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Phase 1c > Endo > Flashcards

Endo Flashcards

1
Q

hyperthyroidism signs and symptoms

A

tremor
anxiety
palpitations
heat intolerance
diarrhoea
oligomenorrhoea

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2
Q

causes of hyperthyroidism

A

Grave’s disease
toxic multinodular goitre
thyroiditis
drugs (i.e amiodarone)

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3
Q

management of hyperthyroidism

A

propanolol
carbimazole (TPO inhibitor)
radioiodine

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4
Q

which antibodies are associated with Grave’s disease

A

anti-TSH receptor antibodies

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5
Q

how does propanolol work to treat hyperthyroidsm

A

used to block b receptors as in hyperthyroidism T4/3 excess leads to increased expression of b-adrenergic receptors thus increased sympathetic tone

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6
Q

antibodies associated with Hashimoto’s thyroiditis

A

anti-TPO antibodies

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7
Q

hypothyroidism signs and symptoms

A

lethargy
cold intolerance
weight gain
constipation
menorrhagia
reduced deep tendon reflexes

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8
Q

causes of hypothyroidism

A

Hashimoto’s thyroiditis
subacute (de Quervain’s) thyroiditis
drugs (i.e. amiodarone, lithium)
iodine deficiency

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9
Q

hypothyroidism mx

A

levothyroxine

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10
Q

thyroid eye disease features

A

bilateral exophthalmos
diplopia
conjunctival oedema (chemosis)
ophthalmalgia
exposure keropathy
optic neuropathy
lid lag and retraction (caused by sympathetic hyperactivity of muscle in upper eyelid)

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11
Q

thyroid eye disease pathophysiology

A

anti TSH receptor antibodies bind to TSH receptor behind eye

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12
Q

Grave’s disease niche signs

A

thyroid eye disease
pretibial myxoedema
thyroid acropachy

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13
Q

thyroid cancer features

A

non-functional, painless, rapidly growing
solitary, irregular (nodular) shape
hoarse voice (recurrent laryngeal nerve)
dysphagia
haemoptysis
airway obstruction
cervical lymphadenopathy

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14
Q

thyroid cancer Ix

A

fine needle aspiration biopsy with USS, CT/PET, thyroid scan

TFTs may be useful to exclude benign (functional) nodules

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15
Q

types of thyroid cancer

A

papillary carcinoma (70%) (female, childhood radiation exposure)

follicular carcinoma (20%) (female, low iodine intake)
- Hurthle cell carcinoma is a variant

medullary carcinoma (5%) - associated with MEN 2A and MEN 2B

anaplastic carcinoma (1%)

lymphoma (rare)

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16
Q

what would biopsy show for thyroid follicular carcinoma

A

neoplastic papillae + psammoma bodies + ground glass nuclei

17
Q

which cells are affected in thyroid follicular carcinoma

A

follicular cells

18
Q

which cells are affected in thyroid papillary carcinoma

A

follicular cells

19
Q

which cells are affected in thyroid medullary carcinoma

A

c-cells
produce calcitonin which is measured in the blood

20
Q

typical age onset for MEN1

A

teens and 20s

21
Q

typical age onset MEN2

A

any age but mostly later in life (50-70)

22
Q

how is MEN1 inherited

A

autosomal dominant inheritance of an inactivating mutation of the tumour suppressor gene MEN1

23
Q

organs affected with MEN1

A

remember 3 Ps

Parathyroid, pancreatic, pituitary
others (eg. carcinoid, adrenal, thyroid)

24
Q

MEN1 signs and symptoms

A

varies depending on organ affected

hypercalcaemia (due to hyperPTH from parathyroid adenoma/hyperplasia)
-stones, moans, groans

peptic ulcer (caused by too much gastrin)
insulinomas, glucagonomas, gastrinomas (gastrinomas most likely to be functional)

pituitary tumours mainly secrete prolactin

25
Q

MEN1 Ix

A

check PTH and Ca for primary hyperthyroidism
elevated gastrin from gastrinoma
hypoglycaemia and raised c-peptide for insulinoma
hyperglycaemia and raised glucagon for glucagonoma
stage with CT/MRI and DEXA for hyper PTH

26
Q

how is MEN2 inherited

A

autosomal dominant inheritance of activating mutation of the proto-oncogene, RET

27
Q

how does MEN2A present

A

presents with parathyroid involvement so hypercalcaemia symptoms and phaeochromocytoma (sweating, palpitations, hypertension, headaches)

28
Q

MEN1 Ix

A

check PTH and Ca for primary hyperthyroidism
elevated gastrin from gastrinoma
hypoglycaemia and raised c-peptide for insulinoma
hyperglycaemia and raised glucagon for glucagonoma
stage with CT/MRI and DEXA for hyper PTH
genetics

Phase 1c (13 decks)

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