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Clinical > 2 Endocrine Workshop > Flashcards

2 Endocrine Workshop Flashcards

1
Q

What is the purpose of cortisol

A

Maintains BP - water and salt homeostasis

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2
Q

What are the three main hormones secreted by the thyroid and their actions

A

T3 - main hormone
T4 - pro-hormone
Calcitonin - reduced blood calcium for bone turnover - opposing effect to parathyroid hormone

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3
Q

t 3 or t 4 is more powerful?

A

T 3

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4
Q

More t 3 or 4 is produced

A

80% t 4 - converted peripherally to t3 in the liver etc.

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5
Q

How is thyroid hormone regulated

A

Hypothalamus releases trh
Pituitary releases TSH
Thyroid releases thyroid hormones

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6
Q

What is trh

A

Tyroppid releasing hormone

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7
Q

How does iodine in affect thyroid funciton

A

Thyroid hormone is synthesised from circulating iodine. Excessive or insufficient causes dysfunction

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8
Q

What are 2 main physiological functions of thyroid hormone

A

Growth and development

Metabolism

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9
Q

Name three drugs that can induce thyroid diseases

A

Lithium
Amioderone
Cholestyramine p

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10
Q

How does amioderone affect thyroid function

A

Hypo caused by blocking conversion of T4 to T3

Hyper due to iodine content of the drug

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11
Q

How does lithium affect thyroid function

A

Hypo – inhibits iodine uptake and thyroid hormone release

Hyper – unknown mechanism

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12
Q

How does cholestyramine affect thyroid funciton?

A

Affects absorbtion of levothyroxine

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13
Q

Signs of hypothyroidism

A 
Fatigue
Cold sensitivity
Dry skin and hair
Depression
Impaired concentration and memory
Muscle pain and weakness
Horse voice
Pernicious anaemia (megloblstic b12 deficient)
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14
Q

Treatment for hypo thyroidism

A

T four is treatment of choice.

Exclude hyhpopituitaryism

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15
Q

Signs of hyperthyroidism

A 
Insomnia
Tremor
Irritability
Weight loss
Decreased appetite
AF
Diarrhoea
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16
Q

Treatment for hyperthyroidism

A

Antithyroid drugs - propylthiouracil, thiamazol, carbimazole

17
Q

Symptoms of Cushings

A 
Weight gain
Thinning skin, brides easily
Purple stretch marks
Moon face, buffalo hump
Decreased interest in sex
Oestoperosis
18
Q

Treatments for Cushings

A

Eradicate tumours
Reduce steroid dose
Metyropone/ketoconazole

19
Q

Symptoms of addisons diseases

A 
Fatigue
Lethargy
Muscle weakness
Low mood
Loss of appetite 
Frequent urination
Thirst
Hyperpigmentation
Craving salty food
20
Q

Treating Addisons diseases

A

Glucocorticoid replacement : hydrocortisone

Mineralocorticoid replacement: fludrocortisone

21
Q

Signs of over and under replacement in addisons

A

Over - hypertension, glucose intolerance, thin skin, hyperglycaemia, electrolyte abnormalities
Under - fatigue, postural hypotension, weight loss, salt craving.

22
Q

Goals of hypothyroidism treatment

A

symptom relief

Normal TSH levels - not too low as osteroperosis risk

23
Q

When to monitor TSH levels?

A

Change slowly so 4-6 weeks after initiating therapy and then annually.

24
Q

Laxative guidelines

A

exercise, fibre, fluids

1: bulk forming
2: osmotic if hard, stimulant if soft
Opioid- osmotic or docusate

25
Q

Whilst waiting for hyperthyroidism therapy to kick in how can we treat symptoms

A

Beta blocker e.g. Propanolol

26
Q

Monitoring for hyperthyroidism treatment

A

Free t4 and TSH during and after carbimazole treatment

27
Q

Before starting carbimazole check

A

LFTs for liver tox

Full blood count (affects WBC so infection and platelets to bruising)

28
Q

Give in patients with respiratory infection….

A

Oxygen

29
Q

When someone with addisons has a temperature over 37.5….

A

Double the hydrocortisone dose

30
Q

When done with addisons voms or is injured

A

20mg HC and ORT

31
Q

If someone with addisons vomits twice

A

Use emergency HC injection and seek help

32
Q

If someone with addisons uses antibiotics

A

Double the HC dose throughout therapy

33
Q

Monitoring in addisons admission for infection 7

A 
Fever
HR and RR
BP (postural is sign of insufficiency)
CRP/WBC
O2 stats
Na and k
Glucagon
34
Q

Generally monitoring for addisons 7

A 
BP
BG
Adrenal function
Thyroid function
U and e
Signs and symptoms
Pt wellbeing
35
Q

What is Addisons?

A

Deficiency of aldosterone and cortisol

Primary adrenal insufficiency

Clinical (32 decks)

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