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Y1&2 Medicine Zoe Veary > ENDO 128 Gen Endocrine > Flashcards

ENDO 128 Gen Endocrine Flashcards

1
Q

What hormones are secreted from the Thyroid Gland?

A

T3 & T4

Calcitonin

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2
Q

Where are the parathyroid glands and what do the secrete?

A

4 glands that sit on the thyroid, secretes PTH

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3
Q

What hormones are released from the adrenal medulla?

A

Adrenaline and Noradrenaline

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4
Q

What stimulates production and release of T3 and T4 and where is it secreted from?

A

TSH from the anterior pituitary

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5
Q

What are the actions of TSH?

A

Increase iodine uptake by the thyroid, stimulates T3 and T4 production, stimulates thyroid growth

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6
Q

What is TSH release stimulated by and controlled by?

A

Stimulated by TRH from hypothalamus and controlled by negative feedback of T3 and T4 levels

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7
Q

Name some general actions of thyroid hormones

A

Increases basal metabolic rate: 0xygen use and heat production

Stimulates protein degradation/production

Potentiate insulin effects: glycogenolysis, glucose use

CVS: increase CO, HR, force and syst BP
vasodilatation so decrease diastolic BP

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8
Q

What is the function of Calcitonin?

A

To prevent hypercalcaemia by inhibiting osteoclasts in bone

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9
Q

What hormone stimulates the release of cortisol from the adrenal gland?

A

ACTH from anterior pituitary

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10
Q

What does CRH do?

A

Stimulate ACTH release from anterior pituitary

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11
Q

What is the disease of Cortisol insufficiency?

A

Addison’s Disease

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12
Q

What is the disease of excess cortisol?

A

Cushing’s syndrome

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13
Q

Where are adrenaline and noradrenaline stored?

A

In chromaffin cells in the adrenal medulla

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14
Q

What is phaecromocytoma?

A

Tumour of the adrenal medulla causing constant secretion of catecholamines

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15
Q

What are some of the signs and symptoms of phaecromocytoma?

A

Anxiety, forceful heartbeat, hypertension and tremor

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16
Q

What is the function of aldosterone and where is it released from?

A

Released from the adrenal cortex an acts to regulate sodium and fluid volume

17
Q

What is Conn’s syndrome?

A

hyperaldosteronism - excess sodium and water retention therefore increasing blood pressure

18
Q

What are some causes of hyperthyroidism?

A

Grave’s disease - autoantibody that stimulates thyroid release
Pituitary adenoma releasing TSH
Thyroid follicular cell tumour

19
Q

Name some of the clinical presentations of hyperthyroidism

A

weight loss despite increased appetite, increased resting heart rate, bounding pulse, heat intolerance, eye protrusion, atrial fibrillation

20
Q

What are some causes of hypothyroidism?

A

Hashimoto’s thyroiditis - an organ speific autoimmune disease against thyroid epithelial cells
Pituitary hypofunction -lack of TSH (non producing pituitary adenoma)
Thyroid hormone resistance

21
Q

Name some clinical presentations of hypothyroidism

A

myxodema (thickening and swelling of the skin), tiredness, lethargy, weight gain, slow mental state, hypothermia and constipation

22
Q

Describe some of the mechanisms of Cushing’s syndrome

A

Pituitary adenoma - produces excess ACTH = Cushing’s Disease
Adrenal cortex adenoma
Excess ACTH or glucocorticoid administration

23
Q

Briefly describe the clinical features of Cushing’s syndrome

A

Central obesity, depression, hirsutism, bruising, thick skin, striae

24
Q

How would you investigate suspected Cushing’s syndrome?

A
  • 24 hour urinary free cortisol
  • 9am cortisol level
  • 48hour low dose dexamethasone test
  • High dose dexamethasone test
25
Q

What would lack of cortisol suppression of a 48 hour low dose dexamethasone test indicate?

A

Cushing’s syndrome

26
Q

What would suppression and non-suppression of cortisol indicate in a high dose dexamethasone test?

A

Suppression: pituitary dependant tumour

Failure: ectopic source of ACTH or adrenal tumour

27
Q

Describe the clinical features of an Addisonian crisis

A

Hypotension

Hyponatraemia, hyokalaemia, hypoglycaemia and dehydration

28
Q

How would you investigate Suspected Addison’s

A

Short ACTH stimulation test: absent or impaired cortisol response
Electrolytes and urea
Adrenal auto-antibodies
9hour plasma ACTH level

29
Q

What response would you expect to see in a 9 hour plasma ACTH test for Addison’s

A

High ACTH with low/normal cortisol = confirmed primary hypoadrenalism

30
Q

What are some of the causes of Hypercalcaemia?

A

Excessive PTH secretion
Malignancy
Excess Vitamin D
Drugs e.g. thiazide diuretics, lithium, vitamin A

31
Q

What are some fo the clinical features of hypercalcaemia?

A

Stones (renal and billiary); Bones (pain); Groans (abdominal pain, nausea and vomiting); Thrones (polyuria); Psychic moans (depression, coma)
Possible arrhythmias

32
Q

What are some causes of hypocalcaemia

A

Increased phosphate levels (CKD); hypoparathyroidism, vitamin D deficiency, PTH resistance, Drugs, Acute pancreatitis, Low plasma albumin

33
Q

What are some of the clinical features of hypocalcaemia

A

Neuromuscular irritability: parasthesia, circumoral numbness, cramps, anxiety and tetany
Chvostek’s sign: tapping on facial nerve causes ipsilateral facial muscles to twitch
Trousseau’s sign: When inflating BP cuff above systolic for 3 minutes induces tetanic spasm of fingers and wrist

34
Q

How would you investigate hypocalcaemia?

A

Serum and urine creatinine, PTH levels, PTH antibodies, Vitamin D and magnesium levels

35
Q

How might an androgen deficiency present in an adult?

A

Small/absent testes, gynaecomastia, sexual dysfunction, small prostate, reduced hair growth

36
Q

What is PTH released in response to?

A

falling plasma calcium

37
Q

How does PTH work?

A

By increasing loss of phosphate
Increasing calcium reabsorption
Increasing metabolism to active Vitamin D
Stimulates calcium flux from bone by activating osteoclasts

38
Q

What does Vitamin D do?

A

increases whole body calcium

increases uptake of calcium in gut

39
Q

Name some actions of cortisol (glucocorticoids)

A

Carbohydrate, protein and lipid metabolism (glucose production)
Increases vascular tone and permeability
Sodium and potassium retention
immunosuppressive

Y1&2 Medicine Zoe Veary (60 decks)

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