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JG Year 1 > 128 Endocrine > Flashcards

128 Endocrine Flashcards

1
Q

Name the 4 types of hormones

A
  1. peptide
  2. aa derivatives
  3. steroid
  4. eicosanoids
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2
Q

Are peptide hormones water soluble or lipid soluble?

A

Water soluble

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3
Q

From which 2 sites is the peptide hormone somatostatin secreted from?

A

Hypothalamus and pancreas

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4
Q

Which 2 peptide hormones does the posterior pituitary secrete?

A

Vasopressin

Oxytocin

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5
Q

Which peptide hormone is secreted from the placenta?

A

hCG

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6
Q

Which 3 peptide hormones are released from the pancreas?

A

Glucagon

Insulin

Somatostatin

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7
Q

Where are steroid hormones synthesises?

A

Adrenal cortex

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8
Q

Where do the steroid hormones bind to receptors?

(cellular)

A

Nuclear membrane

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9
Q

Name the 3 zones of the adrenal cortex

A
  1. Zona glomerulosa
  2. Zona fasciculata
  3. Zona reticularis
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10
Q

Which steroid hormone is secreted from the Zona Glomerulosa of the adrenal cortex?

A

Aldosterone

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11
Q

What is the role of aldosterone?

A

Control of BP - acts on the distal convoluted tubules and collecting ducts in the kidney to increase resorption of H2O and increase BP

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12
Q

What is the mechanism by which aldosterone is released from the Zona glomerulosa of the adrenal cortex?

A

RAAS system –> renin secreted from the kidneys in response to electrolyte conc of the blood. This converts angiotensiogen into angiotensin I. Angiotensin I into angiotensin II by ACE secreted by the lungs. Angiotensin II makes adrenal cortex secrete aldosterone

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13
Q

Which glucocorticoid is secreted by the Zona fasciculata of the adrenal cortex?

A

Cortisol

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14
Q

Where is cortisol secreted from?

A

Zona fasciculata of the adrenal cortex

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15
Q

What is the role of cortisol? (3 listed)

A
  1. Control of carbohydrate metabolism
    • increases aa conc in the blood by inhibiting protein synthesis in tissues
    • promotes use of fat for energy
    • stimulates gluconeogenesis in the liver
  2. Inflammatory response - suppresses by preventing Tcell proliferation
  3. Stress response - ie redistributing glu to the areas which need it most
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16
Q

Which steroid hormones are secreted from the zona reticularis in the adrenal cortex?

A

Sex hormones: androgens and oestrogens

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17
Q

Which amino acid are the catecholamines derived from?

A

Tyrosine

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18
Q

Which catecholamines are secreted by the adrenal medulla?

A

NA and adrenaline

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19
Q

Which amino acid derived hormones are secreted from the thyroid gland?

A

T3 - triiodothyronine

T4 - thyroxine

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20
Q

What are eicosanoids and what are they derived from?

A

Hormones/signalling molecules derived from PUFAs

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21
Q

Which eicosanoid is involved with inflammation and pain sensation?

A

prostaglandin

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22
Q

Which eicosanoid is involved with the increase of vascular permeability and vasodilation during inflammation?

A

thromboxanes

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23
Q

Which enzymes catalyse oxygenation of fatty acids to produce eicosanoids?

A

COX (cyclooxygenase) and LOX (lysil oxidase)

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24
Q

Which nucleus in the hypothalamus is responsible for circadian rhythm?

A

Suprachiasmatic nucleus

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25
Q

In the stress response, which hormone is released from the hypothalamus to act on the anterior pituitary?

A

CRH (corticotropin releasing hormone) –>ant pit secretes ACTH –> acts on the adrenal cortex –> secreted cortisol

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26
Q

Where is calcitonin secreted from?

A

Thyroid gland

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27
Q

What is the function of calcitonin? (3 ways in which it acts)

A

Acts to reduce serum [Ca2+] - opposite effect to PTH

  • Inhibits Ca2+ absorption by the intestines
  • Inhibits osteoclast activity in bones
  • Inhibits renal tubular cell reabsorption of Ca2+ allowing it to be excreted in the urine
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28
Q

What is the function of PTH?

