Endocrine Core Conditions Flashcards

Question

How common is hyperthyroidism?

Answer 1

400 per 100,000

Answer 2

20-50 year olds

Answer 3

60-80% due to Grave's Toxic multinodular goitre Solitary toxic nodule Uncommon acute thyroiditis, pregnancy, neonatal thyrotoxicosis, drugs (amiodarone, exogenous iodine)

Answer 4

``` FHx High iodine intake Smoking TRauma Toxic multinodular goitre Contrast agents Childbirth HAART ```

Answer 5

``` Weight loss Heat intolerance Palpitations Tremor Agitated Decreased appetite Weakness Fatigue Diarrhoea Lowered libido Reduced periods Palmar erythema Tachycardia AF/HF Hair thinning Diffuse alopecia Urticaria Pruritus Brisk reflexes Goitre Lid lag Gynaecomastia ```

Answer 6

``` Goitre Grave's Plummer-Winson syndrome Malignancy Anxiety ```

Answer 7

TFTs TPO and thyroglobulin present in Grave's TSH receptor Abs Thyroid US

Answer 8

Anti-thyroid drugs (carbimazole, methimaxole, propylthiouracil) Radio-iodine Thyroidectomy

Answer 9

``` Diffuse smooth goitre may be physiological (puberty, pregnancy) Autoimmune (Grave's, Hashimoto's) Acute thyroiditis Iodine deficiency Dyshormonogenesis Goitrogens (sulphonylureas) Reidel's thyroiditis Cysts Adenomas Cancer TB/sarcoidosis ```

Answer 10

``` Pregnancy Menopause Lithium Eating too much iodine Exposure to radiation Lack of dietary iodine Female Increasing age FHx ```

Answer 11

``` Neck swelling Painless (unless inflamed) Dyspnoea Dysphagia Coughing Tight feeling in throat Hoarse/vocal changes Bruit (thyrotoxicosis) Retrosternal extension if inferior border cannot be palpated ```

Answer 12

Exam TFTs Thyroid Abs USS CXR for tracheal compression If there is 1 nodule (or 1 dominant) fine needle aspiration Radioactive thyroid scan (hot v cold nodules - cold = 10% chance of malignancy)

Answer 13

Depends on cause | Treat underlying cause

Answer 14

F>M | Uncommon in children and adolescents

Answer 15

``` Iodine deficiency Pregnancy Female Lithium Menopause Malignancy Benign thyroid disease FHx ```

Answer 16

``` Asymptomatic Pain/compression of trachea Swallow water whilst palpating Note movement, asymmetry Check for regional lymphadenopathy ```

Answer 17

``` Non-toxic goitre Grave's/Hashimoto's Solitary thyroid nodule Carcinoma Thyroid lymphoma Acute suppurative thyroiditis ```

Answer 18

``` Physical exam TFTs Thyroid Abs USS CXR Fine needle aspiration Radioactive thyroid scan ```

Answer 19

Based on cause | Benign + asymp = no treatment needed

Answer 20

``` Obese DM HTN Osteoporosis F>M 25-40 y/o ```

Answer 21

Pituitary dependent Ectopic ACTH producing tumours ACTH administration

Answer 22

Adrenal adenomas Adrenal carcinomas Glucocorticoid administration Alcohol induced pseudo-Cushing's

Answer 23

``` Female Lung cancer (ectopic ACTH) Prolonged use of corticosteroids in asthma/RhA ```

Answer 24

``` Central weight gain Depression Psychosis/insomnia Low libido Thin skin, easy bruising Poor wound healing Purple/red striae Kyphosis Back pain Polyuria Growth arrest in children Muscle weakness Hair growth Acne Amenorrhoea Moon face Plethora Frontal balding HTN Glycosuria ```

Answer 25

``` Chronic anxiety/depression Prolonged excess alcohol Obesity Poorly controlled DM HIV ```

Answer 26

``` 24 hour urinary free cortisol 48 hour low dose dexamethasone suppression test and late night salivatory cortisol FBC, U+E Adrenal CT/MRI Hypokalaemia with ectopic ACTH Plasma ACTH CRH test for pituitary dependent Cushing's CXR for lung malignancy ```

Answer 27

Surgical treatment for adrenal tumours Drugs (metyapone, ketoconazole, mitotane) Pit radiotherapy Complications of surgery: Nelson's, loss of hormonal function