T2 Endocrine Dysfunction

Question 1

Describe hypothyroidism; causes,

Answer 1

Goitre is an enlarged thyroid which can be caused by hyperthyroid. Appears nodular/diffuse.

It is a lack of iodine in h diet (Na+).

• Congenital hypothyroidism
• Hashimotos Disease (autoimmune)
• Myxoedema: happens when condition is left untreated: puffy face. ↑ CT

Question 2

Describe hypothyroidism; manifestations

Answer 2

1) Fatigue and low energy
2) Slow HR
3) Weight gain

Question 3

Describe hypothyroidism;

treatment options

Answer 3

Iondine replacement where deficient.

Oral thyroxine.

Question 4

Describe hyperthyroidism; causes,

Answer 4

• Graves disease
• Multinodular goitre
• Adenoma
• Ingestion of excessive t4
• Iodine
• Thyroid storm

Question 5

Describe hyperthyroidism; , manifestations

Answer 5

Hypermetabolisim, ↑ SNS, ↑ HR, Palpitations, buldging on the eyes.

Graves disease: autoimmune, stimulation of thyroid gland; buldging eyes.

Nodules: lumps on gland, usually benign.

Question 6

Describe hyperthyroidism;

treatment options

Answer 6

Drug therapy: aims to reduce conversion of t4 →t3

Surgery

Question 7

Compare and contrast hypoparathyroidism and

hyperparathyroidism in terms of causes

Answer 7

Hypoparathyroidism: ↓ PTH levels, rare, leads to hypocalcaemia. Treated with Ca+ and vit D.
Hyperparathyroidisim (more common): ↑ PTH. Associated with benign tumour or hyperplasia. ↓ Ca+ = negative feedback. ↓ Ca+ in diet. leads to hypocalcaemia

Question 8

Compare and contrast hypoparathyroidism and

hyperparathyroidism in terms of manifestations

Answer 8

Both leads to hypocalcaemia

Question 9

Compare and contrast hypoparathyroidism and

hyperparathyroidism in terms of pharmacological options for treatment/management

Answer 9

Hypo is treated with calcium and vitamin D.

Hyper: drug therapy although inconclusive

Question 10

Describe Addison disease; causes

Answer 10

Addisons disease is an autoimmune disease where the adrenal cortex becomes immunogenic and is destroyed.

Question 11

Describe Addison disease; , manifestations

Answer 11

Mineralocorticoid deficiecy:
↓ aldosterone, Na+ loss, water loss
Hyponatraemia, loss of ECF, ↓ cardiac output, hyperkalaemia.
GLUCOCORTICOID DEFICIENCY: ↓ cortisol, ↓ gluconeogenesis, ↓ stress response.
Hypoglycaemia, feve, anorexia, nasusea, vomiting.
HYPERPIGMENTATION: From elevated ACTH and MSH level because of lack of negative feedback.

Question 12

Describe Addison disease;

treatment options

Answer 12

1) Glucocorticoids: Replaces endogenous cortisol with synthetic long actions equivalents; prednisone. (vary in duration due to hald life, salt retention etc).
Side effects includ: catabolic immunosuppresoive actions of glucocorticoids.
2) Mineralcorticoids replace lost aldosterone.

Question 13

Describe Cushing syndrome; causes

Answer 13

Manifestations of excess cortisol due to any cause is called Cushing’s syndrom.

1) Pituitary - ↑↑ ACTH by a tumour.
2) Adrenal tumour
3) Ectopic - nonpituitary malignant tumour
4) Iatrogenic Cusing syndrime - caused by long-term use of glucocorticoids.

Question 14

Describe Cushing syndrome; manifestations

Answer 14

Hyper glycaema.
Purple skin thining
Alteral fat metabolism: muscle weakness ↓ protein breakdown
Na+ retention
Ca+ loss
Infertility

Question 15

Describe Cushing syndrome;

treatment options

Answer 15

1. Receptor antagonists
2. Synthesis inhibitors: block corticol synthesis
3. Surgical removal of adrenal glands

Question 16

Describe pheochromocytoma; causes

Answer 16

Tumour located in adrena medulla. Secretes excessive amounts of adrenalline), resulting in hypertension.

