Endocrine

Question 1

How do you diagnose Addison disease?

Answer 1

Serum cortisol
SythnACTHen test - measure cortisol at 0-30min after
psotive if under 420
Adeanal autoantibodies
Adrenal imaging

Question 2

What is the management of Addison disease?

Answer 2

Medical: aim to replace steroids
Hydrocortisone (glucocorticoid) twice daily
+/-
Fludrocortisone (mineralocorticoid) – if postural hypotension
Increased dose during “stress” - crucial to avoid addisonian crisis

Question 3

What is secondary adrenal insufficiency?

Answer 3

This when the pituitary gland doesn’t make enough ACTH and adrenal glands don’t make enough cortisol.

Question 4

what is cushing sydrome?

Answer 4

when the body produce too much glucocorticoids e.g cortisol.

Question 5

what are some symptoms of cushing syndrome?

Answer 5

1) Round face (known as a “moon face”)
2) Central obesity
Abdominal striae (stretch marks)
3) Enlarged fat pad on the upper back (known as a “buffalo hump”)
4) Proximal limb muscle wasting (with difficulty standing from a sitting position without using their arms)
5) Male pattern facial hair in women (hirsutism)
6) Easy bruising and poor skin healing
7) Hyperpigmentation of the skin in patients with Cushing’s disease (due to high ACTH levels)

Question 6

what are some symptoms of thyroid storm?

Answer 6

Severe tachycardia, fever, vomiting, diarrhoea, dehydration, weakness,
muscle wasting, extreme restlessness, delirium

Question 7

what is the management for a thyroid storm?

Answer 7

Emergency treatment (high mortality)
* IV fluids, propranolol, hydrocortisone, oral iodine
* Carbimazole or propylthiouracil
* Radioactive iodine (131I); thyroidectomy once patient is euthyroid

Question 8

What are some symptoms of addidson disease

Answer 8

Weight loss
Malasie
weakness
fatigue
depression
abdp pain
N+V
Sycope

Question 9

Name some clincal features of addison disease

Answer 9

Pigmentation
postural
Dehydration
Potassium elevated
reduced soduim
reduced glucose

Question 10

What is the management of an addisonian crisis?

Answer 10

100mg IV hydrocortisone
saline
dextros - if low glucose

Question 11

What is conns syndrome?

Answer 11

hyperaldosteronism resulting in increased sodium and h20 but loss of potassium

Question 12

Names some causes of conns

Answer 12

Adrenal adenoma
Bilateral adrenal hyperplasia
Unilateral adrenal hypersecretion with adenoma

Question 13

What is phaeochrmocytoma?

Answer 13

catecholamine-secreting tumour of adrenal medulla

Question 14

Name the clinical presentation of phaochromocytoma

Answer 14

headache+tachycadia+
sweating

Question 15

What can be used to dignose cushing syndrome?

Answer 15

• serum acth
• CRH stimulation test -if serum ACTH is higher than 35% suggests cushing disease
• dexamethsome supression test
• imaging-MRI

Question 16

What is cushing disease?

Answer 16

It causes cushing syndrome but caused by a pituitary adenoma