Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrine > Thyroid + Paraythroid pathology > Flashcards

Thyroid + Paraythroid pathology Flashcards

1
Q

S+S hyperparathyroidism

A 
Asymptomatic hypercalcaemia 
Bone pain 
Renal calculi 
Muscle weakness 
Proximal myopathy 
N+V 
Constipation 
Polyuria/ dipsia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Blood results for hyperparathyroidism

A

High calcium
High PTH
Low phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of hyperparathyroidism

A

Hyperplasia
Adenoma
Carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Treatment of hyperparathyroidism

A

Surgery - parathyroidectomy
Bisphosphonates or cinacalcet
Vitamin D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Grave’s disease features

A 
Thyroid acropachy 
Eye disease 
Pretibial myxoedema 
TSH receptor Ab 
Proximal myopathy 
Hyperthyroidism S+S
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Mechanism of hyperthyroidism

A

Reduced TRH causes low TSH

Raised T3 + T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Management of hyperthyroidism

A

Carbimazole

Beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Management of hypothyroidism

A

Levothyroxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mechanism of thyroid gland

A

Gland releases T4 (thyroxine) which is converted to T3

Controlled by TSH which is released by pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

S+S parathyroid adenoma

A

Hyperparathyroidism: bone fractures, kidney stones, polyuria

Depression, N+V, myalgia, abdo pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Investigation results for parathyroid adenoma

A

Raised PTH

Abnormal calcium + phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the S+S of congenital hypothyroidism?

A

hypotonia, coarse facial features, hoarse cry, prolonged jaundice, umbilical hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Types of hyperthyroidism

A 
Primary = abnormality of thyroid gland such as Graves 
Secondary = abnormal stimulation of thyroid gland by TSH secreting pituitary tumor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Complications of hyperthyroidism?

A 
o	Graves' orbitopathy.
o	Thyroid storm (thyrotoxic crisis).
o	Atrial fibrillation.
o	Heart failure.
o	Reduced bone mineral density.
o	Increased mortality rate.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

S+S of hyperthyroidism

A

Symptoms of hyperthyroidism include:
o Breathlessness, dysphagia, neck pressure — may be caused by a toxic multinodular goitre.
o Palpitations, anxiety, exercise intolerance, fatigue, muscle weakness.
o Heat intolerance, increased sweating.
o Increased appetite with weight loss, diarrhoea.
o Note: older people may present with atypical or few symptoms.

Signs of thyrotoxicosis include:
o Agitation, fine tremor, warm moist skin, palmar erythema.
o Sinus tachycardia, atrial fibrillation, heart failure, dependent oedema.
o Eye signs (lid lag or retraction).
o Goitre (may be diffuse, multinodular, or single nodule). A tender, irregular thyroid gland may suggest subacute thyroiditis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What markers should be checked in subacute hyperthyroidism?

A

CRP + ESR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Types of hypothyroidism

A 
Primary = high TSH + low T4, due to iodine deficiency or abnormal gland (autoimmune (Hashimotos) or damage to gland from surgery or RT
Secondary = insufficienct TSH due to pituitary or hypothalamic disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is postpartum thyroiditis?

A

Thyrotoxicosis or hypothyroidism within a year of giving birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Complications of hypothyroidism

A

CV: dyslipidiemia, CHD, HF
Repro: reduced fertility, miscarriage, congenital abnormalities
Neuro: deafness, impaired concentration + memory
Myxoedema coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

S+S of hypothyroidism

A

Symptoms: fatigue/lethargy, cold intolerance, weight gain, weakness, arthralgia and myalgia, constipation, menstrual irregularities, depression, and cognitive impairment.
Signs include hair loss, coarse dry hair and skin, oedema, goitre, bradycardia, diastolic hypertension, and delayed relaxation of deep tendon reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the causes of hypercalcaemia?

A

Malignancy (breast, lung, multiple myeloma)
Hyperparathyroidism
Thiazides, lithium, TB, sarcoidosis, CKD

22
Q

S+S of hypercalcaemia

A 
Bone pain + fractures 
Drowsiness, delirium, muscle weakness, depression 
N+V, constipation, abdo pain 
Polyuria + dipsia, dehydration
HTN, shortened QT 
Itching, keratitis, conjunctivities
23
Q

Initial management of bloods with high calcium

A 
Check PTH levels
If high = hyperparathyroidism 
If low = malignancy 
Consider:
CXR 
Renal function + U+E
FBC
Urine protein electrophoresis (MM) 
LFTs 
TFTs
Serum cortisol
24
Q

How does hypercalcaemia of malginancy occur?

A

Tumor secretion of PTH-related protein
Osteolytic mets with release of cytokines
Tumor production of vit D

25
Q

Management of hypercalcemia of malignancy

A 
Saline rehydration 
Calcitonin if symptomatic pts 
IV bisphosphonate long term 
Zoledronic acid. 
Denosumab if refractory
26
Q

What are the features of hypoparathyroidism?

