Flashcards in Endocrinology Deck (52):
3 basic problems with endocrine system?
- excess hormones - widespread effect
- reduced hormones - widespread effect
- physical gland enlargement - mass pressure/effect
pituitary gland produces what hormone that encourages the thyroid to produce T4/T3?
Thyroxine excess is a disease of the thyroid causing?
Thyroxine lack is a disease of the thyroid causing?
Thyroid mass changes is a disease of the thyroid causing?
incidence of hyperthyroidism?
2-3% of women
age common = 20-40 years
most common causes of hyperthyroidism?
autoimmune e.g graves disease = most common
goitre or toxic adenoma
symptoms of hyperthyroidism?
sweating, heat intolerance
irrtable, poor sleep, anxiety, palpitations
excess appetite, weight loss, diorrhea
signs of hyperthyroidism?
warm moist skin
tachycardia - irregular heart rate
increased blood pressure, heart failure
what is graves disease?
loss of visual activity
signs of graves disease?
diagnose graves disease?
blood tests - thyroid function - low TSH, high T3/4, autoantibodies
management of graves disease?
anti thyroid drugs - carbimazole, propylthiouracid
beta blockers - control symptoms while other tx
surgery - control disease first, poss eye surgery
radioactive iodine - caution if youner/pregnant/breastfeeding
incidence of hypothyroidism?
mean age of diagnosis = 60 yrs
causes of hypothyroidism?
autoimmune most common = destructive
iatrogenic - surgery, radioiodine
iodine deficiency - rare - iodised salt/fish, poor mountainous areas
rarely pituitary disease
symptoms of hypothyroidism?
mental slowness/poor memory
signs of hypothyroidism?
loss of eyebrows
coarsening of features
acute - rare - coma - hypothermia
diagnosis of hypothyroidism?
blood tests - thyroid function tests - high TSH, low T4/T3
management of hypothyroidism?
what is goitre?
types of goitre?
- no association with intrinsic thyroid disease - simple cysts/adenomas - iodine deficiency
- associated with intrinsic thyroid disease - autoimmune, toxic multi nodular goitre/adenoma
- Malignant = rare
Goitres can cause?
retro sternal extension = dysphagia/breathing difficulties
what is an ominous sign of goitre?
look for lymph node enlargement
radiology - ultrasound/radioisotope scans
fine needle aspiration
treatment of goitre?
remove underlying cause
may need surgery
anti thyroid drug carbimazole can cause what orally?
types of adrenal disease?
- excess corticosteroid - Cushings
- deficient corticosteroid production - Addisons
what is Cushings syndrome?
excess ACTH caused by pituitary adenoma
or ectopic production by lungs = cancer
excess corticosteroids caused by?
Cushings syndrome has what systemic risk factors?
can cause high bp
pt prone to infection
what is Addison's disease?
- caused iatrogenically by withdrawl of steroids after long term use
- hypopituitarism - b/c cancer, infection, vascular, trauma
- adrenal destruction - b/c autoimmune disease
what is chronic addisons?
what is acute addisons?
response to stress
=> shock, hypoglycaemia, vomiting, abdominal pain
signs of addisons?
buccal mucosa scars, pressure points, skin creases
treatment of addisons?
replacement therapy = baseline tx
hydrocortisone - glucocorticoid 20mg am 20mg pm
flufrocortisone - mineralcorticoid
what is an acute addisonian crisis?
need fluid replacement
treat if infection is present
dentally look out for what with addisons pt? cushings?
addisons - hyperpigmentation
cushings - oral infections/poor wound healing
what is an excess of growth hormone?
caused by pituitary adenoma - rare = 2-3/million
signs of acromegaly?
spade like hands/feet - myopathy/arthritis
pronounced supraorbital ridge
thick greasy skin
treatment of acromegaly?
medically - somatostatin analouges
surgery - compressing nearby structures, also radiotherapy
types of diabetes?
type 1 - IDDM 10% autoimmune young pts
type 2 - NIDDM 90% - insulin resistance/deficiency - more likely if obese >40 yrs. 10% are over 70
what does diabetes cause an increased risk of?
increased risk of all infections
what is seen on skin/mouth with diabetes?
boils, abscesses, cellulitis, candidosis
what kind of diseases are seen commonly with diabetic pt's?
diabetic neuropathy - loss of sensation, loss of bowel/bladder/sexual function, muscle weakeness/pain
what type of heat condition is common with diabetic pts?
foot problems with diabetes?
treat type 1 with?
type 2 treat with?
emergencies with diabetes - high blood sugar?
HONK - hyperosmolar non ketotic coma
low blood sugar?
what is DKA?
insulin not taken in because no food intake
inadequate insulin in acute physiological stress = infection/surgery