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CLM > Clinical Chemistry VI > Flashcards

Clinical Chemistry VI Flashcards

1
Q

Endocrinology

A

Consists of several glands that secrete hormones directly into the blood rather than into a duct system

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2
Q

Amines

A

Single amino acids

-T3, T4

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3
Q

Peptide and protein

A

Pituitary gland hormones

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4
Q

Steroid

A

Converted from cholesterol

-Glucocorticoids, estrogens

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5
Q

Professor Nowak’s Endocrinology Rule

A

95% of endocrinology disorders are due to primary gland dysfunction

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6
Q

Glands in endocrinology

A 
Hypothalamus 
Pituitary
Thyroid
Adrenals
Parathyroid
Pancreas
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7
Q

Hypothalamus

A

Synthesizes hormones
Stimulate or inhibit the secretion of pituitary hormones
Controls body temp, hunger, attachment behaviors, thirst, fatigue, sleep, and circadian rhythms

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8
Q

Anterior pituitary hormones

A 
Growth hormone (GH)
Thyroid-stimulating hormone (TSH)
Adrenocorticotropic hormone (ACTH)
Prolactin (PRL)
Luteinizing hormone (LH)
Follicle-stimulating hormone (FSH)
Melanocyte-stimulating hormone (MSH)
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9
Q

Posterior pituitary hormones

A

Oxytocin- uterine contractions, lactation
Vasopressin (antidiuretic hormone, ADH)
Kidney water reabsorption and excretion

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10
Q

Acromegaly and giantism

A

Too much growth hormone (GH) usually from pituitary adenoma

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11
Q

Sx of acromegaly and giantism

A

Overgrowth of skeleton and soft tissues

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12
Q

Lab of acromegaly and giantism

A

Increased growth hormone
Increased serum insulin-like growth factors (IgF-1)
-IgF-1 circulates in much higher plasma concentrations than GH and is a good screening test of suspected GH abnormalities and for monitoring therapy in pts
-Single measurements of GH are not often reliable because GH secretion is episodic and diurnal

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13
Q

Hyperprolactinemia

A

Too much prolactin usually due to pituitary adenoma (pregnancy, chronic renal failure, medications)

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14
Q

Sx of hyperprolactinemia

A 
Infertility
Anovulation
Menstrual irregularity
Amenorrhea
Oligospermia
Impotence
Gynecomastia
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15
Q

Labs of hyperprolactinemia

A

Elevated prolactin level

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16
Q

Tx for hyperprolactinemia

A

Dopamine agonists (cabergoline, bromocriptine)

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17
Q

Central diabetes insipidus

A

Deficiency of ADH (diuretic effect)

18
Q

Sx of central diabetes insipidus

A

Dehydration (urinates up to 20L per day)
Normal-high serum sodium and osmolality
Low urine sodium and osmolality

19
Q

Labs for central diabetes insipidus

A

Hypernatremia

Decreased ADH

20
Q

Tx for central diabetes insipidus

A

Desmopressin

21
Q

Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

A

Too much ADH (tumors that secrete ADH)

-MDMA, sarcoidosis, pulmonary disease, medications

22
Q

Sx of SIADH

A 
Muscle weakness
Ataxia
Tremor
Lethargy
Confusion
Delirium
Seizures
23
Q

Thyroid gland

A

Produce hormones that affect body metabolism

  • Triiodothyronine (T3)
  • Thyroxine (T4)
  • Calcitonin
24
Q

Triiodothyronine (T3)

A

Minority, but more active hormone

25
Q

Thyroxine (T4)

A

Majority, prohormone
Both T3 and T4 contain iodine and are transported to tissues by plasma proteins
Thyroxine-binding globulin (TBG)- 70%
Transthyretin (10-15%) and albumin (15-20%)

26
Q

Calcitonin

A

Related to calcium homeostasis

Also a tumor marker for medullary thyroid carcinoma

27
Q

Thyroid stimulating hormone (TSH) lab test

A 
Pituitary hormone that stimulates the thyroid gland to produce T4 and then T3
Nl range: 0.3-3.0 
Increased: Primary hypothyroidism
-Secondary hyperthyroidism
Decreased: Primary hyperthyroidism
-Secondary hypothyroidism
28
Q

Total T3 and/or T4

A

Measures amt that is bound to thyroxine-binding globulin (TBG)
Less useful with protein abnormalities

29
Q

Free T3 (0.3%) or T4 (0.03%)

A

May need to be ordered after TSH reviewed

More expensive test compared to TSH

30
Q

Antithyroid antibodies

A

Antimicrosomal/antithyroid peroxidase antibodies (anti-TPO)
Antithyroglobulin antibodies
TSH receptor antibodies

31
Q

Antimicrosomal/antithyroid peroxidase antibodies (anti-TPO)

A

Directed against the protein enzyme TPO

Seen in Hashimoto thyroiditis (99%) and Graves disease (85%)

32
Q

Antithyroglobulin antibodies

A

Hashimoto thyroiditis (85%) and Graves disease (30%)

33
Q

TSH receptor antibodies

A

Immunoglobulins that bind to TSH receptors and influence their action (usually stimulate thyroid like in Graves disease)

34
Q

Radioactive iodine uptake and thyroid scan

A

Nuclear imaging scan of administered radioactive iodine
Low uptake suggests thyroiditis
High uptake suggests Graves disease
Unevenness in uptake suggests the presence of a nodule

35
Q

Thyroglobulin

A

Stored in the follicular colloid of the thyroid as a prohormone
Used to monitor tx in thyroid cancer

36
Q

Hyperthyroidism (thyrotoxicosis)

A

Too much T3/T4 is being made

  • Primary- thyroid gland makes too much T3/T4
  • -Pituitary then decreases the amt of TSH
  • -95% of all hyperthyroidism
  • Secondary- pituitary makes too much TSH
  • -Acts on the nl thyroid to make too much T3/T4
  • Tertiary- hypothalamus makes too much TRH
  • -Acts on the nl pituitary to then make too much TSH
37
Q

Sx of hyperthyroidism

A 
Hypermetabolic features 
Nervousness
Palpitations
Muscle weakness
Increased appetite
Diarrhea
Heat intolerance
Warm skin
Weight loss
Perspiration
Exopthalmous
Emotional changes
Menstrual changes
Fine tremor
38
Q

Graves disease

A

Autoimmubne disease caused by TSH receptor antibodies that bind to and stimulate TSH receptors resulting in autonomous production of thyroid hormone

39
Q

Labs: Graves disease

A

High T3/T4
Low TSH
Diffuse radioactive iodine uptake
+ TSH receptor antibodies

40
Q

Tx for Graves disease

A

Radioiodine therapy
Medications
Thyroid surgery

41
Q

Subacute thyroiditis

A

Secondary to viral infection, lasts for months

42
Q

Labs: subacute thyroiditis

A

High T3/T4
Low TSH
High ESR
No radioactive uptake

CLM (3 decks)

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