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Endocrine > Endocrine > Flashcards

Endocrine Flashcards

1
Q

5 hormones of the anterior pituitary

A 
Growth hormone 
Prolactin
FSH
TSH
ACTH
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2
Q

Two hormones of the posterior pituitary

A

ADH and oxytocin

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3
Q

Causes of hypotituitarism

A

Primary tumor or metastatic tumor
Hemorrhage (pituitary apoplexy)
Sheehan syndrome (post partum pituitary hypoperfusion and infarction)
Infection, trauma, vascular event , infiltration diseases, rads, surgery

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4
Q

Presentation hypopituitarism

A 
Headache,s visual field deficits
Altered mental status
Signs and symptoms of 
Hypothyroid
Hypogonadism
Adrenal insufficiency
Diabetes insipidus
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5
Q

Treatment hypopit

A

Supportive care
Steroids first then thyroid replacement
Endo consult

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6
Q

Three ways pth acts

A

Kidneys: phosphate excretion, calcium absorption, convert vit d to active
Bone: increases osteoclasts
GI: calcium absorption

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7
Q

Three causes hypoparathyroid

A

Iatrogenic eg post thyroid surgery
Congenital eg digeorge
Pseudohypoparathyroid: kidney not responsive to pth

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8
Q

Treatment hypoparathyroid

A

Treat accompanying hypocalcemia with iv replacement

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9
Q

8 causes of hypothyroid

A 
Hyperthyroid treatment 
Post thyroidectomy or rads
Autoimmune hashimoto throiditis
Iodine deficiency 
Meds: lithium, amiodarone 
Pregnancy
Pituitary: tumor, disorder, infiltration, hemorrhage 
Hypothalamic damage or dysfunction
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10
Q

Presentation myxedema coma

A

Hypothermia, altered mental status
Bradycardia, edema,
Respiratory failure due to co2 narcosis from decreased rr
Brisk DTR with delayed relaxation
Low voltage on ecg if pericardial effusion

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11
Q

Treatment myxedema coma

A

Hydrocortisone empirically as may have co existing adrenal insufficiency
300-500 ug iv thyroxine
Rewarming
Correct lytes, glucose

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12
Q

What is the presentation of apathetic hyperthyroidism

A

Lethargy, weakness, weight loss, blepharoptosis and atrial fibrillation with chf

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13
Q

7 precipitants of thyroid storm

A 
Infection
DKA
MI
PE
trauma
Surgery
Stress
Iodine load
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14
Q

7 causes hyperthyroidism

A 
Graves
Exogenous thyroid replacement
Post party thyroiditis
Multinodular or single adenoma thyroid nodule 
Drug induced eg amiodarone
Pituitary adenoma
Thyroid carcinoma
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15
Q

Findings in thyroid storm

A 
Hyperthermia 
Tachycardia, possibly a fib 
Heart failure
CNS effects (agitation,  delirium, seizures)
GI hepatic dysfunction

Look for other signs hyperthyroid eg exophthalmos, goiter, lid lag

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16
Q

Treatment thyroid storm (in order)

A

Propranolol (esmolol if chf) for adrenergic effects
PTU to decrease thyroid hormone production
Wait one hour
Iodine to prevent hormone release
Dexamethasone

Methimazole
Cooling
No aspirin

17
Q

Causes of primary and secondary adrenal insufficiency

A

Primary (low aldosterone and or cortisol): autoimmune (addisons), infectious or infiltration of the gland (TB, sarcoid, hiv), drugs (rifampin, ketoconazole, methadone), hemorrhage
Secondary (cortisol only): prolonged steroid use, etomidate, fluconazole, pituitary tumor or infarction, Sheehan

18
Q

In which type of adrenal insufficiency do you see hyperpigmentation of the skin

A

Primary due to elevation of ACTH

19
Q

Lab findings in adrenal insufficiency

A

Hyponatremia, hyperkalemia, hypoglycaemia

Low am cortisol and poor response to acth stim test

20
Q

How does acute adrenal crisis present

A

Presence of trigger eg withdrawal of steroids, pituitary apoplexy, acute phyiologic stress
Refractory hypotension and hypoglycaemia
Hyponatremia, hyperk

21
Q

Management acute adrenal crisis

A

Iv resuscitation, glucose, treat hyper k
If hyper k and known adrenal insufficiency then hydrocortisone 100mg iv
If k normal and no known diagnosis then dex 4-6mg iv as it does not interfere with acth stim test

22
Q

Four causes of Cushing syndrome

A

Exogenous steroids
Adrenal tumor
Cushing disease: pituitary tumor making excessive acth
Ectopic acth producing tumor

23
Q

What is the classic presentation of pheochromocytoma

A

Episodic headache, sweating, tachycardia
Weight loss

Hypertension

24
Q

What is the treatment of pheochromocytoma

A

Diagnosis with plasma metanephrine and urine 24 hour collection for elevated catecholamines

Treatment: first alpha blockade with phentolamine 1-4 mg bolus
Then bb
Tumor resection is definitive

Endocrine (2 decks)

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