Question

Understand s/sx, patho, etiology, any pertinent labs, and diagnosis of:

? Hyperthyroidism

? Acromegaly

? Hypopituitarism

? Addisons disease

? Cushings syndrome

? Hypothyroidism

Congenital hypothyroidism

? Dwarfism

? Psychosocial dwarfism

? Thyroid storm

? SIADH

Answer 1

• Hyperthyroidism- Due to hypersecretion of thyroid hormones. ( T 3 and T4)
• S/S- Mood swings, Irritability, agitation, weight loss, diarrhea, hypertension, Enlarged thyroid gland ( Goiter)
• Pathophysiology- Excess hypothalamic and pituatory gland secretion- Secrete TSH- Excess thyroid hormone( T3 and T4)- Increased sympathetic activity and hypermetabolic state
• Etiology- Excess iodine, Graves disease, autoimmune disorder, inflammation of thyroid
• Diagnosis and labs- TSH level, Radioactive iodine uptake
• Acromegaly ( Hyperpituitarism)
• Hypersecretion of growth hormone by the anterior pituatory gland in an adult, caused by tumours
• Large hands and feet , protrution of jaw ,Organomegaly,Hypertension, Hyperglycemia
• P/P and Etiology- Hypersecretion of growth hormone, Pituatory tumours, Micro and macroadenomas, Extra pituatory disorders, Elevated GH levels, Pressure from pituatory adenoma, elevated GF and IGF-1
• Diagnosis- Insulin like growth factor 1( IGF -1), Oral glucose tolerance test (OGTT)
• Hypopituitarism- Hyposecretion of 1 or more of the pituatory hormones caused by tumours, trauma, encephalitis, autoimmunity or stroke
• When one or more hormone production is impaired-Reduced secretory action of the particular gland- Action of targeted gland continues to remains low
• Hormones affected are GH< ACTH< TSH< ADH
• Obesity, reduced cardiac output, infertility, fatigue, hypotension, headaches, visual defects( if tumour presents)
• Check TSH , CT Brain, Level of LH, FSH and testosterone
• Addisons disease ( Adrenal Cortex Insufficiency)
• Hyposecretion of adrenal cortex ( Primary)
• Hyposecretion of ACTH ( Secondary)
• Lethargy, fatigue, Muscle weakness, SWeight loss, Hypoglycemia, Hyperkalemia, Hypotension, Hypercalcemia, Weight Loss
• Loss of glucocorticoids/ Mineralocorticoid- decreased vascular tune- decrease vascular response to catecholamines epinephrine and norepinephrine and decreased gluconeogenesis
• ACTH stimulation test, CRH stimulation test, Blood test ( NA, K, Cortisol and ACTH), CT and MRI Scans