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Year 3 > MedEd thyroid and misc endo > Flashcards

MedEd thyroid and misc endo Flashcards

1
Q

What cells produce T3 and T4?

A

Follicular thyroid cells

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2
Q

What does negative feedback to the pituitary?

A

T3 and T4

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3
Q

What are hyperthyroid symptoms?

A 
Tremor 
Anxiety
Palpitations
Diarrhoea
Oligomenorrhea
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4
Q

What are hypothyroid symptoms?

A 
lethary
weight gain
cold intolerance
constipation
menorrhagia 
reduced deep tendon reflexes
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5
Q

What are causes of hyperthyroid?

A

Graves
toxic multinod goitre
viral thyroiditis
drugs

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6
Q

What drug causes hyperthyroidism?

A

Amiodarone

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7
Q

What are causes of hypothyroid?

A

hashimotos
de quervains thyroiditis (subacute)
drugs
iodine deficiency

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8
Q

what drugs cause hypothyroidism?

A

amiodarone

lithium

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9
Q

How is hyperthyroid amanged?

A

Propanolol
Carbimazole
Radioiodine

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10
Q

How does carbimazole work in hyperthyroidism?

A

It is a TPO inhibitor and TPO is needed to make thyroxine

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11
Q

What is a side effect of carbimazole?

A

angranulocytosis ie no neutrophils

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12
Q

how is hypothyroidism managed?

A

Levothyroxine

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13
Q

what causes exopthalamos?

A

anti TSH receptor antibodies binding to TSH receptors behind the eyes

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14
Q

what are the defining features of graves?

A

bilateral exopthalamos
lid lag
pre tibial myexodema
thyroid acropachy

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15
Q

what are features of thyroid cancer?

A 
non functional
painless
rapidly growing 
solitary 
irregular in shape 
palpable nodule thats hard and fixed
hoarse voice 
dysphagia
haemoptysis 
airway obstrcution
cervical lymohadenopathy
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16
Q

what is the most common thyroid cancer?

A

papillary carcinoma

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17
Q

what are defining features of thyroid cancer?

A

hoarse voice

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18
Q

what is seen on hisotology in papillary thyroid cancer?

A

psammoma body

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19
Q

what thyroid cancer is associated with low dietary iodine intake

A

follicular carcinoma

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20
Q

what thyroid cancer is associated with MEN 2A and MEN 2B

A

medullary

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21
Q

what is the GS ix for thyroid cancer?

A

fine needle aspiration with biopsy

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22
Q

what is MEN 1 syndrome? what organs and cells are involved

A

parathyroid adenomas which are functional
pancreatic islet cells
pituitary problems eg prolactinoma
other cells can also be involved

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23
Q

what 3 cells/organs are involved with MEN 1 syndrome?

A

parathyroid gland
pancreas
pituitary

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24
Q

what are hypercalcaemia symtpoms?

A

stones
abdo groans
bones
psychic moans

25
Q

what is GS ix for MEN 1 syndrome?

A

CT/MRI body

26
Q

what causes non MEN 1 gastrinomas?

A

zollinger ellinson syndrome

27
Q

what characterises MEN 2A and 2B?

A

meduallry thyroid cancer

28
Q

what organs/cells are involved with MEN 2A?

A

parathyroid

phaeochromocytoma

29
Q

what tumors/features are involved with MEN 2B?

A

phaeochromocytoma
neuromas
marfanoid habitus

30
Q

what MEN syndrome is someone with marfans like habitus likely to have? what are some examples of this?

A 
MEN 2B 
tall stature
pectus excavatum
long limbs 
eye problems
31
Q

what is GS ix for MEN 2A and 2B? what else might you do

A 
genetic testing for RET oncogene
might also do:
calcitonin
urine catecholamines 
CT/MRI
32
Q

what gene is tested for in MEN 2A and B?

