History and Exam for the Endocrine Patient Flashcards
What is the most common cause for hypocalcemia?
Hypoparathyroidism
What are some symptoms of Hypoparathyroidism?
- NEUROPSYCH: Seizures, dementia, anxiety, depression, exprepyramidal symptoms, papilledema
- NUEROMUSCULAR: Parethesias around mouth and fingers/toes, muscle stiffness, myalgias and spasms
- CV: CHF, hypotension, prolongation of QT interval
- AUTONOMIC: Biliary colic, bronchospasms, diaphoresis
- OTHER: Cataracts, dry coarse skin, hyperpigmentation, eczema, steatorrhea
What are two signs to check for Hypocalcemia?
- Chovstek Sign: Tapping on Facial Nerve
2. Trousseau’s Sign: Spasm of Hand with inflation of blood pressure cuff
What are some common causes of Hypercalcemia? List some of the associated symptoms.
Hyperparathyroidism or Malignancy
“Bones, Groans, Abdominal Moans and Psychic Groans”
- CNS: Lethargy, weakness, confusion, coma
- Renal: Polyuria, dehydration, nocturia, renal stones, renal failure
- GI: Constipation, nausea, anorexia, gastric ulcer, pancreatitis
- Cardiac: Syncope from arrhythmias
What happens to TSH when T3 and T4 go up?
TSH should go down
What are the hormone levels for HYPOthyroidism? What are some causes?
HIGH TSH, LOW T3 and T4
- Hashimoto’s thyroiditis (MOST COMMON cause and it is autoimmune)
- Medications
- Pregnancy
- Thyroidectomy
What are the symptoms of Hypothyroidism?
Constipation, depression, fatigue, pale skin, sensitivity to cold, elevated cholesterol levels, weight gain, brittle nails and hair
What are the hormone levels for HYPERthyroidism? What are some causes?
LOW TSH, HIGH T3 and T4
- Grave’s Disease (MOST COMMON cause and it is autoimmune)
- Toxic nodular or multinodular goiter
- Thyroiditis
- Excessive consumption of iodine or meds
- Pregnancy or first year after birth
What are the symptoms of Hyperthyroidism?
Fatigue or muscle weakness, hand tremors, mood swings, nervousness or anxiety, rapid heart rate, heat intolerance (hot all the time), thinning of heat, light or missing periods, trouble sleeping, skin dryness, GOITER
What is a classic presentation for Grave’s Disease?
Exopthalmos/Proptosis (HYPERTHYROID)
What is a side effect of Long-Term HYPOTHYROIDISM?
Myxedematous Facies
Differentiate between Primary and Secondary Addison’s disease.
“Adrenal Insufficiency”
Primary: 70% (autoimmune) and 20% (Due to TB); Chronic infections, surgical removal, cancer cells affecting adrenals
Secondary: LACK of ACTH; surgical removal of ACTH-producing tumors from pituitary glands; Pituitary glands just stop making ACTH
What are the symptoms in Addison’s Disease?
Chronic worsening fatigue and muscle weakness, weight loss, loss of appetite, salt food cravings, SKIN DARKENING on their PALMAR CREASES and on the Palate, Hypotension (LOW Na and HIGH K), Irritability, Hypoglycemia
What are some possible causes for Cushing’s Syndrome?
“TOO Much Adrenal Activity”
Endogenous: Pituitary Tumor (70%), Adrenal Tumor (15%), Other unknown causes (10%)
Exogenous: Taking medicines containing glucocorticoids (i.e. hydrocortisone)
What are some common signs of Cushing Syndrome?
- Round (moon-shaped) face and/or red face
- Striae
- Buffalo hump
- Unusual build-up of fatty tissue in the abdominal area with thin arms and legs
- Easy Bruising
- Excess facial/body hair growth in women (called “Hirsutism”)
