5. Endocrinology Flashcards Preview

1. BDS2 BAMS Revision > 5. Endocrinology > Flashcards

Flashcards in 5. Endocrinology Deck (12):
1

Pituitary tumours

Types (2) and features (2) of each
Effects of too much (2) and too little (2) GH
Definition and signs/symptoms (8) of acromegaly

Functional - well differentiated, hormone producing
Non-functional - space-occupying, non-hormone producing (visual field defects)

Too much GH - acromegaly, gigantism. Too little - growth failure, metabolic changes

Appositional bone growth. Coarse features, enlarged supra-orbital ridges, broad nose, big hands, big tongue, reverse overbite IHD, visual field defects

2

Thyroid dysfunctions

Types (2)
Investigations (2)

Hormone levels in primary hyperthyroidism (2)
Hormone levels in secondary hyperthyroidism (2)
Hormone levels in primary hypothyroidism (2)
Hormone levels in secondary hypothyroidism (2)

Goitre is due to

Hyperthyroidism, hypothyroidism

Blood test, FNA/FNB

Reduced TSH, raised T3
Raised TSH and T3
Raised TSH, reduced T4
Reduced TSH and T4

Iodine deficiency

3

Hyperthyroidism and hypothyroidism

Causes (2)
Signs and symptoms (7)
Treatment and drug treatment (2)

Definition of Graves disease
Signs and symptoms

Hypothyroidism

Causes (2)
Signs and symptoms (4)
Treatment

Graves disease (primary), pituitary tumour (secondary)

Hot, excess sweating, weight loss, palpitations, increased BP, eyelid retraction, lid lag

Surgery, beta-blockers

Auto-antibody stimulation of TSH receptors

Opthalmopathy

Hashimotos (primary), pituitary tumour (secondary)

Cold intolerance, tired, delayed reflexes, goitre

Thyroxine tablets

4

Diabetes Mellitus

Definition
Diagnosis involves
Definition of glucose tolerance test, including values (4)

Cause of type 1
Features of type 1 (2)
Unusual type of type 1
Signs and symptoms (4)
Management

Cause of type 2 (5)
Diagnosis
Signs and symptoms
Management (2)
Complications (5)

Hypoglycaemia signs and symptoms (4)
Management (2)

Ketoacidosis signs and symptoms (4)
Management (3)

Types of oral hypoglycaemic agents (2)
Oral side effects (5)

Abnormality of glucose regulation

Two random plasma glucose tests, results > 11.1

Normal < impaired glucose tolerance < diabetic diagnosis
GTT - 8 hour fast - normal < 6.1, IGT 6.1-7.0, diabetes > 7.0
75g glucose load, wait 2 hours - normal < 7.8, IGT 7.8-11.1, diabetes > 11.1

Immune-mediated destruction of pancreatic B cells by auto-antibodies

Ketoacidosis, hypoglycaemia

LADA - latent autoimmune diabetes in adults

Polydipsia, polyuria, tiredness, weight loss (maintained appetite)

Insulin

Obesity, sedentary, diet, genetics, environmental

Rule out type 1 diabetes

Often none - present with complications

Weight loss, diet changes

Poor wound healing, unusual infections, diabetic retinopathy, neuropathy, nephropathy

Warm, sweaty, pale, palpitations
Glucose, glucagon

Sweet breath, dehydration, polyuria, increased HR
Insulin, potassium, IV hydration

Insulin secretagogues, insulin sensitisers

Dry mouth, soreness, ulcers, increased risk of decay, lichenoid reactions

5

Hormones and therapeutic steroids

Function of aldosterone
Function of cortisol (2)

Function of therapeutic steroids
Side effects of therapeutic steroids (8)

Salt and water retention (Na uptake, K loss)

Maintains BP (prevents hypotension), reduces bone synthesis

Increase glucocorticoid and mineralocorticoid effects

Hypertension, type 2 diabetes, osteoporosis, increased infection risk, peptic ulceration, easy bruising, hyperlipidaemia, psychiatric disturbances

6

Adrenal dysfunction

Types of hyper function diseases and associated hormones (2)
Types of hypo function and associated diseases (2)

Cushing's syndrome (cortisol), Conn's syndrome (aldosterone)

Primary (Addison's disease), secondary (Sheehan's disease)

7

Cushing's syndrome

Effect
Main cause
Signs and symptoms (4)
Investigations (2)
Diagnosis/results
Treatment is based on whether primary/secondary cause - treatment types (2)

Raised steroid hormones (ACTH and cortisol, etc.)

Cushing's disease

Diabetes features, HTN, purport/thin skin, muscle weakness

24hr urine sample, CRH test

Increased ACTH and cortisol

Tumour removal, enzyme inhibitors

8

Addison's disease and acute adrenal crisis

Effect
Cause
Signs and symptoms (4)
Investigations
Positive synACTHen result when cortisol is not produced - gland destruction. Results of primary (2)/secondary hypo function
Complications
Management (2)

Reduced steroid hormones (ACTH and cortisol, etc.)

TB - autoimmune adrenalitis

Postural hypotension, weight loss, weakness, loss of body hair

24hr urine sample, CRH test

Reduced ACTH, raised cortisol (-synACTHen) - gland adenoma
Reduced ACTH and cortisol (+synACTHen) - pituitary failure)
Raised ACTH, reduced cortisol (-synACTHen) - gland failure

Hormone replacement

Acute adrenal crisis/Addisonian crisis

Hormone replacement (treat problem), fluid resuscitation

9

Causes of oral pigmentation (6)

Race, smoking, drugs (contraceptive pill), pregnancy, melanoma, chronic trauma

10

Cushing's syndrome

Effect
Main cause
Signs and symptoms (4)
Investigations (2)
Diagnosis/results
Treatment is based on whether primary/secondary cause - treatment types (2)

Raised steroid hormones (ACTH and cortisol, etc.)

Cushing's disease

Diabetes features, HTN, purport/thin skin, muscle weakness

24hr urine sample, CRH test

Increased ACTH and cortisol

Tumour removal, enzyme inhibitors

11

Addison's disease and acute adrenal crisis

Effect
Cause
Signs and symptoms (4)
Investigations
Positive synACTHen result when cortisol is not produced - gland destruction. Results of primary (2)/secondary hypo function
Complications
Management (2)

Reduced steroid hormones (ACTH and cortisol, etc.)

TB - autoimmune adrenalitis

Postural hypotension, weight loss, weakness, loss of body hair

24hr urine sample, CRH test

Reduced ACTH, raised cortisol (-synACTHen) - gland adenoma
Reduced ACTH and cortisol (+synACTHen) - pituitary failure)
Raised ACTH, reduced cortisol (-synACTHen) - gland failure

Hormone replacement

Acute adrenal crisis/Addisonian crisis

Hormone replacement (treat problem), fluid resuscitation

12

Causes of oral pigmentation (6)

Race, smoking, drugs (contraceptive pill), pregnancy, melanoma, chronic trauma