Flashcards in Endocrinology Deck (52)
Loading flashcards...
1
3 basic problems with endocrine system?
- excess hormones - widespread effect
- reduced hormones - widespread effect
- physical gland enlargement - mass pressure/effect
2
pituitary gland produces what hormone that encourages the thyroid to produce T4/T3?
TSH
3
Thyroxine excess is a disease of the thyroid causing?
hyperthyroidism
thyrotoxicosis
4
Thyroxine lack is a disease of the thyroid causing?
hypothyroidism
5
Thyroid mass changes is a disease of the thyroid causing?
Goitre
6
incidence of hyperthyroidism?
2-3% of women
0.2% men
age common = 20-40 years
7
most common causes of hyperthyroidism?
autoimmune e.g graves disease = most common
goitre or toxic adenoma
pituitary driven
8
symptoms of hyperthyroidism?
sweating, heat intolerance
irrtable, poor sleep, anxiety, palpitations
excess appetite, weight loss, diorrhea
breathlessness
9
signs of hyperthyroidism?
warm moist skin
tachycardia - irregular heart rate
increased blood pressure, heart failure
fine tremor
goitre
10
what is graves disease?
eye disease
exopthalmus
opthalmaplegia
lid lag/retraction
loss of visual activity
11
signs of graves disease?
pretibial myxoedema
12
diagnose graves disease?
clinical
blood tests - thyroid function - low TSH, high T3/4, autoantibodies
radiology sometimes
13
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
14
incidence of hypothyroidism?
2% women
0.2% men
mean age of diagnosis = 60 yrs
15
causes of hypothyroidism?
autoimmune most common = destructive
iatrogenic - surgery, radioiodine
iodine deficiency - rare - iodised salt/fish, poor mountainous areas
rarely pituitary disease
16
symptoms of hypothyroidism?
cold intolerance
weight gain
constipation
hoarse voice
puffed face/extremities
mental slowness/poor memory
hair loss
17
signs of hypothyroidism?
slow pulse
large tongue
deep voice
thin/dry hair
loss of eyebrows
goitre
coarsening of features
acute - rare - coma - hypothermia
18
diagnosis of hypothyroidism?
clinical
blood tests - thyroid function tests - high TSH, low T4/T3
auto antibodies
radiology
19
management of hypothyroidism?
replacement
thyroxine
levothyroxine
20
what is goitre?
thyroid masses
21
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
22
Goitres can cause?
retro sternal extension = dysphagia/breathing difficulties
23
what is an ominous sign of goitre?
look for lymph node enlargement
24
goitre investigations?
radiology - ultrasound/radioisotope scans
fine needle aspiration
blood tests
25
treatment of goitre?
remove underlying cause
may need surgery
26
anti thyroid drug carbimazole can cause what orally?
neutropenia
taste distrubances
27
types of adrenal disease?
- excess corticosteroid - Cushings
- deficient corticosteroid production - Addisons
28
what is Cushings syndrome?
excess ACTH caused by pituitary adenoma
or ectopic production by lungs = cancer
29
excess corticosteroids caused by?
adrenal adenomas
carcinomas
iatrogenic
30