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Clinical Physiology > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Graves disease

A

autoimmune disease attacking the thyroid

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2
Q

defining factor of graves disease

A

eyes pushed forward, proptosis

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3
Q

what mechanism leads to tsh being low

A

negative feedback from elevated thyroid hormones

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4
Q

main hormones produced by thyroid

A

t4 mainly, some t3

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5
Q

thyrotoxicosis due to Graves disease

A

stimulating receptor binds to tsh
goiter - enlarged thyroid
hyperactive thyroid

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6
Q

symptoms of hyperthyroidism

A

hyperactivity
heat intolerance
palpitations
fatigue
weight loss
diarrhoea
polyuria
oligomenorrhea - abnormal periods (stop)

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7
Q

signs of hyperthyroidism

A

tachycardia/ A fib
tremor
goiter
warm, moist skin
muscle weakness
lid retraction
gynaecomastia

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8
Q

common causes of thyrotoxicosis

A

graves disease
toxic multinodular goitre
toxic nodule
factitious thyrotoxicosis - taking thyroid themselves
thyrotoxicosis associated with subacute thyroiditis

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9
Q

treatment of graves

A

peripheral adrenergic blockade e.g., propanolol (beta blocker)
diltiazem if asthma - beta blocker will cause bronchoconstriction

inhibit hormone synthesis e.g., carbimazole or propylthiouracil (in pregnant or trying to get pregnant)

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10
Q

why is it important to check cortisol in hypothyroid patients

A

addisons disease undiagnosed, give them thyroxin would precipitate an adrenal crisis

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11
Q

advantage of short acting drugs

A

act quickly

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12
Q

disadvantage short acting drugs

A

keep giving them

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13
Q

advantage of T3

A

can give it IV so dont need to rely on gut for absorption

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14
Q

hypothyroidism range

A

sub clinical to myxedema coma

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15
Q

symptoms of hypothyroidism

A

NERVOUS SYSTEM - carpal tunnel, paraesthia, ataxia, forgetfulness

CARDIOVASCULAR - bradycardia, dec CO, pericardial effusion, dependent oedema, reduced voltage on ECG and flat T waves

GASTROINTESTINAL - contripation, pernicious anemia, ascites

RENAL - reduced excretion of water load - hyponatremia, dec glomerular filtration

PULMONARY - pleural effusion, hypoxia and hypercapnia response dec, airway obstruction

MUSCULOSKELETAL - arthralgia, muscle cramps, joint effusions, CK elevated

ANEMIA - noromochromic normocytic

SKIN AND HAIR - loss of lateral eyebrows, dry cool skin, orange skin

REPRODUCTIVE - heavy periods, hyperploactinemia

METABOLISM - hypothermia, intolerance to cold, inc cholesterol and triglycerides, weight gain

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16
Q

diagnosis of hypothyroidism

A

high tsh low free t4

17
Q

hypothyroidism treatment

A

levothyroxine
lower dose if elderly or IHD to avoid cardiac event in known heart condition

18
Q

adrenal insufficiency

A

absolute or relative deficiency of adrenal hormones - cortisol, aldosterone, androgens

19
Q

role of cortisol

A

glucocorticoid produced in relation to stress to make more energy available to the body
has an immunosuppressant effect
important for BP regulation

20
Q

role of aldosterone

A

BP regulation
vascular volume
electrolytes

21
Q

difference between primary and secondary adrenal insufficiency

A
  1. ACTH - primary high, secondary low
  2. PIGMENTATION - primary yes, secondary no
  3. ALDOSTERONE - primary low, secondary normal
  4. K - primary high, secondary low
  5. VOLEMIA - primary hypo, secondary euvo
22
Q

Addison’s disease symptoms

A

weakness
pigmentation of skin
weight loss
anorexia, vomiting , nausea
hypotension
pigmentation of mucous membranes
abdominal pain
salt craving
diarrhoea
constipation
syncope
vitiligo

23
Q

causes of primary adrenal insufficiency

A

autoimmune
infectious
infiltrative - neoplasm
latrogenic - post adrenalectomy
haemhorrage - due to infections e.g., septicaemia
CAH
congenital unresponsiveness to ACTH

24
Q

causes of secondary adrenal insufficiency

A

exogenous glucocorticoids
pituitary insufficiency
sheehan syndrome
hypothalamic insufficiency
head trauma

25
Q

precipitants of adrenal crisis

A

post surgical
injury
migraines
pregnancy, labour
bereavement
vomiting

26
Q

adrenal crisis

A

hypotension, hypovolemic, hypoNa, hyperK, hyperCa, hypoglycaemia

27
Q

adrenal crisis treatment

A

fluid resuscitate 0.9% saline for hypotension
correct hyperkalaemia
hypoglycaemia - 5-10% glucose
correct hormone deficiency - hydrocortisone

treat precipitating factor

28
Q

prevention of adrenal crisis

A

acute illness - double dose

severe illness - hydrocortisone injection

Clinical Physiology (11 decks)

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