Lecture 3: Endocrine - History and Exam Flashcards
Viscerosomatic reflex for thyroid is what levels?
T1-4
Most common cause of hypocalcemia?
Hypoparathyroidism
Chvostek Sign vs. Trousseau’s Sign?
Chvostek Sign = tapping on the Cheek near facial nerve and eliciting twitching at the corner of mouth
Trousseau’s Sign = when you use a Torniquet like BP cuff and as you inflate the cuff the wrist will flex and fingers come together
*Both signs of hypoparathyroidism: hypocalcemia!
What is most common cause of 1° hyperparathyroidism?
Adenomas - may be associated with MEN 1
What leads to 2° hyperparathyroidism?
Low Ca2+ causes high PTH (i.e., renal failure, vit D defeciency, malabsorption)
What’s the mnemonic for Hyperparathyroidism: Hypercalcemia?
Stones: renal or biliary
Bones: bone pain
Groans: abdominal pain, nauseau, vomting
Thrones: polyuria resulting in dehydration
Psychiatric overtones: depression, anxiety, cognitive dysf., insomnia)
What is the most common cause of Hypothyroidism?
Hashimoto’s thyroiditis (autoimmune)
What is the most common cause of Hyperthyroidism?
Grave’s disease (autoimmune)
What is the USPSTF recommendation for screening people for thyroid dysfunction?
No recommendation - Grade: I statement (insufficient evidence)
What is Primary vs. Secondary Adrenal Insufficiency?
Primary: cortisol underproduction from adrenal gland
- Autoimmune, TB, cancer cells
Secondary: due to lack of ACTH
- Suddenly stopping exogenous glucocorticoids
Symptoms of Addison’s disease?
- Skin darkening (hyperpigmentation)
- N/V/D in about 50% of cases
- Salty food craving
- Hypotension
What condition is this usually seen in?
- Addison disease
- Adrenal Insufficiency
What is Addisonian Crisis/Acute Adrenal Insufficiency?
- Usually appears at time of stress (illness, surgey, etc.)
- Sudden penetrating pain of back, extremities, vomiting, diarrhea
What is Cushing’s; what forms are there?
- Adrenal (cortisol) overproduction
- Has both endogenous and exogenous causes
What is the most common cause of endogenous adrenal (cortisol) overproduction?
- Cushing’s disease
- Often times a Pituitary tumor
Signs and Symptoms of Cushing Syndrome?
- A round (moon-shaped) and/or red face
- Purplish streaks across the skin (“striae”)
- Buffalo hump
- Unusual buildup of fatty tissue in the abdominal area
- Easy bruisiing
- Excess facial/body hair growth (hirsutism)
What is the differene between Cushing’s syndrome and Cushing’s disease?
- Cushing’ Syndrome refers to the condition causes by excess cortisol in the body, regardless of the cause
- Cushing’s Disease refers to Cushing’s Syndrome caused by a pituitary tumor
Cushing’s Syndrome vs. Addison’s Disease?
Cushing’s: Adrenal (cortisol) overproduction
Addison’s: Adrenal insufficiency (cortisol underproduction)
What are TSH, T3, and T4 levels like in hyperthyroidism vs hypothyroidism?
Hypothyroidism: High TSH, Low T3, and T4
Hyperthyroidism: Low TSH, High T3 and T4
Type I vs. Type II DM?
Type I: Pancreas doesn’t produce enough insulin
Type II: Body’s cells can’t let the insulin in to use it (insulin resistant)
Common presenting signs/symptoms of DM?
- Urinating often
- Feeling very thirsty
- Extreme fatigure
- Blurry vision
- Feeling very hungry - even though you are eating
- Weight loss - even when eating more
What are some of the consequences of untreated DM?
- Frequent infections (UTI, vaginal, skin)
- Retinopathy –> blindness
- Nephropathy –> kidney failure
- Neuropathy of feet and hands –> ulceration, infection, gangrene
- Vascular changes
What is this and what condition is it associated with?
- Acanthosis nigracans
- Diabetes
How do you screen for diabetic neuropathy?
- Using a 10g monofilament x every 6 months
