Lecture 2: Approach to Endocrine Disorders II

Question 1

What does primary disease mean?
What are secondary diseases indicative of?
What are tertiary diseases associated with?

Answer 1

• Defect at the level of the downstream gland
• Problem with pituitary gland
• Dysfunction of hypothalamus and its releasing of hormones

Question 2

What are some causes of hyperfunction (too much hormones)?

Answer 2

Neoplastic growth of endocrine cells
Autoimmune issue
Excess hormone administration

Question 3

What are some causes of hypofunction (deficient in hormones)?

Answer 3

Autoimmune destruction
Tumor infiltration 
Infection
Inflammation
Hemorrhage

Question 4

What are some causes of hormone resistance?

Answer 4

genetic defects, immunological mechanisms

Question 5

What test assesses endocrine hyperfunction? What is the main treatment goal?

What test assesses endocrine hypofunction? What is the main treatment goal?

Answer 5

Suppression tests, suppress excessive hormone

Stimulation tests, stimulate/replace deficient hormone

Question 6

What are symptoms of hyperthyroidism?

Answer 6

generally: increased metabolism
WHAT PHAD

Weight loss
Heat intolerance
Anxiety
Tremor

Palpitations
Hunger
Amenorrhea
Diaphoresis (sweating)

Question 7

What can cause hyperthyroidism?

Answer 7

Got Too-much TSH

Grave's Disease
Toxic multinodular goiter
Toxic adenoma
Subacute thyroiditis
Hashimoto's thyroiditis

Question 8

What are symptoms of hypothyroidism?

Answer 8

generally: decreased metabolism

FADD Wx3 IC

Fatigue
Weight gain
Anorexia
Dry, coarse skin
Cold intolerance
Depressed mood
Weak hair
Impaired memory
Weakness, muscle cramps

Question 9

What can cause hypothyroidism?

Answer 9

HISC

Hashimoto’s thyroiditis
Iodine deficiency
Severe illness
Certain drugs

Question 10

What are some classic symptoms of Grave’s Disease?

Answer 10

Proptosis

Exophthalmos

Question 11

What are symptoms of classic hyperparathyroidism (HPTH)?

Answer 11

Stones: increased risk of kidney stones
Bones: weaker bones since calcium removed from bone
Groans: abdominal pain

Question 12

Why is PTH important in Vitamin D synthesis?

Answer 12

PTH activates active Vitamin D via 1-α hydroxylase in kidney so Vitamin D can facilitate Ca2+ reabsorption in the intestines

Question 13

What tests can be used to assess for hypocalcemia?

Answer 13

Trousseau’s Sign
Chvostek’s Sign

(usually not used clinically)

Question 14

What are symptoms of hypocalcemia?

How about hypercalcemia?

Answer 14

Muscle spasticity/overactivity

Muscle weakness

Question 15

What characterizes Cushing’s Syndrome?

Answer 15

Excess of cortisol

Question 16

What are symptoms of Cushing’s Syndrome?

Answer 16

CHEW fat PDH

HTN
Central obesity
Weakness
Ecchymosis
Hirsutism
Depression
Purple Striae

Moon shaped face, buffalo hump, abdominal fat

Question 17

What characterizes Addison’s Disease?

Answer 17

insufficient production of steroids/adrenal hormones

can be primary or secondary

Question 18

What are the causes of hyperparathyroidism?

Answer 18

Parathyroid problem: adenoma, hyperplasia, carcinoma
MEN (multiple endocrine neoplasia) sydromes
Chronic renal failure

Question 19

What are the symptoms of Adrenal insufficiency?

Answer 19

Hyperpigmentation (as in Addison’s)