Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
CS Block IV
Endocrine disorders
| Question | Answer |
|---|---|
| ACTH deficiency | reduces adrenal secretion of cortisol, testosterone, and epinephrine (aldosterone secretion remains intact) |
| GH deficiency | causes short stature in children; adults experience asthenia (weakness), and increased cardiac mortality |
| Prolactin deficiency | inhibits postpartum lactation |
| TSH deficiency | causes secondary hypothyroidism |
| LH and FSH deficiency | causes hypogonadism and infertility in men and women |
| ADH deficiency | causes central diabetes insipidus with polyuria and polydipsia; hypernatremia occurs if fluid intake is inadequate |
| Oxytocin deficiency | causes lactation failure in postpartum women |
| ADH deficiency | causes central diabetes insipidus with polyuria and polydipsia; hypernatremia occurs if fluid intake is inadequate |
| Oxytocin deficiency | causes lactation failure in postpartum women |
| Acromegaly and gigantism | exessive growth (hands, feet, jaw, organs); coarse face, deeper voice, amenorrhea, HA, visual field loss, sweaty, weak, |
| Acromegaly and gigantism labs | serum GH is not suppressed following oral glucose; elevated IGF-1; imaging (terminal phalangeal "tufting;" pituitary tumor on CT or MRI |
| Hyperprolactinemia in women | menstrual cycle disturbances (oligomenorrhea, amenorrhea); galactorrhea, infertility |
| Hyperprolactinemia in men | hypogonadism, dec libido, erectile dysfunction, infertility |
| Hyperprolactinemia labs | elevated prolactin; CT or MRI shows pituitary adenoma |
| Thyroid screening tests | Serum TSH (most sensitive for primary hypo and hyper); Free thyroxine (T4) |
| Hypothyroidism tests | Serum TSH (hi in Primary, low in Secondary); Antithyroglobulin and antithyroperoxidase Abs (elevated in Hashimotos hyroiditis) |
| Hyperthyroidism tests | serum TSH (suppressed except in TSH-secreting pituitary tumors or pituitary hyperplasia); Triiodothyrone-T3 (elevated); 123-I uptake (increased; diffuse vs "hot"); Antithyroglobulin/Antimicrosomal Abs; Thyroid stim Ig (TSI)/TSH receptor Ab (hi in Graves) |
| Thyroid nodule testing | fine needle aspiration biopsy - FNAB (best diagnostic for cancer); 123-I uptake (cancer is usu "cold"); 99mTc uptake (vascular vs avascular); Ultrasonography (assists FNAB; monitors pts after surgery) |
| Thyroid nodules and multinodular goiter | single or multiple are found on careful thyroid exams; must get thyroid function test; biopsy for single or dominant nodules or for a Hx of prior head/neck radiation; ultrasound for Bx and follow-up |
| Thyroid nodules with high index of suspicion | Hx of radiation to head/neck/chest; hoarse; Young men, solitary nodule; big nodes; distant metastatic lesions; papillary carcinoma, follicular neoplasm, medullary or anaplastic carcinoma; "cold" solid punctate calcification; Growth with thyroxine therapy |
| Thyroid cancer | painless swelling of thyroid; thyroid fxn tests usu normal; past Hx of irradiation to head/neck; positive thyroid needle aspiration |
| Endemic goiter | common in areas w/low iodine diets; a/w high rate of congenital hypothyroidism (w/impaired cognition & hearing) and cretininsm; may be multinodular and big; most adults are euthyroid (some are hypo or hyper) |
| Hypothyroidism and myxedema (hard, mucin PG filled) | weak, fatigue, cold intolerance, constipation, wt change, depression, menorrhagia, hoarse, dry skin, bradycardia, slow reflexes, anemia, hyponatremia, Low T4 and RAI uptake, Elevated TSH if primary |
| Hyperthyroidism/thyrotoxicosis | sweating, wt loss or gain, anxiety, loose stool, heat intolerance, irritable, fatigue, weak, menstrual irregularity, tachycardia, warm/moist skin, tremor, stare; Graves (goiter w/bruit, opthalmopathy); Suppressed TSH in primary, hi T4, FT4, FT4I |
| Thyroiditis | swelling of thyroid gland (can cause pressure in acute/subacute forms) painless enlargement/rubbery if chronic; variable thyroid fxn tests; Serum antithyroperoxidase & antithyroglobulin Abs high in Hashimotos |
| Hypoparathyroidism & Pseudohypoparathyroidism | tetany, carpopedal spasms; tingling of lips and hands; muscle/abdominal cramps; psychological changes; Positive Chvostek's sign & Trousseau's phenomenon; defective nails/teeth; cataracts; Serum Ca low/PO4 high; Alk phos normal; Urine Ca low; Serum Mg lo |
| Hyperparathyroidism | asymptomatic (detected by screening); renal stones, polyuria, hypertension, constipation, fatigue, mental changes; Bone pain; rare cystic lesions & pathologic fxs; Serum/urine Ca elevated; urine PO4 hi, serum PO4 low-nml; Alk phos nml-high; Elevated PTH |
| Osteoporosis | asymptomatic to severe backache from vertebral fractures; Spontaneous incidental fx findings; loss of height; NORMAL Serum PTH, 25(OH)2, Ca, PO4, AlkPhos; Demineralization of spine, hip, pelvis |
