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Endocrine > Basics of endocrine > Flashcards

Basics of endocrine Flashcards

1
Q

What are the different types of hormone receptors?

A

GPCR
RTK
Nuclear

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2
Q

What is the structure of GPCR?

A

7 transmembrane domain

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3
Q

What are the major intracellular signalling molecues?

A

cAMP

IP3

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4
Q

What are the effectors of GCRP receptors?

A

Adenylyl cyclase
Phospholipase C
GIRk
PI3 kinase

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5
Q

What hormones are released by the anterior pituitary?

A 
GH
LH/FSH
ACTH
TSH
PRL
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6
Q

What hormones are released from the posterior pituitary?

A

ADH

Oxytocin

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7
Q

What needs to be taken into consideration when measuring hormones?

A 
Pattern of secretion
Presence of carrier proteins
Intefering agents
Stability of hormone (consisder half life) 
Absolute concentrations
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8
Q

What hormones commonly require evaluation?

A 
Thyroid
Steroid - cortisol
GH evaluation 
Reproductive and sex hormones
Prolactin 
Calcium and PTH 
Renin/ aldosterone
Catecholamines
Gut hormones
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9
Q

Raised TSH suggests what?

A

Hypothyroid

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10
Q

Supressed TSH sugests what?

A

Hyperthyroid

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11
Q

When might TSH not be a reliable marker of thyroid status?

A

In secondary thyroid disease where the issue arises from the pituitary and therefore the levels of TSH will be off

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12
Q

How is pituitary function assessed?

A 
9am cortiol
TSH, fT4/3
Prolactin
IGF1 (GH)
LH, FSH, E2 (females)/ testosterone (males) 
U&E, plasma/urine osmolality
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13
Q

What rhythm does cortisol secretion follow?

A

Circadian rhythm

Diurinal

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14
Q

When are cortisol levels at their highest and lowest?

A

Highest at 9am

Lowest at midnight

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15
Q

What axis will 9am cortisol give an indication of?

A

HPA axis - ACTH release

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16
Q

How is growth hormone measured?

A

IGF-1 to indicate GH hypersecretion

Formal GH axis requires dynamic testing

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17
Q

What pattern will female sex hormones show?

A

Menstrual cycle

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18
Q

When should testosterone be measured?

A

9am

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19
Q

What is prolactin secreted by?

A

Lactotroph cells of the anterior pituitary

20
Q

What inhibits the production of prolactin?

A

Dopamine

21
Q

What mediates the effects of prolactin?

A

Prolactin receptor (PRLR)

22
Q

What will act on the hypothalamus in the regulation of thirst and water?

A

Hyperosmolarity
Angiotensin 2
Sympathetic stimualtion
Decreased atrial firing

23
Q

What is the action of vasopressin 1?

A

Constriction of blood vessels
Increased systemic vascualr resistance
Increased arterial pressure

24
Q

What is the action of vasopressin 2?

A

Acts on the kidneys to increased fluid reabsorption increasing the blood volume
This increases arterial pressure

25
Q

What is the common precursor of all steroid hormones?

A

Pregenolone

26
Q

What dynamic test is used for hormone excess?

A

Suppression test

27
Q

What dynamic test is used for hormone deficiency?

A

Stimulation test

28
Q

What condition is characterised by primary cortisol deficiency?

A

Addisons disease

29
Q

What is cushings syndrome?

A

Cortisol excess

30
Q

What can cause cushings syndrome?

A

Pituitary origin
Adrenal origin
Ectopic ACTH
Exogenous steroids

31
Q

What is synacthen tests?

A

A stimulation test - used for addisons

32
Q

When is the dexamethasone suppression test used?

A

In cushings syndrome

33
Q

What are the signs and symptoms of cushings syndrome?

A 
Cushoingoid faces
Acne
Hirsutism
Abdominal striae
Obesity
Interscapular and suprascapular fat pads
Proximal myopathy
Osteoporosis 
Hypertension 
Impaired glucose tolerance
34
Q

What is cushings disease?

A

Tumour arising from the corticotroph cells of the anterior pititary

35
Q

Where does cushings DISEASE originate?

A

Pituitary

36
Q

Where does ACTH independent cushings originate?

A

Adrenal adenoma/carcinoma

37
Q

What happens to the adrenal gland in ACTH-independent cushings?

A

Bilateral macronodular adrenal hyperplasia

38
Q

What causes ectopic ACTH?

A

Malignancy - commonly lung cancer

39
Q

What causes exogenous cushings?

A

Oral, inhaled, topical, injectable steroid use

40
Q

What will hapen to the ACTH levels in ACTH-independent cushings?

A

Levels should be undetectable

41
Q

What are the screening tests for cushings?

A

1mg overnight dexamethasone suppression test
24 hour urinary free cortisol
Midnight cortisol

42
Q

What is the formal diagnostic test for cushings??

A

Low dose dexamethasone supression test - failure to suppress = cushings

43
Q

What type of cushings will a low ACTH show?

A

Adrenal origin

44
Q

What type of cushings will a raised ACTH show?

A

Need to disinguish between cushings disease (pituitary origin) and ectopic ACTH

45
Q

What is the formal diagnostic test for cushings disease?

A

Rise in cortisol and ACTH on CRH (corticortophic releasing hormone) test indicates a pituitary source

46
Q

What is an inferior petosal sinus sampling?

A

Used to lateralize the tumour prior to surgery

Endocrine (35 decks)

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