A

To increase serum [Ca2+] by:

  • stimulating osteoclastic bone resorption
  • It enhances active reabsorption of calcium and magnesium from distal tubules and the thick ascending limb
  • It enhances the absorption of calcium in the intestine by increasing the production of activated vitamin D
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29
Q

Which cells produce PTH?

A

Chief cells of the parathyroid gland

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30
Q

Which cells of the pancreas secrete glucagon?

A

α cells of the pancreas

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31
Q

Which cells secrete insulin in the pancreas?

A

β cells

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32
Q

What is the effect of glucagon secretion by the pancreas?

A

Causes glucose production by the liver - glycogenolysis and gluconeogensis therefore prevents hypoglycaemia

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33
Q

What is the effect of insulin secretion by the βcells in the pacreas?

A

Reduction in glucose plasma levels - prevents gluconeogenesis by the liver and increases glucose transport into cells. Prevents hyperglycaemia

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34
Q

Which investigations should be performed when suspecting differentiated thyroid Ca?

(4 listed)

A
  • USS
  • FNAC (fine needle aspiration and cytology)
  • serum thyroglobulin
  • whole body scans
35
Q

What is the treatment for thyroid Ca?

A

Thyroid surgery/ radioiodine Rx (Iodine 131)

36
Q

How can a goitre present?

A

Neck mass with compression symptoms

37
Q

Which disease is associated with a goitre?

A

Hyperthyroidism

38
Q

Which blood test should be performed when diagnosing a goitre?

A

TSH

39
Q

What is the cause of primary hypothyroidism?

A

Insufficient TH produced by the thyroid

40
Q

What is the diagnosis?

  • low metabolic rate
  • sensitivity to cold
  • poor memory
  • increased weight
  • elevated THS
  • low TH
A

Primary hypothyroidism

41
Q

What would a low TSH level and low TH level indicate?

A

Secondary hypothyroidism

42
Q

What is the treatment for primary hypothyroidism?

A

Thyroxine

43
Q

Excess production of chatecolamines caused by adrenal/extra-adrenal tumour.

What is the disease?

A

Pheochromocytoma

44
Q

Which conditions are associated with pheochromocytoma?

(4 listed)

A
  • Von Hippel Lindau syndrome
  • phakomatoses
  • neurofibromatosis
  • multiple endocrine neoplasmas
45
Q

Which investigations should be performed to diagnose pheochromacytoma?

A
  • 24 hour urine –> would show increased chatecholamines and metabolites
46
Q

What is the diagnosis: excess aldosterone production from the adrenal cortex causing endocrine HTN ?

A

Conn’s syndrome

47
Q

What signs and symptoms are present in Conn’d syndrome?

(3 listed)

A
  • HTN
  • hypokalaemia
  • metabolic alkalosis
48
Q

Which invesigations should be performed to confirm diagnosis of Conn’s syndrome?

A
  • 9am rennin and aldosterone –> would show loe rennin and high aldosterone
  • U&EC
  • CT/MRI
  • MIBG scan - to rule out pheochromocytoma
49
Q

What is a MIBG scan?

A

Iobenguane = radioisotope also referred to as MIBG used in scintography method called MIBG scan. Its a similar molecule to NA and so is useful for the diagnosis of pheochromocytoma/neuroblastoma

50
Q

What is spironolactone used to treat?

A

Conn’s syndrome if bilateral hyperplasia of adrenals

51
Q

What is the treatment for Conn’s syndrome if there’s an adenoma present? What if bilateral hyperplasia?

A
  • adrenalectomy if adenoma
  • low salt diet and spironolactone if bilateral hyperplasia
52
Q

What is the most likely diagnosis?

  • Hyperpigmentation
  • general malaise
  • N&V
  • hypoglycaemia
  • postural hypotension
  • W/L
  • hyponatraemia
  • hyperkalaemia
  • inadequate cortisol response to synacthen
  • increased ACTH
A

Addisons disease

53
Q

What is the treatment for Addisons disease?

A
  • hydrocortisone - 10mg BD
  • fludrocortisone - 0.1mg OD
54
Q

What is the immediate treatment of an Addisonian crisis?

A

100mg hydrocortisone IV

55
Q

What syndrome is caused by excess cortisol production cause dby adrenal tumours, pituitary tumours or ectopic ACTH production?

