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MedEd Tutorials > 5. Thyroid and Misc Endo > Flashcards

5. Thyroid and Misc Endo Flashcards

1
Q

Pathway to releasing thyroid hormones

A

Pituitary produces TSH

Follicular cells produce T4 and T3. T4 turns to T3 too.

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2
Q

Hyperthyroid symptoms?

A 
Tremor
Anxiety
Palpitations
Heat into
Diarrhoea
Oligomenorrhoea
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3
Q

Hypothyroidism symptoms?

A 
lethargy
Cold into
Weight gain
Constipation
Mehorrhagia
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4
Q

Causes of hyperthyroidism

A

Hyper -
Graves
Toxic multinoduler goitre
Thyroiditis

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5
Q

How do we treat hyperthyroidism?

A

Propanolol
Carbimazole (can cause agranulocytosis)
Radioiodine

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6
Q

Bilateral exophthalmos?

A

Occurs in grave’s disease in 25-50% of patients.

Causes diplopia and related to lid lag.

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7
Q

Signs of thyroid cancer?

A 
Hoarse voice
Dysphagia
Haemoptysis
Airway obstruction
Cervical lymphadenopathy
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8
Q

Most common thyroid cancers?

A 
Papillary carcinoma (70%) 
Follicular carcinoma (20%) (Hurthle cell is rare variant)
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9
Q

What is MEN 1 syndrome symptoms?

A

Parathyroid adenoma, increasing calcium
Pancreatic adenoma, causing peptic ulcers
Pituitary adenoma, causing low libido and mass effect
Lots of others e.g. carcinoid, adrenal

Needs a CT/MRI of whole body

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10
Q

Hypercalcaemia pneumonic?

A

Stones, groans (GI), bones and psychic moan.

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11
Q

What are MEN 2a and 2b?

A

Both have medullary thryoid cancer plus
A - parathyroid adenomas, phaeochromocytomas
B (associated with marfan’s) - Phaeochromocytomas (associated with marfan’s)

need genetic testing for RET ti differentiate, calcitonin high, urine catecholamines (cant spell)

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12
Q

What is carcinoid syndrome?

A 
Neuroendocrine cells (e.g. in stomach) rapid division causing tumour that metastasises to liver .
You get a build up of serotonin, bradykinin and histamine causing features!
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13
Q

Features of carcinoid syndrome?

A 
Flushing
Diarrhoea
SOB
Pulmonary stenosis
Abdo pain
Itching
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14
Q

What normally regulates serotonin production by neuroendocrine cells?

A

Somatostatin

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15
Q

Investigations for carcinoid syndrome?

A

Urinary 5HI-AA
CT Scan
Octreotide scan

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16
Q

HPG Axis?

A

GnRH from hypothalamus
Ant pit produces LH and FSH
Lh - leydig cells
fSh - sertoli cells for spermatogenesis

LH - theca cells for prog
fSh - granuloSa cells for oestrogen

17
Q

Hypogonadism in female causes?

A

Primary - Genetics e.g. turner’s syndrome (45X0), gonadal damage, primary ovarian failure and PCOS
Secondary (pituitary or hypothalamus) - Kallmann’s, tumours, hyperprolactinaemia, functional (low bmi, excess exercise, stress), contraceptive pill use

Other - pregnancy

18
Q

Hypogonadism in males causes?

A

Primary - Genetics e.g. klinefelter’s (47XXY) or crytochidism, gonadal damage, post-orchitis (mumps)
Secondary - same as females

19
Q

Features of hypogonadism?

A 
Delayed puberty
Infertility
Low libido
Amenorrhoea
Night sweats/hot flushes in women
Erectile dysfunction 
Symptoms of cause
20
Q

Investigations in hypogonadism?

A 
Pregnancy test
LH/FSH (high in primary, low in secondary)
Prolactin
Testosterone/oestragiol
TFTs
Karyotyping
MRI
21
Q

HPS axis (growth hormone)

A

Growth hormones releasing hormone from hypo goes to ant pit
Growth hormone from ant pit to act on liver, muscle, bone and kidneys to produce IGF-1 a s well as increasing blood glucose, insulin resistance, increase muscle growth and bone thickness.

Somatostatin and IGF-1 negatively regulate the axis

22
Q

What causes acromegaly?

A

Mostly pituitary adenoma of somatotrophs that produce lots of GH increasing IGF-1

23
Q

Features of acromegaly?

A 
Coarse features
Prognathism and large tongue
Spade-like hands and large feat
Excessive sweating
Organomegaly
Headaches
Visual disturbance
Hyperprolactinaemia
Hypopituitarism
24
Q

Complication of acromegaly?

A 
Carpal tunnel
Hypertension
Diabetes mellitus
Cardiomyopathy
Colorectal cancer
25
Q

What happens to glucose in acromegaly?

A

It is high and when given glucose, GH goes up when normally it should go down.
(this is an OGTT and an investigation)

26
Q

How to manage acromegaly?

A 
Trans-sphenoidal surgery
Radiotherapy
Somatostain analogues
Dopamine receptor agonist
GH - receptor antagonists.

MedEd Tutorials (32 decks)

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