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5TH YR- CMS- Endocrinology > Thyroid > Flashcards

Thyroid Flashcards

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Introductory Sommelier Exam (CMS) flashcards
1
Q

what does endocrinology include

A

Disorders of hormones and the glands

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2
Q

What is the term steroids often used to describe

A

Anti-inflammatory and immunosuppressive drugs act via cortisol receptors

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3
Q

What are the 3 basic things that can go wrong with an endocrine gland

A
  1. Failure to produce its hormone
  2. Excessive production of hormone
  3. Swellings
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4
Q

What is a common cause of endocrine gland failure

A

Destruction of the gland

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5
Q

Give some examples of what may cause endocrine gland failure

A

1, Infection
2. Radiation
3. Invasion by tumours
4. Pituitary disease
5. Secondary to unregulated pituitary hormone secretion
6. Tumours

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6
Q

Give examples of adrenal gland disorders

A
  1. Cushing’s disease
  2. Addison’s disease
  3. Conn’ syndrome
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7
Q

What is Cushing’s disease caused by

A

An excess glucocorticoid production secondary to adrenal hyperplasia.

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8
Q

What effect does systemic steroid treatment suppress

A

Normal pituitary adrenal axis resultan in atrophy of the norm cortisol secretion adrenal cells

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9
Q

What can cortisol cause

A

Resistance to insulin resulting in impaired glucose tolerance or diabetes

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10
Q

What test should we do to assess and diagnose non iatrogenic bushings disease

A

measurement of the plasma or urine cortisol level, which will be elevated, and is not suppressed by dexamethasone

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11
Q

What can measurement of plasma ACTH help to distinguish

A

Pituitary cases from adrenal casues
Pituitary causes= raised ACTH
Adrenal causes= suppressed ACTH

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12
Q

What is Addisons disease

A

A non specific disease with general tiredness, weakness and weight loss

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13
Q

What is a key clinical clue indicating Addisons disease

A

hyperpigmentation generally seen over the whole skin but particularly prominent in the palmar creases of the hands, and on the buccal mucosa

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14
Q

If we don’t manage Addisons disease what can happen

A

Can become Addisons crisis

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15
Q

What are some feature of Addisons crisis

A
  1. Vomitting
  2. Loss of salt and water resultign in hypotension or hypoglycaemia
  3. May result in coma
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16
Q

How do we investigate for Addisons disease

A

Plasma cortical levels= will be low
ACTH may be raised
Adrenal autoantibodies
Real electrolytes and glucose also measured

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17
Q

How is Addisons crisis managed

A

Intravenous hydrocortisone, glucose, and fluid and electrolyte replacement

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18
Q

How is Addisons disease managed

A

hydrocortisone (cortisol) and fludrocortisone (aldosterone)

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19
Q

What does aldosterone do

A

Stimulates retention of salt and loss of potassium via the kidneys

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20
Q

In whom does conns syndrome occur in

A

People with a tumour or hyperplasia of the adrenal cortex resulting in high levels of aldosterone secretion

21
Q

What can high levels of aldosterone lead to

A

Potassium loss and sodium retention

22
Q

What can potassium loss lead to

A

Muscle weakness and polyuria

23
Q

What can sodium retention lead to

A

Hypertension

24
Q

What diseases/ disorders can the thyroid gland suffer from

A
  1. Hyperthyroidism
  2. Hypothyroidism
25
Q

What does the thyroid gland do

A

Secreted iodine containing hormones thyroxine and triiodothyronine

26
Q

What is overproduction of the thyroid hormone also known as

A

Hyperthyroidism or thyrotoxicosis

27
Q

Give an example of hyperthyroidism

A

Graves Disease

28
Q

What is Graves disease caused by

A

An antibody that binds to the thyroid stimulating hormone (TSH) receptor on the thyroid cells and stimulates it

29
Q

Give some causes of hyperthyroidism

A
  1. Thyroid adenoma
  2. Toxic multi nodular goitre
  3. Graves disease
30
Q

What does goitre mean

A

applies to a swelling of the thyroid gland

31
Q

What are some symptoms of hyperthyroidism

A
  1. Weight loss
  2. Dislike of heat
  3. Tremor
  4. Irritability
  5. Emotionally labile
32
Q

What are some signs of hyperthyroidism

A
  1. Tachycardia
  2. Atrial fibrillation
  3. Tremor
  4. Enlarged thyroid
  5. Exophthalmos Goitreo
33
Q

What is the treatment for hyperthyroidism

A
  1. Carbimazole
  2. Partial thyroidectomy
  3. Radioactive iodine
34
Q

Why do patients with hyperthyroidism lose weight without trying

A

Due to increased metabolic rate

35
Q

Where might a patent with hyperthyroidism present with a goitre

A

front of the larynx in the neck which might move upwards on swallowing can be lumpy or smooth

36
Q

Give some signs and symptoms of graves disease

A
  1. Smooth goitre
  2. Protrusion of the eyes (exophthalmos)
  3. Double vision
  4. Thyroid acropachy (fingernail clubbing)
  5. Thickening of the shins and dorsum of the foot
37
Q

How can hyperthyroidism be investigated

A

Measurement of free plasma of t4 and t3 = will be raised
Thyroid secretion hormone will be suppressed

38
Q

What is hypothyroidism

A

Severely underactive thyroid

39
Q

What is a key characteristic of hypothyroidism

A

Deposition of mucinous material in the subcutaneous tissues - MYXOEDEMA

40
Q

Describe the blood biochemistry of a patient with hypothyroidism

A

Low levels of T4 and T3
High thyroid secretion hormone

41
Q

What can hypothyroidism be caused by

A
  1. Spontaneous due to primary autoimmune disease
  2. Drug induced eg antithyroid drugs
  3. Iodine deficiency
  4. radioiodine therapy or surgery to the thyroid gland
42
Q

What are the symptoms of hypothyroidism

A
  1. Weight gain
  2. Dislike of cold
  3. lethargy
  4. Depression
  5. Puffy features eg bags under the eyes
  6. Deep and croaky voice
43
Q

What are some of signs of hypothyroidism

A
  1. Bradycardia
  2. Goitre
  3. Dry skin and hair
44
Q

How id hypothyroidism managed

A

Thyroxine replacement

45
Q

What can hypothyroidism drugs be classified into

A
  1. Antithyroid drugs
  2. Iodide
  3. Radioactive iodine.
46
Q

Other than thyroxine drugs what else might a person with hypothyroidism take

A

β-adrenergic-blocking drugs can be used to manage symptoms of thyrotoxicosis such as tremor and tachycardia

47
Q

Give examples of antithyroid drugs

A

thioureylenes,
carbimazole
propylthiouracil

48
Q

How are antithyroid drugs work

A

By prevention of incorporation of iodine into the thyroid hormones levothyroxine and tri-iodothyronine

49
Q

What considerations should we taken dentally in a patient with hyperthyroidism

A

Contra indication to the use of adrenaline
Opportunistic infection such as oral candidiasis may occur

5TH YR- CMS- Endocrinology (3 decks)

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