Miscellaneous Endo Flashcards
(15 cards)
Acromegaly
⬆️GH production (GH secreting pituitary tumour)
Headaches, bitemporal hemianopia
⬆️prolactin
⬇️glucocorticoids/sex steroids/thyroid hormones
Hyperhidrosis
Frontal bossing
Macroglossia
OSA
Glucose intolerance (DM)
HTN
Colonic polyps and colon adenocarcinoma
Bilateral carpal tunnel
Test insulin-like growth factor 1 (IGF-1)
Conn’s syndrome
Primary hyperaldosteronism
⬆️aldosterone secretion from adrenal glands - adenoma
⬇️renin
HTN + ⬇️K+
30-60y/o 👩🏻
Fatigue, muscle weakness, cramping, headaches, palpitations (⬇️K+)
Polydipsia and polyuria (diabetes insipidus)
Rx-surgery
Phaeochromocytoma
Catecholamine-secreting tumour from chromaffin cells
Headaches, palpitations, sweating, severe HTN - vary in occurrence
More common with genetic disorders:
MEN IIa and IIb
Neurofibromatosis
Von Hippel-Lindau (VHL) disease
Plasma free metanephrines
24h urine catecholamines
Rx - a-blockers, B-blockers, surgery
MEN IIb
PMMM
Phaeo
Medullary thyroid Ca
Mucosal neuroma
Marfinoid habitus
MEN I
PPP
Pituitary adenoma
Pancreatic tumour
Parathyroid hyperplasia
MEN IIa
PPM
Phaeo
Parathyroid
Medullary thyroid Ca
Primary Hyperparathyroidism
Tumour of parathyroid gland
⬆️PTH
⬆️Ca2+
Secondary Hyperparathyroidism
⬇️vit D/CKD
⬇️absorption of Ca2+
⬆️PTH
Ca2+ remains ⬇️/normal
Rx - renal transplant/vit D replacement
Tertiary Hyperparathyroidism
Prolonged 2nd HPT
Hyperplasia of parathyroid gland (used to producing +++PTH)
2nd HPT treated
⬆️PTH and ⬆️Ca2+
Rx - surgical removal of part of parathyroid gland
Cushing’s syndrome
Pituitary adenoma secreting ⬆️ACTH
⬆️glucocorticoids (cortisol)
Obesity, hirsuitism, buffalo hump, moon face, hyperpigmentation (Cushing’s disease + paraneoplastic)
Overnight dex. supp. test (give dex, measure cortisol, should be low but if high then Cushing’s)
48h dex. supp. test
Cushing’s syndrome - prolonged use of steroids/paraneoplastic (SCLC)/adrenal adenoma
Rx - metyrapone, surgery
Haemochromatosis
Autosomal recessive
HFE gene on chr. 6
⬆️iron
Severe fatigue
Impotence
Arthralgia
Hepatomegaly
Later: skin bronzing, DM, cirrhosis
R of hepatocellular Ca
Addison’s disease
Primary adrenal insufficiency
Autoimmune
Fatigue
Weakness
Mucocutaneous hyperpigmentation
⬇️BP
Salt craving
⬇️Na+, ⬆️K+
Cortisol levels
⬆️ACTH (⬇️/normal in secondary)
Sheehan’s syndrome
Major PPH
Avascular necrosis of pituitary gland
Diabetes Insipidus
⬆️thirst ⬆️urine (dilute)
⬆️Na+ ⬆️serum Osm
⬇️urine Osm
Salty blood, dilute urine
Neurogenic - ⬇️ADH
Urine Osm returns to normal after desmopressin
Nephrogenic - kidneys don’t respond to ADH, e.g. lithium therapy
Urine Osm remains ⬇️ after desmo
Psychogenic polydipsia - normal urine osmolality
Carcinoid tumours
Most common NET
2/3 - GI tract (small intestine)
Secretion of bradykinin and serotonin:
Bronchospasm
Diarrhoea
Skin flushing
R heart valve lesions
Convert tryptophan to serotonin leading to tryptophan and niacin deficiency —>pellagra
