Endocrine 2 medicine Flashcards

(28 cards)

1
Q

endocrine glands

A

ductless glanads

release directly into the blodostream

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2
Q

hormones

A

chemical signals produced by an endocrine glands that act some distance from the gland

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3
Q

what does the thyroid glands pridce

A

thyroxine t4
tri-iodotyronine T3
(T4 usually converted to T3 which is the main hormone which has an effect on tissues)
calcitonin

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4
Q

what does calcitonin do

A

regulate blood calcium levels

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5
Q

cascade of hormone release from thryodi

A

hypothalamus secretes TRH
TSH secreted by pituitary
thyroid secretes T3/4

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6
Q

measurement of the thyroid hormones

A

T4
T3
TSH (stimulating hormone)

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7
Q

hypothyroidism

A

T4/3 insufficient

suspected if TSH higher the normal

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8
Q

primary hypothyroidism and secondary

A

1) primary hypothyroidism
- Thyroid not producing enough T4/T3
- pituitary produces more TSH to compensate
can see a goitire
2) secondary hypothyroidism
- Pituitary not producing enough TSH
- therefore lack of T3/T4

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9
Q

symptoms and signs of hypothyroidism

A
symptoms
weight gain
lethargy
cold intolerance
menorrhagia
signs
- facial puffiness
bradycardia
hoarsness
periorbital oedema
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10
Q

causes of primary/secondayr/teritiary hypothyroidism

A
primary 
- dyshormogenesis
iodine deficiency 
autoimmunity 
post radioactivity iodine

secondya
pituitary tumour/granuloma

Tertiary
isolated TRH deficiency

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11
Q

indicatons for screening hypothyroidism

A

1) Congenital hypothyroidism
2) Treatment of hyperthyroidism
3) Neck Irradiation
4) Pituitary Surgery or Irradiation
5) Patients on lithium and amiodarone

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12
Q

treament of hypothyroidism

A

levothyroxine

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13
Q

graves diseas

A

increase T3/4
decreased TSH
goitre
abnormal thyroid stimulating IgG

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14
Q

causes of hyperthyroidism

A

autoimmune thyroid disease eg graves
nodular goitre
toxic adenoma

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15
Q

symtoms and signs of hyperthyroidisim

A

symptoms
weight loss
heat intolerance
increased sweating, appetite

signs
goitre
tremor
tachyarida
warm skin
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16
Q

graves disease clinical features

A
diffuse goitre
eye signs (bulging, dry eyes)

hyperthyroidism

17
Q

treatment of hyperthyroidism

A

oral antithyroid drugs

surgical

18
Q

primary diagnostic tool for thyroid issues

19
Q

hypothalamus

A

produces hormones which influences the pituitary to release hormones

20
Q

pituitary dysfunction can lead to 3 options..

A

1) tumour mass effects
- can cause headaches and visual defects
2) hormone excess
- signs of excess hormone
3) hormone deficiency
- peripherally in the body

21
Q

causes of hypopituitarism

A
pituitary tumours
radiotherapy 
trama
infarction
infiltration
22
Q

acromegaly and features

A

excess growth hormone therefore high IGF 1

Clinical features 
Head related
-	Coarse facial features
-	Enlargement of supraorbital ridges
-	Separation of teeth
-	Prognathism
-	Macroglossia
23
Q

adrenal gland cortisol - how is it stimulated for production

A

hypothalamus produces CRH
drives production of ACTH from pituitary
cortisol released from adrenal gland

  • disruption to this can be a disorder e.g. cushings
24
Q

Cushing syndrome and cuases

A

excess glucocorticods
causes
pituitary/adrenal tumour

25
pituitary tumour/adrenal tumour causes
Pituitary tumour – ACTH dependant hypocortisolism (cushings) - producing too much ACTH - stimulates adrenal to produce too much cortisol Adrenal tumour – ACTH independent hypocortisolism - excess cortisol - ACTH levels will go low
26
adrenal insufficiente
primary - lack of cortisol in adrenal gland, moree ACTH to compensat Secondary , lack of cortisol production, lack of ACTH can indicate problem from pituitary
27
causes of adrenal insufficiency
autoimmune tuberulosis secondary after treatment of cushings after exogenous glucocorticoids
28
glucocorticoid cover for dental procedure
patients may be on glucocorticoids, steroids for procedures should up the dose to prevent adrenal crisis Simple - double dose 1 hr before surgery, double dose for 24hrs after major hydrocortisone 100mg im at induction; 50mg im 6 hourly until well and then double dose oral steroids for 24 – 48hours