A

Cushings

56
Q

What is the diagnosis? -

  • central obesity
  • buffalo hump
  • moon face
  • HTN
  • poor wound healing
  • thin skin
  • hirsuitism
  • depression
  • fatigue
A

Cushing’s syndrome

57
Q

In Cushings, where is the disease if the ACTH levels are high?

A

Pituitary

58
Q

In Cushings, where is the disease if ACTH is low?

A

Adrenals

59
Q

What investigation should be performed to diagnose Cushing’s?

A
  • 24 hour dex test
  • give low dose dexamethasone at night - in normal individuals, it should cause cortisol suppression
  • cortisol not suppressed in Cushing’s at 9am the next day
60
Q

What condition is metyrapone used to treat?

A

Cushing’s

61
Q

What is the MOA of metyrapone in the treatment for Cushing’s syndrome?

A

To reduce cortisol and corticosterone production by inhibiting the 11-ß-hydroxylation reaction

62
Q

What condition is associated with a deficiency in 21 hydroxylase?

A

Congenital adrenal hyperplasia

63
Q

Which pathway is 21-hydroxylase involved with in the adrenal cortex?

A

Glucocorticoid pathway ending in production of Aldosterone

64
Q

Which condition causes reduced aldosterone secretion in children and excess androgen production in adults?

A

Congenital adrenal hyperplasia

65
Q

What investigations should be performed when diagnosing congenital adrenal hyperplasia?

A

Synacthen

66
Q

What is the cause of primary hyperparathyroidism?

A

Adenoma/hyperplasia of the parathyroid glands

67
Q

What signs and symptoms are associated with primary hyperparathyroidism?

A

Generally asymptomatic but can have symptoms of hypercalcaemia:

  • Stones, moans and groans…
    • kidney stones
    • tiredness
    • muscle weakness
    • dehydration
    • N&V
    • bone pain
    • arrhythmias
68
Q

What investigations should be performed to diagnose primary hypoparathyroidism?

(4 listed)

A
  • serum PTH (high)
  • serum Ca2+ (high)
  • serum P04- (low)
  • urinary Ca2+ (high)
69
Q

What is usually the cause of hypoparathyroidism?

A

Surgery - e.g. partial/complete thyroidectomy

70
Q

What is the diagnosis? -

  • increased neuromuscular excitability
  • tingling in the extremities
  • tetany
  • epileptic convulsions
  • prolonged QT intervals
  • cataracts
  • low PTH
  • low Ca2+, high phosphate
A

Hypoparathyroidism

71
Q

What symptoms are associates with hypomagnasaemia?

(hint: causes low PTH secretion)

6 listed

A
  • Increased neuromuscular excitibility
  • tingling in extremities
  • tetany
  • epileptic convulsions
  • prolonged QT intervals
  • cataracts
72
Q

What can cause hypomagnasaemia?

A
  • D&V
  • PPIs
73
Q

What is ‘knuckle knuckle dimple dimple’ a characteristic of?

A

Albrights Hereditary Dystrophy in pseudohypoparathyroidism - short 4th and 5th metacarpals

74
Q

What is the treatment for pseudohypoparathyroidism?

A

VitD

75
Q

What can cause primary hypogonadism in males?

(4 listed)

A
  • Klinefelters
  • Castration
  • chemoTx
  • chronic liver/kidney disease
76
Q

What are the signs and symptoms in primary hypogonadism in ♂

A
  • small/ absent testes
  • gyneacomastia
  • infertility
  • decreased libido
  • decreased hair
  • osteoporosis
77
Q

What is the treatment for primary hypogonadism in males?

A
  • Testosterone
  • sildenafil
  • infertility Tx
78
Q

What investigations should be performed to diagnose primary hypogonadism in males?

A
  • bloods
    • testosterone (low)
    • LH (high)
    • FSH (high)
  • seminal analysis
79
Q

What could primary amenorrhoea indicate?

A

Turners

Foetal androgen deficiency

80
Q

What is the treatment for precocious puberty?

A

LHRH

81
Q

What could cause premature ovarian failure?

A
  • previous chemo
  • organ specific immune disease
82
Q

What are the S&S of PCOS?

A
  • hirsuitism
  • acne
83
Q

What is the treatment for PCOS?

A
  • metformin
  • oestrogen and progesterone
  • infertility treatment

JG Year 1 (27 decks)

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