Endocrine Flashcards
(156 cards)
prolcatinoma basics
benign
men - decreased libido, macroadenoma, bitemporal hemaniopsia
women - amenorrhea + galactorrhea - microadenoma
dx of prolactinoma
check meds –> check TSH –> normal –> check prolactin level –> if elevated –> MRI
tx of prolactinoma
dopamine agonist - carbergoline > bromocriptine
sx only if tumor unresponsive to meds or >3cm
Acromegaly basics
benign GH secreting tumor, increased risk for cancer
kids - gigantism
adults - big hands, feet, face, visceral organs (diastolic HF), diabetes
dx of acromegaly
increased ILGF-1 –> glucose suppression test –> (+) –> MRI
glucose suppression test explained
give pt glucose you expect: insulin to go down epi to go up cortisol to go up growth hormone to go up - but here it doesnt change
Acute or sudden hypopituitarism
path - infection, infarction, iatrogenic
(Sheehans, apoplexy (big tumor))
hypotensive, tachy - lack of cortisol
lethargy, coma - lack of T4
dx and tx of acute hypopituitarism
dx - cortisol levels, T4 levels
tx - replace hormones
chronic hypopituitarism
path - autoimmune, deposition dz ( sarcoidosis, etc), tumor
prioritize ACTH and TSH so stop making FSH/LH –> decreased libido, fatigability, menstrual issues
dx and tx of chronic hypopituiraism
dx - insulin stim test - similiar to glucose stim test - no Change in GH –> MRI
tx- replace hormones and fix underyling dz
empty stella
pituitary gland out of place
pt asymptomatic
dx - MRI
tx - nothing
SIADH
path - brain lesion, small cell lung cancer - exogenous ADH production
dx of SIADH
increase Urine Osm and increased Urine Na
decreased serum Osm - due to continuous absorption of water
tx of SIADH
water restriction -> doesnt work –> democlocycline (which basically induces DI)
causes of nephrogenic DI
democlocycline or lithium ADR
leads to decreased ADH
presentation of DI
polydipsia
polyphagia
nml blood glucose
no glucose in urine
dx of DI
water deprivation test
- deprive them of water
- > pts urine osm goes up = psychogenic
- > no change –> give ADH
- –> urine osm goes up = central DI
- –> no change in urine osm = nephrogenic Di
tx of central DI
DDAVP - vasopressin
tx of nephrogenic DI
gentle diuresis with HCTZ +/- amilioride
basic hyperthyroidism symptoms
tachycardia
heat intolerance
increased DTR
weight loss
diarrhea
afib
dx of hyperthryoidism
TSH decreased
T4 increased
TSH decreased
T4 decreased
central thyroid issue TRH issue
Graves dz
thyroid stimulating abs –> increased growth and activity
diffuse increased RAIU
exopthalmus, tibial myxedema
Thyroiditis Painless
painless
due to preformed T4 –> gets released due to inflammation –> spills T4 –> initial transient Hyperthyroidism state –> goes normal or hypothyroidism (Hashimotos)