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FOCP > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What can be seen in patients with hypothyroidism?

A

Hair loss, eyebrow loss, toad face, paleness, depression, dry hair, cold feet

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2
Q

What is the clinical presentation of Cushing’s syndrome?

A

Moonface, muscle wasting, buffalo hump, lemon of sticks appearance

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3
Q

What can be seen in patients with Addison’s disease?

A

Hyperpigmentation

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4
Q

What can be seen in patients with acromegaly?

A

Overgrowth of soft tissue, hands, and feet and jaw

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5
Q

What can be seen in patients with hyperandrogenism?

A

Hirturtism, temporal balding, acne

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6
Q

What can be seen in patients with hypopituitarism?

A

Yellowing of skin, thinning of skin, patients look older

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7
Q

What can be seen in patients with thyrotoxicosis?

A

Hair loss, pretibial myxedema, oncholysis, bulging eyes

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8
Q

When does type 1 diabetes present?

A

Usually at adolescents, but can be at any age

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9
Q

What causes type 1 diabetes?

A

Autoimmune destruction of pancreatic beta cells

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10
Q

How does type 2 diabetes present?

A

Increased prevalence in Asians, usually at 40

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11
Q

What causes type 2 diabetes?

A

Reduced insulin secretion with increased insulin resistance

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12
Q

What are the risk factors of type 2 diabetes a?

A

Obesity, lack of exercise, calorie and food excess

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13
Q

What are some other causes of DM?

A

Steroids, pancreatic obstruction, cancer, pancreatitis, pancreatic surgery, trauma, Cushing’s, acromegaly, glycogen storage, congenital, pregnancy, hyperthyroidism

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14
Q

What is the definition of hypoglycaemia?

A

Fasting glucose less than 3mmol/l

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15
Q

What are the signs and symptoms of a hypo?

A

Sweating, clamminess, anxiety, tremor, hunter, drowsiness, confusion, dizziness, coma, seizures

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16
Q

What are the symptoms of thyrotoxicosis?

A

Diarrhoea; weightloss, appetite gain (if , paradoxical weight gain in 10%); over-active; sweats; heat intolerance; palpitations; tremor; irritability; labile emotions; oligomenorrhoea ±infertility. Rarely psychosis; chorea; panic; itch; alopecia; urticaria.

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17
Q

What are the signs of thyrotoxicosis?

A

Pulse fast/irregular (AF or SVT; VT rare); warm moist skin; fine tremor; palmar erythema; thin hair; lid lag (fig 1; eyelid lags behind eye’s descent as patient watches your finger descend slowly); lid retraction (exposure of sclera above iris; causing ‘stare’). There may be goitre (fig 2); thyroid nodules; or bruit depending on the cause.

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18
Q

What are the symptoms of grave’s disease?

A

Eye swelling, pretibial myxedema, thyroid atrophy

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19
Q

What is the typical Graves patient?

A

Female, aged 40-60

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20
Q

What causes Graves?

A

circulating IgG autoantibodies binding to and activating G-protein-coupled thyrotropin receptors, which cause smooth thyroid enlargement and  hormone production (esp. T3), and react with orbital autoantigens.

21
Q

What can trigger Graves?

A

stress; infection; childbirth.

22
Q

Name 4 other causes of thyrotoxicosis

A

Toxic multinodular goitre:
• Toxic adenoma:
• Ectopic thyroid tissue:
• Exogenous: Iodine excess, eg food contamination, contrast media

23
Q

What are the symptoms of hypothyroidism?

A

Tired; sleepy, lethargic; mood; cold-disliking; weight; constipation; men- orrhagia; hoarse voice; memory/cognition; dementia; myalgia; cramps; weakness.

24
Q

Apart from BRADYCARDIA what are the signs of hypothyroidism?

A

BRADYCARDIC; reflexes relax slowly; ataxia (cerebellar); dry thin hair/skin; yawning/drowsy/coma (p844); cold hands ± T°; ascites ± non-pitting oedema (lids; hands; feet) ± pericardial or pleural effusion; round puffy face/double chin/obese; de- feated demeanour; immobile ± ileus; CCF.e

25
Q

What are the causes of,primary hypothyroidism?

A

Hashimotos, atrophy, thyroidectomyk radiological treatment, drug induced, subclinical,

26
Q

What are the causes of secondary hypothyroidism?