A

Low calcium
High phsophate
Low PTH

27
Q

What is pseudohypoparathyroidism?

A

Low calcium
High phosphate
High PTH (due to resistance)

28
Q

Causes of hypoparathyroidism

A 
Following anterior neck surgery (acquired) 
Radiation
Magnesium deficiency 
Congenital 
Transient in neonates
29
Q

Symptoms of hypoparathyroidism

A 
Muscle pain 
Bone pain 
Paraesthesia 
Facial twitching 
Carpopedal spasm 
Stridor 
Convulsions 
Syncope 
Emotional lability 
Lethargy 
Headaches
Painful menstruation
30
Q

Signs of hypoparathyroidism

A 
Chvosteks sign 
Trousseaus sign 
Raised ICP = papilloedema 
Cataracts 
Brittle nails 
Dry, rough skin 
Hyperreflexia
31
Q

What is chvostek’s sign?

A

Detects latent tetany

Tapping 5th facial nerve in front of ear with pt’s mouth slightly open = contraction of facial muscles

32
Q

What is Trousseaus sign?

A

Occlude arterial circulation of forearm using BP cuff for 3 mins
Carpopedal spasm is induced

33
Q

What is DiGeorge’s syndrome?

A

Deletion on chromosome 22
Recurrent infection due to T cell immunodeficiency
Congenital heart disease
Speech delay
Abnormal facies - cleft palate, micrognathia, ear abnormalities

34
Q

What is familial autoimmune polyglandular syndrome type 1?

A 
APS-1
Chronic mucocutaneous candidiasis 
Adrenal failure 
Vitiligo 
Dental enamel hypoplasia
35
Q

Management of hypocalcaemia

A

Calcium + vitamin D

Parathyroid autotransplantation

36
Q

Complications of hypocalcemia

A 
Laryngospasm - stridor 
Muscle cramps, tetany + seizures 
QT interval changes - syncope 
Renal calculi 
Stunted growth, malformed teeth
37
Q

What is De Quervain’s thyroiditis?

A

Neck pain, fever + lethargy soon after URTI or viral illness

38
Q

What is acute suppurative thyroiditis?

A

Results from bacterial or fungal infection causing an abscess

39
Q

What is the classic pattern of thyroiditis?

A

Hyperthyroidism, then hypothyroidism, then recovery

40
Q

Pathology of hyperthyroidism in thyroiditis

A

Damage to thyroid follicular cells leading to unregulated release of T3 + T4
Lasts 2-6 weeks until stores of T4 + T3 are depleted

41
Q

What are the causes of thyroiditis + how to identify which type?

A

Thyroid pain = subacute thyroiditis/ infection/ radioiodine therapy
Painless = autoimmune, lithium, immunotherapy

42
Q

What is the difference between cortisol deficiency due to ACTH deficiency + cortisol deficiency due to adrenal disease?

A
  • ACTH deficiency does not cause salt wasting, volume contraction, and hyperkalemia, because it does not result in clinically important deficiency of aldosterone.
  • ACTH deficiency does not result in hyperpigmentation.
43
Q

How does hypopituitarism present?

A

Hypothyroidism, hypogonadism + growth hormone deficiency

44
Q

How to investigate ?hypopituitarism?

A

Serum cortisol (AM x3)
Total T3 + T4
Serum testosterone or estradiol

45
Q

What are prolactinomas + what are the effects of raised prolactin?

A

Benign tumours of pituitary gland
Inhibits gonadotrophin secretion, leading to menstrual dysfunction, galactorrhea
Reduced libido + erectile dysfunction in men

46
Q

What are the causes of high prolactin?

A 
Pregnancy 
Stress 
Pituitary tumours 
Head injury 
Hypothyroidism 
Cushings 
Liver cirrhosis 
PCOS
Celiacs 
Dopamine receptor antagonists (APs) , antidepressants, verapamil + opiates
47
Q

Investigations for ?prolactinoma

A 
TFTs
Exclude pregnancy 
Serum prolactin 
Visual field testing
MRI
48
Q

Management of prolactinomas

A

Cabergoline
Surgery
RT

49
Q

Complications of hypogonadism

A

Osteoporosis

Reduced fertility

50
Q

S+S of pituitary adenoma

A

Asymptomatic

Hypopituitarism symptoms due to compression

51
Q

When does HPA suppression occur?

A

Complication of steroid therapy - glucocorticosteroids exert negative feedback on HPA

52
Q

What is a thymoma - presentation, investigations + management?

A

Rare neoplasm of thymus
Asymptomatic, found on CT chest
Surgical resection + RT or palliative chemo

Endocrine (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions