2. Pituitary and Thyroid Disease Flashcards Preview

BDS2 BAMS Endocrinology > 2. Pituitary and Thyroid Disease > Flashcards

Flashcards in 2. Pituitary and Thyroid Disease Deck (40):
1

Endocrine disease can be (2)

Primary - gland failure
Secondary - control failure

2

Types of multiple endocrine neoplasia (3)

MEN 1 - parathyroid, pancreatic islets
MEN 2a - parathyroid, phaeochromocytoma
MEN 2b - medullary thyroid, phaeochromocytoma

3

Divisions of pituitary (2)

Anterior
Posterior

4

Hormones secreted by anterior pituitary (6)

TSH
ACTH
GH
LH
FSH
Prolactin

5

Hormones secreted by posterior pituitary (2)

ADH
Oxytocin

6

Types of pituitary tumours (2)

Functional adenoma
Non-functional adenoma

7

Features of functional adenoma (2)

Well-differentiated
Hormone-producing

8

Functional adenoma associated with age (2) and diseases (2)

<40yrs old - Cushing's disease
>40yrs old - Acromegaly

9

Features of non-functional adenoma (2)

Space-occupying
Non-hormone producing

10

Effects of non-functional adenoma (2)

Visual field defects
Other hormone deficiencies

11

Pituitary tumour treatment

Surgery - trans-sphenoidal surgery

12

Unregulated GH in children can lead to (2)

Excess - gigantism
Insufficient - growth failure

13

Unregulated GH in adults can lead to (2)

Excess - acromegaly
Insufficient - metabolic changes (increased fat, reduced vitality)

14

How do you measure GH

IGF-1

15

Definition of acromegaly

Hormonal disorder caused by excess GH in adulthood

16

Result of acromegaly

Appositional bone growth (hands, feet, face - mandible)

17

Acromegaly presentation changes (9)

Coarse features
Enlarged supra-orbital ridges
Broad nose, thickened lips and soft tissues
Enlarged hands (Carpal tunnel syndrome)
Type 2 diabetes mellitus
CVD
Visual field defects (CN III, IV and VI nerve palsies)
Hyperprolactinaemia
Hypopituitarism

18

Intra-oral acromegaly changes (4)

Enlarged tongue
Interdental spacing
Shrunk dentures
Reverse overbite

19

Types of thyroid dysfunction (2)

Hyperthyroidism
Hypothyroidism

20

Causes of hyperthyroidism (4)

Graves' disease
Toxic multi-nodular goitre
Toxic adenoma
Pituitary tumour (rare)

21

Symptoms and signs of hyperthyroidism ((17)

Hot and excess sweating
Weight loss
Diarrhoea
Palpitations
Muscle weakness
Irritable, manic and anxious
Warm moist skin
AF and tachycardia
Increased BP
HF
Tremor and hyperreflexia
Eyelid retraction and lid lag

22

Cause of Graves' disease

Auto-antibodies stimulating TSH receptors

23

Symptoms and signs of Graves' disease (2)

Ophthalmopathy (thyroid eye disease) - scleral injection, proptosis, periorbital oedema
Conjunctival oedema - chemosis

24

Types of hypothyroidism (2)

Primary
Secondary

25

Causes of primary hypothyroidism (6)

Autoimmune (Hashimoto's) thyroiditis
Idiopathic atrophy
Radioiodine treatment, thyroidectomy surgery
Iodine deficiency
Drugs
Congenital

26

Causes of secondary hypothyroidism

Hypothalamic/pituitary disease

27

Outcome of hypothyroidism

Reduced metabolism

28

Symptoms and signs of hypothyroidism (16)

Tired
Cold intolerance
Weight gain
Constipation
Hoarse voice
Goitre
Puffed face and extremities
Angina
Slow, poor memory
Dry coarse skin
Bradycardia, hyperlipidaemia
Psychiatric confusion
Hashimoto's goitre
Delayed reflexes

29

Population for Hashimoto's thyroiditis

Middle-aged to elderly women

30

Presenting features of Hashimoto's thyroiditis (2)

Goitre
Hypothyroid features

31

Hashimoto's thyroiditis is associated with (2)

FH of autoimmune disease (vitiligo, PA, type 1 DM, Addison's)
Downs syndrome

32

Causes of idiopathic atrophy (2)

Lymphocyte infiltration
Associated with organ specific autoimmune disease

33

Thyroid disease investigations (3)

Blood tests - TSH, T3, T4
Imaging - ultrasound, radioisotope scan
Tissue (fine needle aspirate/biopsy)

34

Secondary hyperthyroidism investigation results (2)

Raised TSH
Raised T3

35

Primary hyperthyroidism investigation results (2)

Low TSH
Raised T3

36

Secondary hypothyroidism investigation results (2)

Low TSH
Low T4

37

Primary hypothyroidism investigation results (2)

High TSH
Low T4

38

Hyperthyroidism treatment (4)

Carbimazole
B-blockers
Radioiodine
Surgery

39

Hypothyroidism treatment

T4 (thyroxine) tablets

40

Causes of thyroid enlargement (2)

Goitre
Solitary nodular enlargement