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Diabetes & Endocrine > Adrenal & Thyroid conditons > Flashcards

Adrenal & Thyroid conditons Flashcards

1
Q

What hormones are created in the anterior pituitary gland?

A

Prolactin, FSH, LH, Gonadotropins, MSH, TSH, ACTH, GH

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2
Q

What hormones are created in the prosteior pituitary gland?

A

oxytosin, vasopressin

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3
Q

What does Oxytocin do?

A

Contraction of utrine muscles to help women expel infant during child birth.
Promotes ejection of milk from mammary glands during breat feeding.

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4
Q

What does Vasopresin do?

A

Increases the retention of water by, binding to V2 receptors causing an increase in water permeability in distal tubule.

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5
Q

What does Vasopresin do?

A

Increases the retention of water by, binding to V2 receptors causing an increase in water permeability in distal tubule.
V1 binding causes vasoconstriction

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6
Q

What causes Diabetes insipidus?

A

Caues by the lack of vasopresin.

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7
Q

What is the treatment to Diabetes insipidus?

A

Vasopressin injections.

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8
Q

What does TSH do?

A

Stimulates thyroid hormone from thryoid gland.

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9
Q

What does GH do?

A

Stimulates secretion of IGF-1 from liver and other cells and protein synthesis and carbohydrate and lipid metabolism in many tissues.

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10
Q

What does ACTH do?

A

Stimulates cortisol secretion by adrenal cortex and stimulates adrenal cortex growth.

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11
Q

What can cause GH deficiency?

A

Primary - Pituitary Defect
Secondary - Hypothalamic dysfunction, lack of GHRH or IGF.

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12
Q

What can cause GH excess?

A

Begign tumour of somatotrophs.

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13
Q

What are the types of Somatostatin?

A

Octroeotide, Lanreotide, Pasireotide.

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14
Q

What deos Octroeotide do?

A

Long-lasting analogue of somatostatin.

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15
Q

Somatorelin (GHRF) do?

A

Diagnostic for GH secretion.

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16
Q

Somatotrophin?

A

Given for short stature , turners sundrome.

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17
Q

Pro-opiomelanocortin (POMC) can turn into what 3 molecules?

A

ACTH, Endorphin, MSH

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18
Q

Where is Aldosterone released from?

A

Zona Glomerulosa

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19
Q

Where is Cortisol released from?

A

Zona Fasciculata

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20
Q

Where is DHEA (Sex hormones) released from?

A

Zona Reticularis.

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21
Q

What is Aldosterone?

A

Mineralocorticoid

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22
Q

What does Aldosterone do?

A

Promotes Na reabsorption in the kidney which causes water retention, Increases K+ & H+ excretion in urine.

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23
Q

What is Corisol?

A

Glucocorticoid

24
Q

What does cortisol do?

A

Stimulates gluconeogenesis, Stimulates protein breakdown (Catabolism), Stimulates lypolysis. Anti-inflammatory / Immunosuppresive effects.

25
Q

What causes Cortisol release?

A

In response to ACTH from the pituitary, which then releases CRF from the hypothalamus.

26
Q

What is Aldosterone Hypersecretion called?

A

Conn’s Syndrome.

27
Q

What can Aldosterone hypersecretion cause?

A

Hypernatraemia, hypokalaemia and hypertension.

28
Q

What is Cortisol Hypersecretion called?

A

Cushings Syndrome

29
Q

What causes Cortisol Hypersecretion?

A

From excess CRH/ACTH. Adrenal turmours secreting excess cortisol.

30
Q

What can Cortisol hypersecretion cause?

A

Abnormal fat distribution (Buffalo hump, moonface), thin skin, oesteoporosis, hypertension. Thin arms/legs from muscle breakdown, poor wound healing.

31
Q

Treatments for Cushings Syndrome Treatment?

A

Surgery/radiotherapy.
Drug - Metyrapone, Ketoconazole.

32
Q

What is both cortisol & Aldosterone deficiency called?

A

Addison’s Disease.

33
Q

What are the symptoms of Addisons Disease?

A

Lethargy, Depression, anorexia, weight loss.

34
Q

Treatments for Addison’s disease.

A

Lifelong steroid.
Hydrocortisone - Replaces cortisol (Glucocorticoid) 20-30mg daily
Fludrocortisone - Replaces Aldosterone (Mineralcorticoid) 50-300mcg daily

35
Q

What is Thyroid hormone?

A

Combination of T4 & T3.

36
Q

What is Calcitonin?

A

Plays a role in calcium metabolism.

37
Q

What is primary hypothyroidism?

A

Lack of T3&T4.

38
Q

What is hashimoto’s disease?

A

Autoimmune disease, body makes antibodies to thyroglobulin.

39
Q

What is secondary hypothyroidism?

A

Pituitary dysfunction -> Low lvls of TSH

40
Q

What is tertiary hypothyroidism?

A

Low lvls of TRH.

41
Q

What are the symptoms of hypothyroidism?

A

Slow speech, cold intolerance, memory loss, depression, constipation, weight gain, dry skin, bradycarida.

42
Q

What is the diagnosis of hypothroidism?

A

High lvls of TSH, Low lvls of T3&T4

43
Q

What are the reference ranges for the throid hormones?

A

TSH (0.4-4.5uIU/mL)
T4 (10-24pmol/L)
T3(4-7.8pmol/L)

44
Q

What is the treatment for hypothroidism?

A

Levothyroxine should be given with a starting dose between 50-100mcg in the morning (1.6mcg/kg).
Secondary treatment (Severe) - Liothyronine.

45
Q

What are the symtpoms hyperthroidism?

A

Palpitations, sweating, tremor, anxiety, diarrhoea, inability to tolerate heat and weight loss, goitre and blunging of eyes.

46
Q

What is the diagnosis of hyperthroidism?

A

Low TSH lvls, High T3&T4

47
Q

What is the symptomatic treatment options for hyperthyroidism?

A

You can use propranolol, because it would treat all the symtoms. because its a non-selective beta blocker.

48
Q

What are the anti-thyroid drugs?

A

Carbimazole,propylthiouracil.

49
Q

What are the counselling points for thiouracils?

A

Patient should be told to stop medication immediatley and go to the doctor is the have, sore throat, mouth ulcers, fever, cough, bruising.

50
Q

What are the surgical treatments for hyperthyroidism?

A

Thyroidectomy, where you need thyroid replacement therapy for the rest of their life.
Radiotherapy, shootign radiation as the thyroid to kill the cells. if therapy fails can cause hypothroidsm which will make the patient need levo for the rest of their life.

51
Q

What are the Topical adverse effects of steroids?

A

Skin thinning, skin infection, stretch marks, acne.

52
Q

What are the inhaled adverse effects of steroids.

A

Hoarsness, throat irritation, dysphonia, candida.

53
Q

Systemic adverse effects of steroids.

A

can cause adrenal suppression, Happens when on long term therapy, abrupt withdrawal can casue adrenal insufficiency which can cause death. Patient should carry a steroid card.

54
Q

When should gradual withdrawal of steroids happen?

A

> 40mg prednisolone OD for >1 week. >3weeks treatment.

55
Q

What can steroids cause?

A

Increased susceptibility to infections becuase steroids have an immunosuppresive effect.

56
Q

Side effects of mineralcorticoids?

A

Hypertension, sodium & water rention, pottasium & calcium loss.

57
Q

What is the MOA of carbamazole?

A

inihibit synthesis of thyroid hormones
inhibit thyroperoxidase therefore reducing the production of thyroid hormones T4,T3

Diabetes & Endocrine (7 decks)

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