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19 Cards in this Set
- Front
- Back
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What are the endocrine glands?
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Thyroid
Parathyroid Pituitary and hypothalamus Adrenals Gonads (testes or ovaries) Pancreas Pineal gland |
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What past history needs to be obtained for the endocrine system?
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- previous pregnancies (ease of conception, post partum hemorrhage etc)
- relevant surgery (e.g. thyroidectomy, orchidoplexy) - radiation (e.g. to gonads, thyroid) - drug exposure (e.g. chemotherapy, sex hormones, oral contraceptives) - childhood developmental milestones and growth |
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What family history needs to be obtained for the endocrine system?
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- autoimmune disease
- endocrine disease - hypertension - diabetes - family details |
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What social history needs to be obtained for the endocrine system?
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- alcohol intake
- drug abuse - occupation (exposure to chemicals) - diet (salt, liqorice, iodine) |
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What other information should be obtained for the endocrine system?
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- height
- weight - body habitus - hair growth - age of sexual development |
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What is goitre?
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An enlarged thyroid is called a goitre.
Enlargement can be: - diffuse - multinodular - uninodular Enlargement can be associated with - euthyroidism - hyperthyroidism - hypothyroidism |
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What are the complications of goitre?
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- Obstruction (blood vessels, airway, swallowing)
- associated with disease state - cosmetic |
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How do you look for retrosternal extension?
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Palation - feel for a lower border. Absence suggests retrosternal extension.
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What do you look for when auscultating the thyroid gland?
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Listen over each lobe for a bruit. This is a sign of increased blood supply which may occur in hyperthyroidism, or occasionally from the use of antithyroid drugs. The differential diagnosis also includes a carotid bruit (obliterated by gentle pressure over the base of the neck). If there is a goitre, apply mild compression to the lateral lobes and listen again for stridor.
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What are the clinical features of hyperthyroidism?
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Weight loss, increased appetite
Recent onset of heat intolerance Agitation, nervousness Hot, sweaty palms Fine peripheral tremor Bounding peripheral pulses Tachycardia, atrial fibrillation Lid retraction & lid lag Goitre with or without bruit Brisk tendon reflexes |
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What are the clinical features of hypothyroidism?
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Constipation and weight gain
Hair loss, dry flaky skin Hoarse croaky voice Balding and loss of eyebrows (laterally firts) Xanthelasma's (hyperlipidaemia) Goitre especially with iodine deficiency Effusions, pericardial or pleural Delayed relaxation phase of tendon relflexes Carpal tunnel syndrome |
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What are the clinical features of hyperparathyroidism?
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Nonspecific symptoms (nausea, lethargy, drowsiness, constipation, muscle weakness, polydipsia, polyuria)
Kidney stones (with associated symptoms) Peptic ulcers Oteitis fibrosa cystica, osteopaenia Psychiatric Asymptomatic |
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What are the clinical features of hypoparathyroidism?
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Muscle spasms (carpopedal, facial grimacing, larynospasm, convulsions)
Intestinal cramps Arrhythmias Depression, pscyhosis Trousseau's, Chvostek's signs |
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What is Trousseau's sign?
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Trousseau's sign is elicited with a blood pressure cuff placed on the arm with the pressure raised above the patient's systolic pressure. Typical contraction of the hands occurs within two minutes when hypocalcaemia has caused neuromuscular irritability. The thumb becomes strongly adducted and the fingers are extended except at the metacarpophalangeal joints. The appearance is that of an obstetrician about to remove the placenta manually and is called the main d'accoucheur.
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What is Chvostek's sign?
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Chvostek's sign is performed by tapping gently over the facial (7th) cranial nerve under the ear. The nerve is hyperexcitable in hypocalcaemia and a brisk muscular twitch occurs on the same side of the face.
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What are the clinical features of Cushing's syndrome?
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Round, moon shaped plethoric face
Hirsutes, acne Hypertension Buffalo hump on neck (fatty deposit) Central distribution of fat Proximal muscle wasting & weakness Purple skin striae, ecchymoses Amenorrhoea, polyuria & polydipsia Psychiatric changes |
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What are the symptoms & signs in Addisons disease?
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Muscle weakness
Pigmentation (& vitiligo) - skin & mucous membranes Malaise, nausea, vomiting & weight loss Hypotension (esp postural) Abdominal pain (diarrhoea & constipation) |
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What are the clinical features of Acromegaly?
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Coarse, prominent facial features
Prognathoid jaw Prominent nose & forehead Thickened lips & large tongue "Spade shaped" hands Excessive sweating & greasy skin Kyphosis Hypertension Bitemporal hemianopia develops Carpal tunnel syndrome Impaired glucose tolerance |
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What are the clinical features of Hypopituitarism?
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Men - loss of libido, impotence, infertility
Women - amenorrhoea, infertility, vaginal atrophy, dysparenuria, breast atrophy Loss of axillary and pubic hair Mild to moderate hypothyroidism ACTH defic. - weakness, hypotension, pallor, hypoglycaemia ADH defic - polyuria, polydipsia |
