Cushing’s syndrome- what is it?
Normally, adrenal glands release cortisol. Prolonged abnormal elevation of cortisol.
Cushing’s syndrome symptoms
Striae-stretch marks mainly on abdomen
Cushing’s syndrome causes
Excessive steroid use
Can also be cause by a tumour that secretes the hormone
Patient- reduce steroid dose or stop taking it at all
If the cause is a tumour we’ll have to do surgery to remove the tumour OR radiotherapy to destroy the tumour OR medications to reduce the effects of cortisol on the body, eg ketconazole
Loss of muscle mass
Addison’s - what is it?
When the immune system attacks the adrenal gland dmging it therefore it doesn’t produce enough cortisol or aldosterone
Addison’s signs and symptoms
Hyponatraemia and hyperkalaemia
Replace the missing hormones- hydrocortisone and fludrocortisone lifelong
Risk of sudden worsening of symptoms- Adrenal cfrisis
Can be fatal if untreated
Call 999 if severe worsening of symptoms
Hyperthyroidism- what is it?
thyroid is a small organ in front of windpipe. Normally produces thyroxine which controls various processes in your body eg heart rate and temperature control.
Hyperthyroidism is when your gland produces too much hormone producing symptoms like palpitations, weight loss, sweating, heat sensitivity, swelling in neck
Graves- immune system attacks thyroid causing overactivity.
Thyroid nodules- modules form on gland causing more production and release of thyroxine
Medications- certain iodine containing meds eg amiodarone can cause overactive thyroid
Carbimazole- stops thyroid from producing excess hormones. May take 1-2 months to notice change so will be given a B blocker symptom relief. Complete remission and ability to stop taking it is usually achieved within 18 months, however some need to take for years/life.
Radioiodine drink in hospital- destroys some of the thyroid tissue. Will need to avoid prolonged contact w/ children or pregnant women for a few days. May need artificial thyroxine treatment after.
Surgery- remove thyroid whole or toxic nodules. Levothyroxine given lifelong after
Graves- can affect eyes- reduction in eye movement and bulging of the eyes- leading to vision loss
Thyroid storm- severe hyperthyroidism
What is hypothyroidism
Not enough thyroid hormones produced-> symptoms like tiredness, weight gain, depression
What causes hypothyroidism
Usually caused by immune system attacking the thyroid gland meaning not enough thyroid hormones is produced. Can laso be linked to viral infections and certain drugs (eg lithium, amiodarone)
Oral levothyroxine- artificial version of hormone taken daily.
Yearly blood tests to measure thyroid hormone levels
Heart problems- more cholesterol can build up in blood increasing chance of heart attack
Goitre- large lump in neck
What is diabetes?
Condition that causes high blood sugar levels. Normally controlled by insulin hormone which is produced by an organ called pancreas, which allows cells body to use this sugar and so remove it from the blood.
Diabetes T2 is when these cells stop responding to the insulin, leading to high glucose lvls in blood
diabetes common symptoms
numbness in hands and feet
Lifestyle: Change diet (reduce sweet things, carbs and alcohol) and lose weight.
Physical exercise for at least 20 mins 3 times a week
Meds- May need to be put on tablets in the future eg metformin which increases sensitivity of your cells to insulin
Can annually check your blood sugar as well as kidney function amonst other things. Can also put you in touch w/ a dietician to help make changes to your diet
can make you feel v ill, urinating a lot, dehydrated,
Can dmg blood vessels in body, can dmg organs in your body- increase chances of heart attack stroke, kidneys, eye
Hyperparathyroidism what is it
Parathyroid hormone is released by parathyroid glands when we have low calcium to raise it. Calcitonin is the counter hormone taht acts to decrease calcium.
Primary hyperthyroidism what is it? Most common cause
Primary hyperparathyroidism: normally released in response to low calcium- leads to high calcium and low phosphate.
Cause- Parathyroid adenoma
Primary hyper parathyroidism symptoms
Asymptomatic or hypercalcaemic features- bones, stones, abdominal groans and psychic moans:
pancreatitis, peptic ulceration, constipation, N&V
depression, anorexia, psychosis
primary hyperparathyroidism treatment
total parathyroidectomy or conservative- Cinacelcet- calcimemetic (copies calcium)
Treatment for secondary