Endrocrine

Question 1

Adrenal insuffiency

Answer 1

Primary:
Autoimmune adrenalitis (most common)
Polyglandular autoimmune syndromes 
Infection (Tb/HIV)
Haemorrhage (waterhouse frederichsen in meningococcal sepsis)
Drug induced (ketoconazole)
Infiltration (sarcoidosis, metastases, amyloid)
Congenital adrenal hyperplasia
X-linked adrenoleukodystrophy

Secondary:
Panhypopituitarism
Abrupt cessation of exogenous steroids
Pituitary or hypothalamic disease

Question 2

Thyrotoxicosis

Answer 2

Graves disease
Multi-nodular goitre
Toxic functioning adenoma
Thyroiditis 
- hashimotos
- subacute (painful)
- Reidels
- postpartum
Iodine induced (Jod Basedow effect - increased hormone production on iodine replacement after period of iodine deficiency)
Drugs (amiodarone, lithium)
Exogenous thyroid hormone
Secondary hyperthyroidism (rare)

Question 3

Goitre

Answer 3

Idiopathic
Pregnancy/postpartum/puberty
Graves disease
Thyroiditis - hasimotos, reidels, subacute
Iodine deficiency
Goitrogens (iodine excess, drugs e.g. lithium)
Inborn errors of thyroid hormone synthesis

Question 4

Hirsutism

Answer 4

Constitutional (normal)
Polycystic ovarian syndrome
Cushings
Congenital adrenal hyperplasia
Stromal ovarian tumors
Drugs: phenytoin, diazoxide, corticosteroids, androgens, testosterone
Acromegaly

Question 5

Thyroid nodules

Answer 5

Carcinoma
- Anaplastic (bad)
- Folicullar
- Papillary (most common)
- Medullary
Adenoma
Multi-nodular goitre

Question 6

Hypothyroidism

Answer 6

Primary
With a goitre (decreased synthesis of thyroid hormone)
- Chronic thyroiditis
- Drugs: Lithium, Amiodarone
- Endemic iodine deficiency
- Inborn errors
Without a goitre (decreased or absent thyroid tissue)
- idiopathic atrophy
- Agenesis or lingual thyroid
- Post- treatment - radioactive iodine, surgery

Secondary: pituitary lesions
Tertiary: Hypothalamic lesions

Transient:

• withdrawal of thyroid hormone treatment
• subacute thyroiditis
• postpartum thyroiditis

Question 7

Neck swelling

Answer 7

Midline:
Goitre - moves up with swallowing
Thyroglossal cyst - moves with tongue protrusion
Submental Mass
Parathyroid gland (rarely)

Lateral:
Lymphadenopathy
Salivary glands (stone, mass)
- submandibular
- parotid
Skin - lipoma, sebaceous cyst
Carotid artery aneurysm, tumour (pulsatile)
Pharynx: pharyngeal pouch, branchial cyst