Endocrine

Question 1

Cushing’s syndrome- what is it?

Answer 1

Normally, adrenal glands release cortisol. Prolonged abnormal elevation of cortisol.

Question 2

Cushing’s syndrome symptoms

Answer 2

Weight gain
Depression
Insomnia
Amenorrhea
Hair growth
Acne
Moon face
frontal balding
Striae-stretch marks mainly on abdomen
Buffalo hump
Kyphsois- hunchback

Question 3

Cushing’s syndrome causes

Answer 3

Excessive steroid use
Can also be cause by a tumour that secretes the hormone

Question 4

Cushing’s management

Answer 4

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

Question 5

Cushing’s complications

Answer 5

Bone loss
Hypertension
T2DM
Frequent infections
Loss of muscle mass

Question 6

Addison’s - what is it?

Answer 6

When the immune system attacks the adrenal gland dmging it therefore it doesn’t produce enough cortisol or aldosterone

Question 7

Addison’s signs and symptoms

Answer 7

Fatigue
Weakness
Thirst
Hyperpigmentation- bronze
Hyponatraemia and hyperkalaemia

Question 8

Addison’s management

Answer 8

Replace the missing hormones- hydrocortisone and fludrocortisone lifelong

Question 9

Addison’s complications

Answer 9

Risk of sudden worsening of symptoms- Adrenal cfrisis
Medical emergency
Can be fatal if untreated
Call 999 if severe worsening of symptoms

Question 10

Hyperthyroidism- what is it?

Answer 10

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

Question 11

Hyperthyroidism causes

Answer 11

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

Question 12

Hyperthyroidism treatment

Answer 12

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

Question 13

Hyperthyroidism complications

Answer 13

Graves- can affect eyes- reduction in eye movement and bulging of the eyes- leading to vision loss
Thyroid storm- severe hyperthyroidism

Question 14

What is hypothyroidism

Answer 14

Not enough thyroid hormones produced-> symptoms like tiredness, weight gain, depression

Question 15

What causes hypothyroidism

Answer 15

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)

Question 16

Hypothyroidism treatment

Answer 16

Oral levothyroxine- artificial version of hormone taken daily.
Yearly blood tests to measure thyroid hormone levels

Question 17

Hypothyroidism complications

Answer 17

Heart problems- more cholesterol can build up in blood increasing chance of heart attack
Goitre- large lump in neck

Question 18

What is diabetes?

Answer 18

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

Question 19

diabetes common symptoms

Answer 19

polyuria
polydipsia
numbness in hands and feet

Question 20

diabetes management

Answer 20

Lifestyle: Change diet (reduce sweet things, carbs and alcohol) and lose weight.
Physical exercise for at least 20 mins 3 times a week
Stop smoking.
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

Question 21

diabetes complications

Answer 21

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

Question 22

Hyperparathyroidism what is it

Answer 22

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.

Question 23

Primary hyperthyroidism what is it? Most common cause

Answer 23

Primary hyperparathyroidism: normally released in response to low calcium- leads to high calcium and low phosphate.
Cause- Parathyroid adenoma

Question 24

Primary hyper parathyroidism symptoms

Answer 24

Asymptomatic or hypercalcaemic features- bones, stones, abdominal groans and psychic moans:
bone pain
renal stones
pancreatitis, peptic ulceration, constipation, N&V
depression, anorexia, psychosis

Question 25

primary hyperparathyroidism treatment

Answer 25

total parathyroidectomy or conservative- Cinacelcet- calcimemetic (copies calcium)

Question 26

Treatment for secondary
hyperparathyroidism