Question 17

Describe pheochromocytoma; manifestations

Answer 17

Headaches, nervousness, facial tremour, weakness, fatigue, weightloss

Question 18

Describe pheochromocytoma; options

Answer 18

Non-selective surgical excision (removal).

Question 19

Compare and contrast type 1 and type 2 diabetes

mellitus in terms of causes,

Answer 19

Type 1 diabetes: Pathological loss of pancreatic beta cells, hence the ability to produce and secrete insulin.
Type 2 diabetes: Characterised by slowly developing resistance to or dysfunction in insulin signalling in muscle and fat cells.

Question 20

Compare and contrast type 1 and type 2 diabetes

mellitus in terms of manifestations

Answer 20

Type 1: Severe hyperglycaemia, ketaogenesis, acidosis, dehydration
Type 2: ↑ blood glucose
↑ insulin , obesity/hypertension

Question 21

Compare and contrast type 1 and type 2 diabetes
mellitus in terms of options
for treatment/management

Answer 21

Type 1: Insulin

Type 2:

Question 22

Describe the causes and consequences of untreated

gestational diabetes

Answer 22

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Question 23

Outline the acute & chronic complications of diabetes

mellitus

Answer 23

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Question 24

Describe the lifestyle and pharmacological management

options for treatment of diabetes mellitus

Answer 24

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Question 25

``` Compare and contrast the different types of multiple endocrine neoplasia (MEN) and their treatment options ```

Answer 25

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Question 26

Describe hyper pituitary disorder causes

Answer 26

Symptoms include; headaches, vision problems:pressure on optic nerve.

Question 27

List the causes and treatment options for hypopituitism

Answer 27

Mass lesions Radiation therapy Surgery - Long term: replacement of target gland hormones

Question 28

Explain the cause, manifestations and pharmacological options for treatment/management of hyperprolactinaemia

Answer 28

PROLACTINOMA: Prolactin secreting hormone. Related to milk synthesis ( milk leaking) in both men and women. Related to actions to suppress LH. Manifestations include: menstral disturbances, infertility. Tx: Inhibt PRL secretion with dopamine agonist. Surgical removal of tumour.

Question 29

Compare and contrast hypo- and hyper- secretion of antidiuretic hormone (ADH) in terms of causes, manifestations and pharmacological options for treatment/management

Answer 29

Produced by hypothalamus, released by pituitary. Hypothalamus - detects osmolarity. Antidiuretic hormone. Hypersecretion of ADH:

Question 30

Compare and contrast hypo- and hyper- secretion of growth hormone (GH) in childhood and adulthood in terms of causes, manifestations and pharmacological options for treatment/management M

Answer 30

Increased metabolic effects of excess GH. 'Giantisim', overgrown mandibule, forehead and height. Adult: acromegaly Children - gigantism

Question 31

Differentiate the different types of pituitary tumours in | terms of manifestations and treatment options

Answer 31

Hy[erpituitarism: is a pituitary tumour (adenoma). Usually benign.

Question 32

List the causes and treatment options for hypopituitism

Answer 32

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Question 33

Explain the cause | hyperprolactinaemia

Answer 33

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Question 34

Explain the manifestations of | hyperprolactinaemia

Answer 34

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Question 35

Explain the pharmacological options for treatment/management of hyperprolactinaemia

Answer 35

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Question 36

Compare and contrast hypo- and hyper- secretion of antidiuretic hormone (ADH) in terms of causes,

Answer 36

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Question 37

Compare and contrast hypo- and hyper- secretion of antidiuretic hormone (ADH) in terms of manifestations

Answer 37

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Question 38

Compare and contrast hypo- and hyper- secretion of antidiuretic hormone (ADH) in terms of pharmacological options for treatment/management

Answer 38

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Question 39

Compare and contrast hypo- and hyper- secretion of growth hormone (GH) in childhood and adulthood in terms of causes

Answer 39

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Question 40

Compare and contrast hypo- and hyper- secretion of growth hormone (GH) in childhood and adulthood in terms of manifestations

Answer 40

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Question 41

Compare and contrast hypo- and hyper- secretion of growth hormone (GH) in childhood and adulthood in terms of pharmacological options for treatment/management

Answer 41

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