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IMS Endocrinology > Lecture 32 - clinical abnormalities of glands > Flashcards

Lecture 32 - clinical abnormalities of glands Flashcards

(70 cards)

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1
Q

over active thyroid

A

hyperthyroidism

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2
Q

under active thyroid

A

hypothyroidism

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3
Q

primary defect means problem in…

A

thyroid gland

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4
Q

secondary defect means defect in…

A

pituitary gland not secreting stimulating hormone to thyroid gland

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5
Q

static tests are used to diagnose problems in

A

thyroid, sex glands, prolactin

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6
Q

stimulation test used for

A

suspected hormonal UNDER secretion

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7
Q

supression test used for

A

suspected hormonal OVER secretion

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8
Q

hyperthyroidism static test for =

A

high T3 and T4 (thyroid hormones)

undetectable TSH

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9
Q

test for prolactin

A

static

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10
Q

test for thyroid

A

static

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11
Q

test for ovaries/testis

A

static

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12
Q

FSH in men

A

sperm maturation, testicular growth, production of ADP (androgen binding protein) on Sertoli cells

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13
Q

LH in men

A

stimulates testosterone production

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14
Q

test for adrenal insufficiency = low cortisol levels

A

synacthen test

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15
Q

synacthen test

A

give patient ACTH, if patient fails to respond, gland failure is diagnosed

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16
Q

glucagon stimulation test is what type of test

A

stimulation test

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17
Q

insulin stress test is what type of test

A

stimulation test

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18
Q

glucagon stimulation test - to check

A

pituitary failure - production of ACTH and GH

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19
Q

insulin stress test (injection of insulin via cannula)

A

pituitary failure - production of ACTH and GH

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20
Q

gland failure diagnosed from suppression test if

A

excessive production still continues - negative feedback system not working as large dose given should switch off production

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21
Q

glucose suppression test

A

glucose administered, should reduce GH secretion

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22
Q

High T4, very low TSH

A

primary hyperthyroidism

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23
Q

High TSH, very low free T4

A

primary hypothyroidism

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24
Q

symptoms of (primary) hypothyroidism

A

fatigue, lethargy, depression, being cold, weight gain

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25
High TSH, high T4
secondary hyperthyroidism
26
Normal TSH, low T4
secondary hypothyroidism
27
low FSH, LH, testosterone
primary gonadofailure
28
symptoms of adrenal failure
weight loss, dizziness, visibly ill, low BP
29
prolactin over-secretion = prolactinoma
galactorrhoea = breast milk production headaches and visual field problems men = sexual dysfunction, lowered libido women = amenorrhoea (periods stop)
30
prolactinoma diagnosis (noncancerous tumour causes excess production of prolactin)
static test, pituitary MRI
31
why visual field defects
tumour can compress optical chiams behind optical nerve
32
reasons behind mildly raised levels of prolactin = do not confuse with prolactinoma
sex, nipple stimulation, stress, drugs (antipsychotics, antidepressants), if tumour is between hypothalamus and pituitary, can suppress interaction between
33
what is the only over-secreting pituitary tumour that can be treated with drugs
prolactinomas - rarely require surgical intervention
34
GH over-secretion in children
excessive growth, large feet and hands, if left untreated can lead to gigantism
35
GH over-secretion in adults
Acromegalic face, wide hands and feet, increased sweating
36
test for GH over-secretion
suppression test = glucose given
37
prolactinoma usually due to
pituitary tumour
38
GH over-secretion diagnosis
suppression glucose test, MRI to confirm pituitary tumour
39
GH over-secretion treatment
surgical excision, radiotherapy and medical therapy may also be needed
40
Possible causes of Cushing's syndrome
- pituitary secreting ACTH = Cushing's disease - adrenal tumours secreting cortisol - cancers producing ACTH like substances
41
Hirsuitism
male-pattern hair growth in women
42
What is Cushing's syndrome
over-secretion of cortisol, steroid hormone
43
Cushing's clinical presentation facial features
round (moon) face, acne, hirsuitism
44
Cushing's clinical presentation fat distribution
truncal obesity, thin extremities
45
Cushing's clinical presentation skin abnormalities
thin skin, easy bruising, stretch marks (striae) on abdomen
46
Cushing's complications
hypertension, diabetes, high infection rate, poor wound heeling
47
Cushing's diagnosis
suppression test = dexamethasone used to confirm the failure to suppress cortisol production
48
difference between adrenal failure and pituitary Cushing's
problem in adrenal = undetectbale ACTH | problem with pituitary or tumour present = detectable ACTH
49
Cushing's treatment
adrenal and pituitary surgery, radiotherapy and medical therapy may be needed
50
Causes of hyperthyroidism (10 times more common in women, 2% prevalance in female population)
``` Graves disease Toxic nodule or MNG Thyroiditis Drug induced (amiodarone) Rarities ```
51
Graves disease = 80% of cases
autoimmune disease that affects the thyroid, body produces anitbodies that work the same as TSH so receptors on thyroid are stimulated, more thyroid hormones secreted
52
MNG
Multi nodular goitre = swelling of thyroid gland causing lump(s) in front of neck
53
Thyroiditis
Inflammation of thyroid gland, typical after viral infection, destruction of gland that causes release of hormones (not over production)
54
Thyroiditis stages
biphasic condition = overactive then underactive when ti is injured then stabilises
55
Amiodarone
drug prescribed by cardiologists, controls heartbeat, can cause over and under-active thyroid, 40% of drug is iodine
56
Graves' disease symtpoms
hyperactivity, irritability, heat intolerance, sweating, palpitations, weight loss despite overeating, menstrual problems
57
Quick examination, signs of thyrotoxicosis
- hand tremour, - increased sweating - fast pulse
58
thyrotoxicosis hand examination
ask patient to hold out both hands, assess shaking (can place sheet of paper on top to make more obvious), feel palms for sweat and temperature using back of hand, assess nails, check radial pulse
59
Thyroid inspection = usually enlarged
Smooth: Graves’ disease Nodular: toxic nodule(s) Tender: thyroid inflammation = thyroiditis
60
Extrathyroidal disease = eyes
swelling round the eyes, protrusion of eyeball (proptosis), paralysis of eye muscles
61
proptosis
protusion of eyeball
62
periorbital edema
swelling around the eyes, fluid accumulation
63
Thyroid problems test
static test is enough = blood test, suppressed TSH
64
Thyroid hromone over-production treatments
surgery, anti-thyroid drugs , radioactive iodine
65
radioactive iodine tablets
thyroid takes up all the iodine, goes from overactive t underactive, then treatment of underactive thyroid = easy just give hormones for life
66
Levothroxine
daily hormone replacement tablets for under active thyroid
67
Anti-thyroid drugs
disease remission in 50% of patients after treatment for 6-18 months
68
problem with anti-thyroid drugs
VERY RARE = suppress WBC production = patient susceptible to infection and so immediate admission to A and E (given special card)
69
symptoms of patient with WBC suppression from anti-thyroid medication
sore throat, temperature, mouth ulcers
70
Anti-thyroid drug most common
Carbimazole

IMS Endocrinology (4 decks)

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