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Endocrine System > Summary > Flashcards

Summary Flashcards

1
Q

Describe hyperthyroidism

A

Overproduction of thyroid hormones T3 and T4
Thyrotoxicosis effects of abnormal or excessive amounts of thyroid hormone

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2
Q

What are the symptoms of hyperthyroidism?

A

Weight loss, heat intolerance, fatigue, insomnia, sexual disfunction, goitre, and brisk reflexes

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3
Q

What is the treatment for hyperthyroidism?

A

Carbimazole (teratogenic esp. in first trimester)and Propylthiouracil - first line anti-thyroid drug
May need levothyroxine if it blocks all function
RAI

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4
Q

Describe Graves disease

A

Autoimmune drive condition where thyroid peroxidase and TSH receptor antibodies are seen
The anti-TSH receptor antibodies stimulate activity

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5
Q

What are the features of Graves disease?

A

Weight loss, heat intolerance, sexual dysfunction, tachycardia, goitre, and brisk reflexes.
Graves eye disease - exophthalmos and pretibial myxoedema
Also, thyroid acropachy - clubbing and hand swelling

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6
Q

What is the treatment for Graves disease?

A

Anti-thyroid drug - carbimazole
BB to relive symptoms

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7
Q

Describe toxic multinodular goitre

A

Condition where nodule develop on thyroid gland which are upregulated by thyroid axis and produce excess TH
Common cause of thyrotoxicosis in elderly

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8
Q

What are the features of toxic multinodular goitre?

A

Characteristic goitre and absence of Graves disease
General hyperthyroidism symptoms - weight loss, heat intolerance, tachycardia, brisk reflexes and fatigue

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9
Q

Describe Subacute (de Quervain’s) thyroiditis

A

Condition where there is temporary swelling of thyroid gland with 3 phases - thyrotoxicosis, hypothyroidism, and returns to normal

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10
Q

What is the cause of De Quervain’s thyroiditis?

A

Viral trigger - enteroviruses and coxsackie

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11
Q

What are the symptoms and signs of De Quervains thyroiditis?

A

During thyrotoxicosis - thyroid swelling and tenderness, flu like illness and myalgia
Raised ESR and CRP

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12
Q

What is the treatment for De Quervain’s thyroiditis?

A

May need short term steroids and NSAIDs

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13
Q

Describe subclinical hyperthyroidism

A

Thyroid hormone level is normal but TSH levels are low
Concern for bone density decrease

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14
Q

When are ATD used for subclinical hyperthyroidism?

A

If persistent esp. in elderly and if have cardiac risk

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15
Q

Describe primary hypothyroidism

A

Insufficient production of T3 and T4 thyroid hormones
Increased TSH from negative feedback but has no effect on TH

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16
Q

What are the symptoms of primary hypothyroidism?

A

Weight gain, fatigue, dry skin, course hair, heavy irregular periods, and constipation.
Cold intolerance, non-specific weakness, and bradycardia

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17
Q

What is the treatment for primary hypothyroidism?

A

Oral levothyroxine - synthetic version of T4
Dose titrated by TSH levels

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18
Q

Describe secondary hypothyroidism

A

Pituitary abnormally produces inadequate TSH which results in inadequate stimulation of the thyroid gland
T3, T4 and TSH will be low

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19
Q

What is the treatment for secondary hypothyroidism?

A

Oral levothyroxine

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20
Q

Describe Hashimoto’s thyroiditis

A

Autoimmune condition resulting in an underactive thyroid gland
Autoimmune destruction of thyroid epithelial
Autoantibodies for thyroglobulin and thyroid peroxidase

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21
Q

What are the symptoms of Hashimoto’s thyroiditis?

A

Diffuse enlargement of goitre and general hypothyroidism symptoms - weight gain, cold tolerance, bradycardia, dry skin, course hair and weakness in muscles

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22
Q

Describe Addison’s disease

A

Primary adrenal insufficiency
Most common cause is autoimmune damage
Causes decreased cortisol and aldosterone secretion

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23
Q

What are the symptoms of Addison’s disease?

A

Weakness, anorexia, weight loss, skin pigmentation or vitiligo, hypotension, salt craving, postural symptoms and unexplained vomiting

24
Q

What is the investigations for Addison’s disease?

A

Synacthen test - if abnormal then plasma ACTH which is elevated - Addison’s
Check for adrenal autoantibodies

25
Q

What is the treatment for Addison’s disease?

A

Hydrocortisone (glucocorticoid) is used to replace cortisol
Fludrocortisone (mineralocorticoid) to replace aldosterone

26
Q

Describe secondary adrenal insufficiency

A

Inadequate ACTH which results in lack of stimulation of adrenal glands

27
Q

What are the symptoms of secondary adrenal insufficiency?

A

Fatigue, muscle, weakness, muscle cramps, dizziness, thirst, craving salt, abdo pain, depression, hypotension and bronze hyperpigmentation

28
Q

Describe Cushing’s syndrome

A

Prolonged high levels of corticosteroids in the body - glucocorticoids (cortisol) and mineralocorticoids (aldosterone)
Can be ACTH dependant or independent

29
Q

What are the symptoms of Cushing’s syndrome?

