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SM Endocrine > Basic Principles > Flashcards

Basic Principles Flashcards

1
Q

At what stage in pregnancy is a goitre seen

A

Perinatal period

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2
Q

Many endocrine disorders are associated with defects in what

A

GPCRs

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3
Q

What do GPCRs act as

A

Biological sensors

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4
Q

What is a good example of intrinsic tyrosine kinase activity

A

Insulin receptor

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5
Q

What are 2 examples of cytokine receptors

A

Prolactin receptor and growth hormone

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6
Q

What are cytokine receptors linked to

A

Tyrosine kinase activity

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7
Q

Steroid hormones are typically intracellular or extracellular

A

Intracellular

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8
Q

Where exactly are steroid hormone receptors located

A

either in the cytoplasm or the nucleus

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9
Q

What are included in the nuclear receptor family

A

Oestrogen, androgen receptos

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10
Q

What do steroid/receptor complexes do ?

A

Bind DNA response elements

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11
Q

When do receptors translocate to the nucleus

A

Only when a hormone or a ligand is present

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12
Q

Give an example of a steroid hormone receptor and what it does

A

Testosterone

It causes alterations in gene transcriptions with interactions with DNA

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13
Q

What can a circulating corticosteroid that is bound to by either a hormone or a ligand cause

A

Transactivation or transrepression

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14
Q

What is the master regulator of hormones

A

Pituitary gland

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15
Q

At what sites can the pathways be disrupted

A

Hypothalamus
Pituitary gland
Peripheral glands e.g. thyroid, adrenal, cortex or gonad

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16
Q

What does a disruption in a pathway result in

A

Endocrine problems

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17
Q

Where is the site of central regulation from the hypothalamus

A

Anterior pituitary gland

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18
Q

What are the 5 hormones secreted by the anterior pituitary gland

A 
Growth hormone 
LH/ FSH
Adrenocorticotropic hormone 
Thyroid stimulating hormone 
Prolactin (PRL)
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19
Q

What is secreted by the posterior pituitary gland

A

ADH or vasopressin

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20
Q

What factors affect the ability to accurately measure hormone levels

A 
Pattern of secretion 
The presence of carrier proteins
Interfering agents 
Stability of hormone (consider 1/2 life) 
Absolute concentrations
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21
Q

What is a major determinant of hormone concentration?

A

Rate of secretion

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22
Q

Measuring hormones is typically determined by highly refined by what

A

Feedback loops - ie. need to know the right time to measure the right hormone levels (circadian rhythm)

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23
Q

What types of hormones are commonly evaluated

A

Thyroid hormones
Steroid hormone production (e.g. cortisol)
Growth hormone evaluation
Reproductive and sex hormone (e.g. testosterone)
Prolactin
Calcium and parathyroid homrone

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24
Q

Why might reproductive hormones be evaluated

A

Infertility
Puberty
Loss of libido
Erectile dysfunction

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25
Q

What is the function of renin and aldosterone and what gland are the associated with

A

Adrenal gland

They regulate salt and water balance

26
Q

When might TSH not be a reliable marker of Thyroid status

A

If the patient had a primary hypothalamic pituitary problem e.g. a tumour and was therefore unable to secrete TSH

27
Q

What does the thyroid axis rely on

A

highly regulated feedback control

28
Q

What does the patient have if they have a raised TSH

A

Hypothyroid

29
Q

What does the patient have if they have a suppressed TSH

A

Hyperthyroid

30
Q

What hormone has the strongest circadian rhythm in humans

A

Cortisol

31
Q

When are the cortisol levels highest

A

First thing in the morning

32
Q

When should cortisol be measured

A

First thing in the morning when they should be at their peak

33
Q

Describe the release of growth hormone from the pituitary

A

Under pulsatile release from and short lived in the blood

34
Q

What happens if there is excess growth hormone before puberty was complete

A

Marked elongation within the long bones of the body

35
Q

What happens if the growth hormone was in too little quantities around puberty

A

Dwarfism

36
Q

Describe the relationship between gamete production and sex hormone synthesis

A

These are coordinated so there is a close relationship

37
Q

What is prolactin secreted by

A

Lactotroph cells of the anterior pituitary

38
Q

The effects of Prolactin are mediated by what

A

The prolactin receptor (PRLR)

39
Q

Where is thirst tightly regulated within

A

The hypothalamus

40
Q

What are the 3 main steroid hormones that can lead to specific endocrine disorders

A

Aldosterone
Cortisol
Testosterone

41
Q

What happens if the body can’t produce the precursors of steroid hormones

A

There will be an excess of the hormone

42
Q

When is biochemical testing typically perfumed with regards to imaging

A

Before imaging

43
Q

To test for hormone excess, what test do we do

A

Suppression test

44
Q

To test for hormone deficiency, what test do we do

A

Stimulation test

45
Q

In what situation might there be a need for combined imaging/ biochemical testing

A

Adrenal vein sampling or petrosal sinus sampling

46
Q

If there is a cortisol deficiency, what does this mean

A

You have adrenal insufficiency

47
Q

If there is primary adrenal failure, what disease is this known as

A

Addison’s disease

48
Q

Cortisol excess is more commonly known as what

A

Cushing’s syndrome

49
Q

Stimulation test with cortisol is known as what

A

Synacthen tes

50
Q

What is the cortisol suppression test known as

A

Dexamethasone suppression test

51
Q

What are some symptoms of Cushing’s syndrome

A 
Cushingoid facies 
Acne 
Hirsutism 
Abdominal striae and centripetal obesity 
Inter scapular and supraclavicular fat pads 
proximal myopathy 
osteoporosis 
hypertension 
impaired glucose tolerance
52
Q

What is important to know before removing any adnreal gland

A

Whether it is unilateral or bilateral

53
Q

What are some causes of Cushing’s syndrome

A

High levels of ACTH
Increased production of cortisol
Ectopic ACTH
Exogenous steroids (causing ACTH to be switched on)

54
Q

Investigation for Cushings can be done as an outpatient or always an inpatient

A

Outpatient

55
Q

If there is a failure to suppress in a low dose dexamethasone suppression test what does this indicate

A

Cushing’s syndrome

56
Q

If the ACTH is low, what does this indicate

A

Adrenal origin is likely

57
Q

What can be lost if there is a pituitary tumour or an adrenal tumour

A

The circadian rhythm

58
Q

What is MEN

A

Multiple endocrine neoplasia

59
Q

What gene is affected in MEN1

A

MEN 1 gene - 11q

60
Q

What gene is affected in MEN2

A

RET gene - 10q

61
Q

What are 2 of the most important things to try and avoid with patients with MEN1

A

Premature morbidity and mortality

SM Endocrine (27 decks)

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