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10. CP - Endocrine System and Disease > (55) Endocrine investigations > Flashcards

(55) Endocrine investigations Flashcards

1
Q

What are hormones?

A

Chemicals secreted by endocrine glands that circulate and influence other tissues producing short and long-term changes in various cells - the cell needs target receptor for that hormone

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2
Q

Describe the basic feedback regulation in endocrine systems

A

hypothalamus - anterior pituitary - endocrine organ

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3
Q

Where does hypothalamus receive signals from?

A
  • environmental influences

- psychological influences from higher brain

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4
Q

Give 2 examples of what the hypothalamus releases to the pituitary gland? (male)

A
  • FSH releasing factors

- LH releasing factor

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5
Q

Give 2 examples of what the pituitary gland releases in response to hypothalamus signals (male)

A
  • FSH

- LH

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6
Q

Give examples of effects of FSH and LH (from pituitary) on testes (male)

A
  • FSH - sertoli cells, seminiferous tubules, maturation of sperm - inhibin
  • LH - leydig cells - testosterone
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7
Q

What effects do inhibin and testosterone have on the regulatory endocrine system? (male)

A

Negative feedback to hypothalamus and pituitary gland

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8
Q

What provides the negative feedback to the hypothalamus and anterior pituitary in the female?

A
  • estradiol
  • progesterone
  • inhibin
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9
Q

Describe the basic feedback cycle in terms of thyroid hormones

A
  • anterior pituitary
  • TSH
  • thyroid gland
  • thyroid hormones
  • back to anterior pituitary
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10
Q

Describe the basic feedback cycle in terms of parathyroid hormones

A
  • parathyroids
  • PTH
  • bone, GIT and kidney
  • calcium
  • back to parathyroids
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11
Q

Describe the basic feedback cycle in terms of insulin

A
  • pancreas
  • insulin
  • liver, fat, muscle
  • glucose
  • back to pancreas
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12
Q

Describe the basic feedback cycle in terms of ADH

A
  • hypothalamus
  • ADH
  • water absorption
  • osmolality
  • back to hypothalamus
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13
Q

What does decreased TSH and decreased thyroxine indicate?

A

Pituitary failure

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14
Q

What does increased TSH but decreased thyroxine indicate?

A

Unresponsive thyroid

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15
Q

What does decreased TSH and increased thyroxine indicate?

A

Thyroid gland overproduction

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16
Q

What does increased TSH and increased thyroxine indicate?

A

Pituitary gland overproduction or feedback failure

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17
Q

What is cortisol produced by?

A

The zona fasciculata of the adrenal cortex within the adrenal gland

18
Q

When is cortisol released by the adrenal glands?

A

In response to stress and low blood-glucose concentration

19
Q

What are the clinical features of Cushing’s disease?

A
  • obesity (moon face, central, shoulders)
  • skin (think purple striae, bruising)
  • hypertension
  • glucose intolerance
  • menstrual disturbances/impotence
  • thin limbs/muscle weakness
  • back pain due to osteoporosis
  • psychiatric disturbances (depression, psychoses)
20
Q

What is the dexamethasone test?

A

Used to assess adrenal gland function by measuring how cortisol levels change in response to an injection of dexamethasone. It is typically used to diagnose Cushing’s syndrome

21
Q

What are the causes of Cushing’s syndrome?

A
  • long-term use of corticosteroid medication
  • tumour of pituitary gland
  • tumour of the adrenal gland
22
Q

What are the clinical features of adrenal failure?

A
  • tiredness
  • weight loss
  • pigmentation
  • hypoglycaemia
  • abdominal pain
  • hypovolaemic collapse

Due to adrenal atrophy/destruction

23
Q

What is a synacthen test?

A

Tests how well the adrenal glands make cortisol - involves stimulating the adrenal glands and then checking to see if they respond. Synacthen is another name for tetracosactide, the chemical used in the test

24
Q

Which secretory systems have annual cycle?

A

Hair growth

25
Q

Which secretory systems have monthly cycles?

A

Menses

26
Q

Which secretory systems have diurnal cycles?

A

Cortisol

27
Q

What secretory systems have rapid amplitude cycles?

A

Insulin

28
Q

Which secretory systems are stress-related?

A

Anterior pituitary hormones

29
Q

Which secretory systems are stimulus-related?

A

Insulin

30
Q

What is an indirect measure of insulin?

A

Glucose

31
Q

What is an indirect measure of PTH?

A

Calcium

32
Q

What is an indirect measure of GH?

A

IGF-1 (insulin-like growth factor 1)

33
Q

What is an indirect measure of LH/FSH

A

Oestradiol

34
Q

What is an indirect measure of TSH?

A

Thyroxine

35
Q

What is an indirect measure of prolactin?

A

Hair growth (animals)

36
Q

How does testosterone change throughout life in males?

A

Ups and downs through foetus and infancy, low at childhood, steady increase during puberty, high and steady in adult life, slight steady decrease in old age (andropause)

37
Q

Why examine urine?

A
  • integration of fluctuating single serum hormone
  • integration of multiple hormones
  • analysis of unstable serum hormones
  • collection at time of symptoms
  • avoid venepuncture
38
Q

Total hormones =

A

free hormones + protein-bound hormones

39
Q

What are the binding proteins for free hormones T4 and T3?

A
  • TBG (thyroxine-binding globulin)
  • albumin
  • TBPA (thyroxine-binding pre-albumin)
40
Q

What are the binding proteins for sex hormones?

A
  • SHBG

- albumin

41
Q

What are the binding proteins for IGF-1?

A

6 forms of IGFbp

10. CP - Endocrine System and Disease (5 decks)

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