Endocrine system

Pheochromocytoma

Submitted by Jothi04 on Mon, 26/09/2011 - 07:53
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Pheochromocytoma is a tumour of chromaffin cells.

Chromaffin cells secrete catecholamines.

Rule of 10

  • 10% familial (MEN 2, Neurofibromatosis etc)
  • 10% extra adrenal (mediastinum, heart, bladder wall)
  • 10% malignant

 

Clinical Features : 5P's

1. Pounding headache

2. Palpitations

3. Perspiration

4. Paroxysmal hypertension (usually)

5. Pain (abdominal pain)

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Hypopituitarism (Simmond's disease):Clinical Features

Submitted by devarshee on Tue, 15/03/2011 - 22:31
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Hypopituitarism is otherwise known as "SIMMOND'S" disease.

There is a two-fold risk of death in patients with hypopituitarism due to untreated GH deficiency.
Houssay Phenomenon: a diminishing requirement of insulin by diabetics may be a sign of Hypopituitarism with diminished secretion of GH and ACTH (and thus corticosteroids).
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Addison's disease/ Hypoadrenalism

Submitted by devarshee on Sat, 12/03/2011 - 09:04
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Features of Addison's disease can be remembered as  "SynACTHEN"

In the acutely ill patient in whom you suspect adrenal insufficiency do not delay treatment; establish venous access and give i.v hydrocortisone 100 mg immediately.
Thyroid function abnormalities may revert to normal with satisfactory glucocorticoid replacement in Addison's disease
When present symptoms are often non-specific and the disease is sometimes only detected at post mortem leading to its description :"the unforgiving master of nonspecificity and disguise".
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Eye signs in Thyroid disease

Submitted by devarshee on Thu, 24/02/2011 - 14:54
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Eye signs in thyroid disease in the usual pattern of appearance can be remebered as,

'NO SPECS'

  •  No signs or symptoms.
  •  Only signs of upperlid retraction and stare, with or without lid lag and exophthalmos
  •  Soft tissue involvement
  •  Proptosis
  •  Extraocular muscle involvement
  •  Corneal involvement
  •  Sight loss due to optic nerve involvement
Proptosis is assessed using Hertel's exophthalmometer.
Many of the manifestations of thyrotoxicosis reflect increased sensitivity to circulating catecholamines, eg. tremor, sweating & anxiety.
Certain eye signs are specific to Grave's disease like proptosis, ophthalmoplegia, chemosis and periorbital edema.
Lid lag and lid retraction are commonly found in thyrotoxicosis of any cause.
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