A

Weakness of skin, muscles + bones, hypertension, HF, and may cause DM.
Signs - central obesity, hirsutism, purple striae, proximal weakness, moon face, buffalo lump, and oedema

30
Q

What is the investigations for Cushing’s syndrome?

A

24hr urinary free cortisol
1mg overnight dexamethasone suppression test taken at midnight - lack of cortisol response shows Cushing’s

31
Q

What is the treatment for Cushing’s syndrome?

A

Trans-sphenoidal surgery if pituitary adenoma
Medical - adrenal hormone synthesis inhibitors (ketoconazole, metyrapone, amino glutethimide and etomidate)
Also, Milotane to destroy adrenocortical cells
RT and bilateral adrenalectomy

32
Q

What is Cushing’s disease?

A

Pituitary adenoma secreting excessive ACTH which stimulates excessive cortisol release from adrenal glands

33
Q

What is Conn’s syndrome?

A

Adrenal adenoma producing too much aldosterone which controls blood pressure and sodium/ potassium levels
Primary hyper-aldosteronism

34
Q

What are the symptoms of Conn’s syndrome?

A

Uncontrolled increasing BP, excessive thirst, increased urinary frequency, nocturia, weakness/ tingling, dizziness, blurred vision, and headaches.

35
Q

What is the treatment for Conn’s syndrome?

A

Fludrocortisone (mineralocorticoid) is used to replace aldosterone

36
Q

What is the investigation for Conn’s syndrome?

A

Bloods for aldosterone, renin, sodium, and potassium levels.
CT scan
Suppression tests, such as saline or a captopril suppression test.

37
Q

Describe primary hyperaldosteronism

A

Adrenal glands are responsible for overproduction of aldosterone
Hypertension is a key feature

38
Q

What is the investigations for primary and secondary hyperaldosteronism?

A

Primary - high aldosterone and low renin
Secondary - high aldosterone and high renin
Raised BP, hypokalaemia and alkalosis

39
Q

What is secondary hyperaldosteronism?

A

Excessive renin stimulating the release of excessive aldosterone
Released due to disproportionally lower BP

40
Q

Describe a pheochromocytoma

A

Tumour of the adrenal glands that excretes excessive and unregulated amounts of catecholamines (adrenaline)
In medulla of adrenal gland
10% tumour

41
Q

What is the symptoms of pheochronocytoma?

A

Hypertension, paroxysmal attacks - headaches, sweating, palpitations, tachycardia, tremor, pallor and anxiety/ fear

42
Q

What is the investigations for pheochromocytoma?

A

24hr urine measure total metaphrines - if increased then MRI or CT scan
If mass seen then consider 123-IMIBG scan

43
Q

What is the treatment for pheochromocytoma?

A

Pre-operative alpha blockage then surgical resection

44
Q

Describe type I diabetes

A

Pancreases is unable to produce adequate amounts of insulin which means cell can not absorb glucose
Hypercalcaemia and early age of onset

45
Q

What is the symptoms of type I diabetes?

A

Short duration of thirst, tiredness, weight loss, blurred vision and abnormal pain from high ketones
Ketones on breath, increased RR, tachycardia, hypotension and low grade infections

46
Q

Describe type II diabetes

A

Condition where there is insulin resistance and reduced insulin production leading to hyperglycaemia
Usually older age and overweight

47
Q

What are the symptoms of type II diabetes?

A

Thirst, tiredness, polyuria, weight loss, blurred vision, and signs of complications (CVD)
No ketones, usually overweight and low grade infections
Acanthosis nigricans (thickening and darkening of skin)

48
Q

What is acromegaly?

A

Result of excessive growth hormone due to pituitary tumour
After epiphyseal plates have closed so growth happens in outward direction

49
Q

What is the symptoms of acromegaly?

A

Normal height, enlarged hands, feet with prominent facial features and bitemporal hemianopia
Headaches, course, sweaty skin, large tongue, and spacing of teeth
Also, hypertension

50
Q

What is the treatment for acromegaly?

A

Surgery to remove tumour or somatostatin analogues to treat

51
Q

What are the investigations for acromegaly?

A

IGF-1 measured in blood test - raised
GH suppression test - 75g sugary drink with GH tested after 2 hrs
If not suppressed then shows acromegaly
MRI

52
Q

Describe gigantism

A

Excessive growth hormone production before the epiphyseal plates of long bones close

53
Q

Describe hyperparathyroidism

A

Raised parathyroid hormone
PTH acts to raise Ca levels and converts vitamin D to active form
Primary - uncontrolled PTH release
Secondary - decrease in Ca resorption so low Ca - increases PTH

54
Q

What are the symptoms of hyperparathyroidism?

A

Stones, bones, groans, and moans.
Kidney stones, painful bones, abdominal groans from constipation + N/V, and psychiatric moans - fatigue, depression and psychosis

55
Q

What is adrenal crisis?

A

Acute presentation of adrenal insufficiency where absence of steroid hormones leads to medical emergency

56
Q

What is the symptoms for adrenal crisis?

A

Can present with reduced consciousness levels, hypotension, hypoglycaemia, hyperkalaemia, and hyponatraemia

57
Q

What is the treatment for adrenal crisis?

A

IM or IV hydrocortisone and IV fluids
Correct hypoglycaemia and careful monitoring of electrolytes

Endocrine System (23 decks)

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