A

Insufficient TSH

27
Q

What is Cushing’s syndrome?

A

Excess glucocorticoid with loss of hypothalamus,pituitary adrenal axis

28
Q

What can cause Cushing’s syndrome?

A

Cushing’s disease (pituitary adenoma) oral steroids, adrenal adenoma, adrenal hypertrophy, ectopic ACTH production

29
Q

What are the signs of Cushing’s?

A

Central obesity; plethoric, moon face; buffalo neck hump; supraclavicular fat distribution; skin & muscle atrophy; bruises; purple abdominal striae (fig 1); osteopo- rosis; BP; glucose; infection-prone; poor healing

30
Q

What are the symptoms of Cushing’s

A

Weight; mood change (depression, lethargy, irritability, psychosis); proximal weakness; gonadal dysfunction (irregular menses; hirsutism; erectile dys- function); acne; recurrent Achilles tendon rupture; occasionally virilization if .

31
Q

What causes Addison’s disease?

A

Destruction of adrenal cortex caused by autoimmune, TB, adrenal metastasis, lymphoma, adrenal haemorrhage,

32
Q

What is Addison’s?

A

Adrenal insufficiency

33
Q

What are the signs of Addison’s?

A

Often diagnosed late: lean, tanned, tired, tearful ± weakness, anorexia, dizzy, faints, flu-like myalgias/arthralgias. Mood: depression, psychosis, low self- esteem.12 GI: nausea/vomiting, abdominal pain, diarrhoea/constipation. Think of Addison’s in all with unexplained abdominal pain or vomiting. Pigmented palmar creases & buccal mucosa (ACTH; cross-reacts with melanin receptors). Postural hypo- tension. Vitiligo. Signs of critical deterioration (p846): Shock (BP, tachycardia), T°, coma.

34
Q

What can cause hirsutism?

A

familial, idiopathic or are due to  androgen secretion by the ovary (), the adrenal gland (eg late-onset congenital adrenal hyperplasia, Cushing’s syndrome, adrenal cancer), or drugs (eg steroids)

35
Q

What are the causes of gynaecomastia?

A

Hypogonadism (see BOX), liver cirrhosis (oestrogens), hyperthyroidism, tumours (oestrogen-producing, eg testicular, adrenal; HCG-producing, eg testicular, bronchial); drugs: oestrogens, spironolactone, digoxin, testosterone, marijuana

36
Q

What is acromegaly?

A

Increased secretion of GH from pituitary tumour

37
Q

What are the symptoms of acromegaly?

A

Acroparaesthesia (akron=extremities); amenor- rhoea; libido; headache; sweating; snoring; arthralgia; backache;

38
Q

What are the signs of acromegaly?

A

Skin tags, puffy eyes, widely spaced teeth, coarsening face, increased growth of hands and feet and jaw, skin darkening, scalp folds, acanthosis nigrans, goitre, proximal weakness, carpal tunnel

39
Q

What are the complications of acromegaly?

A

Impaired glucose tolerance (~40%), DM (~15%).
•Vascular: Hypertension , left ventricular hypertrophy (±dilatation/CCF), cardiomyopathy, arrhythmias. There is risk of ischaemic heart disease and stroke (?due to BP ± insulin resistance and GH-in-
duced increase in fibrinogen and decrease in protein S).
• Neoplasia: colon cancer risk; colonoscopy may be needed.

40
Q

What drug blocks over active thyroids?

A

Carbiamazole

41
Q

Cotton will spots in the retina are signs of what?

A

Retinal ischaemia, which suggests worsening diabetes

42
Q

What test is used to confirm adrenal suppression?

A

Synadhen teste

43
Q

What is the first line oral hypoglycaemic for BMI>25?

A

Metformin

44
Q

What does new vessel formation in the retina show?

A

Worsening diabetic retinopathy

45
Q

What is the test for acromegaly?

A

OGTT

46
Q

What should be tested for a possible diagnosis of subclinical hyperthyroidism?

A

Serum thyroid peroxidase antibodies

47
Q

Confusion, drowsiness, polyuria and polydypsia is what until proven otherwise?w

A

Diabetic ketoacidosis

48
Q

What is raided prolactin caused by?

A

Raised dopamine

FOCP (12 decks)

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