Basic Principles Flashcards
cortisol and testosterone are types of what?
steroids
steroids are derived from what?
cholesterol
adrenaline and thyroid hormone are derived from what?
tyrosine and tryptophan derivatives
what is the receptor for insulin?
receptor thyroxine kinase
what are the steroid hormone receptors?
nuclear
what does the posterior pituitary secrete?
ADH and oxytocin
what does the anterior pituitary secrete?
GH LH/FSH ACTH TSH PRL
raised TSH =
suppressed TSH =
raised TSH = HYPOTHYROID
suppressed TSH = HYPERTHYROID
TSH is NOT a reliable marker in what setting?
pituitary disfunction - secondary hypothyroidism or TSHoma
who do you not measure thyroid hormone in?
the sick/ill
at what time is cortisol measured to assess pituitary function?
9am
name the test whereby you give them synthetic ACTH and measure the adrenal gland function to assess pituitary gland
synacthen test
at what time is LH, FSH, E2/testosterone measured to assess pituitary function?
9am
prolactin is secreted from the _________ pituitary
prolactin is secreted from the ANTERIOR pituitary
prolactin is under tonic inhibition by what?
hypothalamic dopamine
name the important hormone in regulation of thirst and water balance
vasopressin
what is the overall test you perform if there is hormone EXCESS?
suppression test
what is the overall test you perform if there is hormone DEFICIENCY?
stimulation test
name the test performed in cortisol deficiency
syncACTHen test
primary adrenal failure is also known as what?
Addisons disease
cortisol excess is also known as what?
Cushing’s syndrome
name the test performed in cortisol excess (i.e. Cushing’s syndrome)
dexamethasone suppression test
name the 2 different types of tumour that results in cushing’s syndrome
pituitary tumour (too much ACTH)
adrenal tumour (too little ACTH)
name the 3 screening tests of cushings
1mg overnight Dexamethasone suppression test
(24hour urinary free cortisol)
(Midnight cortisol)
name the formal diagnostic test of cushing’s
Low dose dexamethasone suppression test
Failure to suppress = Cushing’s syndrome
if ACTH is low =
if ACTH is raised =
if ACTH is low = ADRENAL ORIGIN
if ACTH is raised = NEED TO DISTINGUISH CUSHINGS AND ECTOPIC ACTH
rise in cortisol and ACTH on CRH test indicated what source?
pituitary
name the 4 causes of cushings
pituitary
adrenal
actopic ACTH
exogenous steroids
clinical signs of cushings?
Cushingoid facies Acne Hirsutism Abdominal striae & centripetal obesity Interscapular & supraclavicular fat pads Proximal myopathy Osteoporosis Hypertension Impaired glucose tolerance
who still has no idea what’s going on?
me:)
