
Ps over M (2Ps and 1M)
Medullary carcinoma of the thyroid
Phaeochromocytoma
Parathyroid hyperplasia
What are the conditions included in Multiple endocrine neoplasia, Type 2B (MEN2B syndrome)
Ms over P (3Ms, P M)
Mucosal neuromas
Marfanoid habitus
Medullary thyroid cancer
Phaemochromocytoma
