Basic Principles

Question 1

cortisol and testosterone are types of what?

Answer 1

steroids

Question 2

steroids are derived from what?

Answer 2

cholesterol

Question 3

adrenaline and thyroid hormone are derived from what?

Answer 3

tyrosine and tryptophan derivatives

Question 4

what is the receptor for insulin?

Answer 4

receptor thyroxine kinase

Question 5

what are the steroid hormone receptors?

Answer 5

nuclear

Question 6

what does the posterior pituitary secrete?

Answer 6

ADH and oxytocin

Question 7

what does the anterior pituitary secrete?

Answer 7

GH
LH/FSH
ACTH
TSH
PRL

Question 8

raised TSH =

suppressed TSH =

Answer 8

raised TSH = HYPOTHYROID

suppressed TSH = HYPERTHYROID

Question 9

TSH is NOT a reliable marker in what setting?

Answer 9

pituitary disfunction - secondary hypothyroidism or TSHoma

Question 10

who do you not measure thyroid hormone in?

Answer 10

the sick/ill

Question 11

at what time is cortisol measured to assess pituitary function?

Answer 11

9am

Question 12

name the test whereby you give them synthetic ACTH and measure the adrenal gland function to assess pituitary gland

Answer 12

synacthen test

Question 13

at what time is LH, FSH, E2/testosterone measured to assess pituitary function?

Answer 13

9am

Question 14

prolactin is secreted from the _________ pituitary

Answer 14

prolactin is secreted from the ANTERIOR pituitary

Question 15

prolactin is under tonic inhibition by what?

Answer 15

hypothalamic dopamine

Question 16

name the important hormone in regulation of thirst and water balance

Answer 16

vasopressin

Question 17

what is the overall test you perform if there is hormone EXCESS?

Answer 17

suppression test

Question 18

what is the overall test you perform if there is hormone DEFICIENCY?

Answer 18

stimulation test

Question 19

name the test performed in cortisol deficiency

Answer 19

syncACTHen test

Question 20

primary adrenal failure is also known as what?

Answer 20

Addisons disease

Question 21

cortisol excess is also known as what?

Answer 21

Cushing’s syndrome

Question 22

name the test performed in cortisol excess (i.e. Cushing’s syndrome)

Answer 22

dexamethasone suppression test

Question 23

name the 2 different types of tumour that results in cushing’s syndrome

Answer 23

pituitary tumour (too much ACTH)

adrenal tumour (too little ACTH)

Question 24

name the 3 screening tests of cushings

Answer 24

1mg overnight Dexamethasone suppression test

(24hour urinary free cortisol)

(Midnight cortisol)

Question 25

name the formal diagnostic test of cushing's

Answer 25

Low dose dexamethasone suppression test Failure to suppress = Cushing’s syndrome

Question 26

if ACTH is low = if ACTH is raised =

Answer 26

if ACTH is low = ADRENAL ORIGIN if ACTH is raised = NEED TO DISTINGUISH CUSHINGS AND ECTOPIC ACTH

Question 27

rise in cortisol and ACTH on CRH test indicated what source?

Answer 27

pituitary

Question 28

name the 4 causes of cushings

Answer 28

pituitary adrenal actopic ACTH exogenous steroids

Question 29

clinical signs of cushings?

Answer 29

``` Cushingoid facies Acne Hirsutism Abdominal striae & centripetal obesity Interscapular & supraclavicular fat pads Proximal myopathy Osteoporosis Hypertension Impaired glucose tolerance ```

Question 30

who still has no idea what's going on?

Answer 30

me:)