A

RET oncogene

33
Q

what are the types of MEN syndrome, what are they associated with and hwo do you remember this?

A

MEN 1- parathyroid, pancreas, pituitary (3Ps)
MEN 2A- phaeo, parathyroid (2Ps)
MEN 2B- phaeo, neuromas, marfanoid habitus (1P)

3Ps, 2Ps, 1P

34
Q

what is the most common feature of carcinoid syndrome?

A

flushing

35
Q

what is carcinoid syndrome? ie how does it arose

A

uncontrolled division of neuroendocrine tumors which mets to the liver

36
Q

what is there buildup of in carcinoid syndrome?

A

serotonin
bardykinin
histamine

37
Q

what are features of carcinoid syndrome?

A 
flushing 
dairrhoea
SOB
pulmonary stenosis 
abdo pain
itching
38
Q

how fastly do tumors grow in carcinoid syndrome

A

slow growing

39
Q

what gene mutation is carcinoid syndrome associated with?

A

MEN 1 mutation

40
Q

what are ix for carcinoid syndrome?

A

urinary 5-HIAA
CT scan
ocreotide scan- specific

41
Q

what is a specific ix for carcinoid syndrome?

A

ocreotide scan

42
Q

describe what LH acts on in males v females and what it produces

A

males: acts on leydig cells, makes testosterone
females: acts on theca cells, makes progesterone

43
Q

describe what FSH acts on in males v females and what it produces

A

males: acts on sertoli cells and makes sperm (spermatogenesis)
females: acts on granulosa cells and makes oestrogen

44
Q

what are features of PCOS?

A

hirtuism
oligomenorrhea
polycycstic ovaries
infertility/trouble concieving

45
Q

what causes physiological hypogonadism?

A

pregnancy

46
Q

what causes negative feedback onto the gonadotrophs on the anterior pituitary

A

LH and FSH

47
Q

what is a defining symptom of kallmanns syndrome hypogonadism

A

anosmia

48
Q

where are gonadotrophs found

A

anterior pituiatry

49
Q

what are some causes of primary hypogonadism in females

A

degenesis of the gonadotrophs eg turners
gonadal damage
primary ovarian failure
pcos

50
Q

what are some causes of secondary hypogonadism

A 
kallmann syndrome
pituitary or hypothalamic tumor 
hyperprolactinaemia 
functional (low bmi, excess exercise, stress)
ocp use
51
Q

what are some causes of primary hypogonadism in males

A

gonadal degenesis eg klinefelters, cryptorchidism
gonadal damage
post orchitis eg mumps

52
Q

what are features of hypogonadism?

A 
delayed puberty
infertility
reduced libido 
amenorrhea
night sweats/hot flushes
erectile dysfunction
symptoms of cause eg visual changes if tumor
53
Q

what ix are done for hypogonadism?

A 
preg test
LH/FSH
prolactin
testosterone/oestradiol
TFTs
karyotyping
MRI
54
Q

what does gnrh stimulate the production of and where does it act?

A

growth hormone- acts on all organs

igf-1- made in organs and also acts everywhere

55
Q

what is acromegaly usually caused by?

A

pituitary adenoma

56
Q

what are features of acroomegaly

A 
coarse facial features
large tongue
large jaw
spade like hands and feet
excess sweating 
organomeagly 
headaches, visual disturbance (bitemp hemianopia), hyperprolactinaemia etc- due to tumor
57
Q

what are common complications of acromegaly?

A

carpal tunnel syndrome
colorectal cancer
diabetes
hypertension

58
Q

what investigation is done to diagnose acromegaly? what is seen?

A

OGTT

there will be a paradoxical rise in GH if the patient has acromegaly

59
Q

how is acromegaly managed? give GS and other treatments

A

GS: trans sphenoidal surgery to resect tumor

can also do radiotherapy, somatostatin analogues, dopamine receptor agonists and GH receptor antagonists

Year 3 (104 decks)

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