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Summary Endocrine Core Conditions
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A condensed summary of the endocrine core conditions for the Leeds MBChB year 3 syllabus
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ENDOCRINE CORE CONDITIONS SUMMARYCondition Summary Epidemiology Pathophysiology Prognosis Aetiology Risk Factors S/S Investigations DDs Treatment Complications
Decreased adrenocortical Dysfunction of the Adrenal suppression
Disease of Adrenocortical Fatigue; anorexia; N&V;
hormone production as a result of Life-long HRT autoimmune system U&Es; FBC; ACTH from corticosteroids;
primary adrenal Developed antibodies; adrenal weight loss; Secondary Cushing’s;
Addison’s disease insufficiency, destruction of adrenal cortex or required; non- with antibodies stimulation test; secondary/tertiary Glucocorticoids;
countries haemorrhage; TB; hyperpigmentation in treatment-related
(adrenal insufficiency) disruption to hormone synthesis; compliance may directed against the morning serum adrenal insufficiency; mineralocorticoids
causing ↓cortisol M<<F malignancy; mucosa and sun-exposed HTN; osteoporosis
adrenal medulla may also be be life-threatening adrenal cortex; TB; cortisol haemochromatosis;
and ↓aldosterone coeliac disease areas; hypotension
affected from TB or metastases malignancy; drugs hyperthyroidism
Facial plethora (moon face); Urine pregnancy Medical therapy;
Clinical manifestation results from ACTH-secreting acne; weight gain; test; MRI; serum surgical resection Adrenal insufficiency
Clinical excess tissue exposure to Poor if untreated; pituitary adenoma; Same as aetiology; supraclavicular fullness glucose; late-night of tumour; secondary to adrenal
Cushing’s syndrome manifestation of 20-50y/o cortisol; degree of symptoms treatment may adrenal adenoma; exogenous cortisol (buffalo hump); striae; HTN; salivary cortisol; Obesity; metabolic adrenalectomy; suppression; CVD;
(hypercortisolism) pathological M<F syndrome
based on degree of cortisol resolve features neuroendocrine use (e.g. steroids) menstrual problems; pituitary; post-surgical HTN; osteoporosis;
hypercortisolism excess tumours depression; proximal dexamethasone corticosteroid nephrolithiasis; DM
muscle weakness suppression test replacement
Autoimmune pancreatic beta cell
Good glycaemic Polyuria; polydipsia, weight DKA; hypoglycaemia;
Absolute insulin- destruction that exists sub-
control, reduces Geographic loss; blurred vision Random/fasting diabetic neuropathy/
deficiency due to clinically for months-years; at Genetic factors with
Diabetes type 1 destruction of Young Europeans 80-90% destruction, patients are the incidence of environmental location; genetic plasma glucose; T2DM Insulin nephropathy/
(T1DM) <10% of DM complications; predisposition; N&V, abdominal pain, plasma/urine retinopathy; CVD;
pancreatic beta unable to utilise glucose so triggers
fatal if untreated, young age tachypnoea, and lethargy ketones; HbA1c CAD; cerebrovascular
cells present with symptoms of
due to DKA suggest DKA disease; PVD; coma
hyperglycaemia
Deficiency of An initial deficit in insulin secretion Related to quality Unknown Age; obesity; pre- Usually asymptomatic; Lifestyle changes; Diabetic neuropathy/
Random/fasting
insulin secretion, is followed by peripheral insulin of glycaemic diabetes; FHx; recurrent candida infection/ metformin; BP nephropathy/
Diabetes type 2 leading to Non-white adults resistance, impaired regulation of control and/or Genetic and physical inactivity; UTI; fatigue; blurred vision; plasma glucose; Pre-diabetes; T1DM control; lipid retinopathy; foot
(T2DM) >90% of DM HbA1c; glucose
abnormal glucose hepatic glucose production and compliance with environmental PCOS; HTN; CVD; polydipsia, polyuria; management; ulcers; amputation;
tolerance test
metabolism declining beta-cell function medication factors likely dyslipidaemia acanthosis nigricans antiplatelets CVD; CCF; CVA
