12.17 Diverse Endocrinology

Question 1

Define actopic hormone syndromes

Answer 1

• hormone production by tissue that do not normally produce that hormone
• peptide hormones

Question 2

Hypercalceamia

Answer 2

• Commonest paraneoplastic manifestation (PTH Low)
• Malignancy causing hyperCa:
  ➡️PTH-related Peptide (PTHrP)
• Bony metastases
• Exclude HyperPTH (PTH ↓↓) (hyperparathyroidism)

Question 3

SIADH

Answer 3

• syndrome of inappropriate ADH
• Euvolemic
• Serum Na < 135
• Serum osmol < 275
• Urine Na > 20 mmol/d
• No renal, adrenal or thyroid dysfunction
• CAUSES : Head, Chest, Drugs, other
• ADH -> antidiuretic hormone
• If you are inappropriate holding on to water, your sodium drops low, urine sodium is high

Question 4

Hyponatraemia

Answer 4

• Se Na+ < 135 mmol/l
• Confusion, Coma, Convulsions
• ASSESS fluid status clinically:
• Fluid overload – CCF
• Dehydrated – Addisons, D&V
• Clinically in fluid balance - SIADH

Question 5

Polyglandular auto-immune failure

Answer 5

• Type 1 DM
• Addison’s
• Hashimoto’s & Graves
• Vitiligo
• Premature Ovarian failure
• Hypoparathyroid
• Pernicious anaemia