| Paget's Disease of Bone (osteitis deformans) | often asymptomatic; bone pain may be 1st Sx; kyphosis, bowed tibias, large head, deaf, frequent fxs; NORMAL Serum Ca & PO4; HIGH AlkPhos & urinary hydroxyproline; Dense, expanded bones on x-ray |
| Acute adrenocortical insufficiency (adrenal crisis) | weakness, abdominal pain, fever, confusion, N/V/D; Low BP, dehydration; Inc skin pigmentation; HIGH Serum K, BUN; LOW Na; ACTH canot stimulate normal increase in serum cortisol |
| Chronic adrenocortical insufficiency (Addision's disease) | weak, fatigue, anorexia, wt loss, N/V/D, pain, amenorrhea; Sparse axillary hair, inc skin pigment (creases/pressure/nipples); Hypotension, sm heart; LOW Na; HIGH K, Ca, BUN; Neutropenia, LOW Plasma cortisol (no change w/corticotropin admin); HIGH ACTH |
| Cushing's syndrome | central fat, wasting, thick skin, bruisable, psych changes, hirsutism (excess hair), purple striae; osteoporosis, HTN, poor healing; Hyperglycemia, glycosuria, leukocytosis, lymphocytopenia, hypokalemia; HIGH cortisol/free in urine; not suppr. w/dexameth |
| Hirsutism & virilization | menstrual probs, hair growth, acne, inc muscles, androgenic alopecia, deep voice, enlaged clitoris; a/w palpable pelvic tumor; urine 17-ketosteroids & serum DHEAS/androstenedione HIGH in adrenal disorders (variable in others); HIGH serum testosterone |
| Primary hyperaldosteronism | HTN, polyuria, polydipsia, muscular weakness; Hypokalemia, alkalosis; HIGH plasma/urine Aldosterone; LOW plasma renin |
| Pheochromocytoma | "attacks" of HA, sweat, palpitations, nausea, abd pain; chest pain, weakness, dyspnea, tremor, visual disturbances, anxiety, wt loss, heat intolerance; HTN, freq sustained but often paroxysmal; HIGH urine catecholamines/metabolites; NORMAL serum T4, TSH |
| Islet cell tumors | 50% of tumors are non-secretory; pts present with wt loss, abdominal pain, jaundice; Secretory tumors cause a variety of manifestations depending on the hormones secreted (insulin, gastrin, glucagon, somatostatin, VIP) |
| Male hypogonadism | diminished lipido/erection; dec growth of body hair; small or nml testes; LOW serum testosterone; HIGH serum LH and FSH in testicular failure; LOW LH and FSH in hypogonadic hypogonadism |
| Causes of Primary Amenorrhea | Hypothalamic-Pituitary (low-nml FSH); Hyperandrogenism (low-nml FSH); Ovarian dysgenesis/Turners (high FSH); Pseudohermaphroditism (high LH); No uterus (nml FSH); Pregnancy (high hCG) |
| Causes of Secondary Amenorrhea & menopause | Pregnant (hi hCH); Hypothal-pituitary causes (low-nml FSH; low frequency GnRH pulses; Hyperandrogenism (nml-low FSH, polycystic ovary excess FSH favors favors LH); uterine infxn/sclerosis (nml FSH); Premature ovarian failure (high FSH); menopause (hi FSH) |
| Turners syndrome | gonadal dysgenesis; 45 XO; primary hypogonadism, short stature; primary amenorrhea & early ovarian failure; High FSH and LH; Risk of DM, HTN, dyslipidemia, osteoporosis, reduced life expectancy |
| Multiple Endocrine Neoplasia: MEN1 - Wermer's Syndrome | mc multiglandular syndrome; hyperparathyroidism (hypercalcemia d/t hyperplasia or adenoma); pancreatic islet cell tumors (gastrinomas; PUD, diarrhea); pituitary adenoma (usu nonfxnl) |
| Multiple Endocrine Neoplasia: MEN2a - Sipple's Syndrome | multiglandular hypersecretion; auto dom (ret protooncogene); medullary thyroid carcinoma; pheochromocytoma; or Hirschsprung's disease |
| Multiple Endocrine Neoplasia: MEN2b | syndrome characterized by mucosal neuromas, pheochromocytomas, medullary thyroid carcinoma; prophylactic thyroidectomy in pts w/mucosal neuromas |
| Type I Diabetes | polyuria, polydipsia, wt loss a/w plasma glucose >200mg/dL; plasma glucose >126 after overnight fast; Ketonuria/ketonemia; Islet autoantibodies |
| Type II Diabetes | Most pts >40yo & obese; Polyuria, polydipsia; initial manifestation may be candidal vaginitis; Plasma fasting glucose >126 & >200 after 75g oral glucose; HTN, dyslipidemia, atherosclerosis |
| Type I immune-mediated diabetes | ketosis, present of islet cell Abs, HLA positive; eucaloric healthy diet & preprandial rapid-acting insulin + basal insulin replacement w/intermediate or long-acting insulin |
| Type I idiopathic diabetes | ketosis, no antibodies, no HLA association; eucaloric healthy diet & preprandial rapid-acting insulin + basal insulin replacement w/intermediate or long-acting insulin |
| Type II nonobese diabetes | no ketosis, no antibodies, no HLA; Tx w/eucaloric diet alone OR Diet plus insulin or oral agents |
| Type II obese diabetes | no ketosis, no antibodies, no HLA; Tx w/weight reduction OR hypocaloric diet + oral agents or insulin |
Created by:
bscaryp