Bones (osteoporosis,
Most common Most commonly Osteoporosis;
Overproduction of Normally, low calcium stimulates Good cure rate osteomalacia, arthritis);
cause of hyper- parathyroid Serum calcium/ Parathyroid- nephrolithiasis; post-
PTH, resulting in and high calcium suppresses with parathyroid- Age; FHx; lithium groans (N&V, myalgia) Multiple myeloma;
Hyperparathyroidism derangement of calcaemia in adult PTH secretion; in PHPT, PTH is ectomy; CVD is adenoma; inherited treatment; neck/ moans (fatigue, psychosis,
phosphate; PTH; thyrotoxicosis; ectomy; vitamin D surgical recurrent
(primary) disease; lithium; urinary calcium; supplements; laryngeal nerve injury;
calcium outpatients not suppressed by high serum most common head irradiation depression); stones (kidney leukaemia
malignancy; external vitamin D; DEXA bisphosphonates pneumothorax,
metabolism M<F calcium, resulting in excess PTH cause of mortality stones); thrones (polyuria,
neck irradiation hypocalcaemia
polydipsia, constipation)
Heat intolerance,
Autoimmune Anti-TSH receptor antibodies hyperhidrosis; weight loss; Corticosteroids;
Excellent with Stimulation of the Toxic nodular goitre;
thyroid disease; cause thyroid hormone palpitations; tachycardia; beta blocker;
Hyperthyroidism most common M<F overproduction, thyroid good adherence thyroid by TSH FHx; tobacco use anxiety; tremor; change in TSH; serum-free or thyroiditis; TSH- iodine; lithium; Bone mineral loss;
(Graves’ disease) cause of to anti-thyroid receptor antibodies total T4/T3 producing pituitary AF; CCF; blindness
hypertrophy and hyperplasia or bowel habits; diffuse goitre; cholestyramine;
hyperthyroidism medication specific to Graves’ adenoma
thyroid follicular cells menstrual problems; surgery
pretibial oedema
Surgery-related
Thyroid cell growth is mainly Multiple recurrent laryngeal
stimulated by TSH; TSH receptor Goitre; heat intolerance; TSH; free T4; total I-131 therapy;
Hyperthyroidism An active
activity is mediated through alpha
Most become autonomously
Iodine-deficiency; hyperphagia; weight loss; T3; thyroid scan and
Graves’ disease;
pre-treatment
nerve damage,
multinodular Elderly euthyroid ca. 3m functioning nodules toxic adenoma; hypoparathyroidism;
(toxic multinodular goitre a/w M<F subunits of G-protein and cAMP;
after I-131 with germline age; head/neck depression; nervousness; uptake; USS; U&Es; functional thyroid thiamazole; bone mineral loss;
in germline mutations, cAMP irradiation palpitations; tachycardia; LFTs; FBC; TSH thyroid surgery;
goitre) hyperthyroidism
levels are increased, causing
treatment mutations that affect
fine tremor receptor antibodies
cancer
beta-blockers
AF; with large goitres
TSH receptors choking, dysphagia;
excess growth of thyroid cells thyroid storm
Thyroid cell growth is mainly Benign tumour that Surgery-related
stimulated by TSH; TSH receptor Surgery and grows to produce Palpable thyroid nodule; TSH; free T4; total I-131 therapy; recurrent laryngeal
Hyperthyroidism An autonomously
activity is mediated through alpha I-131 therapy thyroid hormones, Iodine-deficiency; hyperphagia; weight loss; T3; thyroid scan and
Graves’ disease;
pre-treatment nerve damage,
functioning thyroid Adults toxic multinodular
(toxic thyroid nodule causing M<F
subunits of G-protein and cAMP; confer moderate after activation of young adult; head/ sweating/heat intolerance; uptake; USS; U&Es;
goitre; functional
thiamazole; hypoparathyroidism,
in germline mutations, cAMP long-term risk of germline mutations neck irradiation palpitations; tachycardia; LFTs; FBC; TSH thyroid surgery; hypothyroidism; bone
adenoma) hyperthyroidism levels are increased, causing hypothyroidism in thyroid cells; fine tremor receptor antibodies thyroid cancer beta-blockers mineral loss; AF;
excess growth of thyroid cells iodine-deficiency thyroid storm
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