Endocrine Flashcards
What is cortisol
Glucocorticoid hormone
Increase blood sugars
Aiding in fat protein carb metabolism
Anti inflammatory
Where is cortisol produced
Adrenal cortex - zona fasciculata
What triggers cortisol release
hypothalamus reacts to low levels cortisol
Produces CRH
cHR stimulates ACTH production in pituitary
ACTH stimulates adrenal cortex to produce cortisol
Cortisol stimulates the medulla to secrete adrenaline and norad
Causes of primary adrenal failure
Autoimmune- addisons
Tumour
Sepsis
Ischaemia
What is a marker of Addison’s disease
21 hydroxylase autoantibodies
What causes secondary and tertiary adrenal failure
Secondary- absent acth production from pituitary problems (surgery or Tumour)
Tertiary failure of crh production from hypothalamus
What is sick euthyroid
Dyregulation of thyrotropic feedback when t3 or t4 are abnormal
Tell me about the Correction of sodium
Correct with hypertonic saline until over 120
Increase by no more than 8-10 over 24 hours
Tell me about siadh changes
Normovolaemic
High urinary sodium
Low osmolality state
Failure to suppress adh
Causes hyperosmolar hyponatraemia (>295)
Hyperglycaemia
Mannitol
Causes of normal osmolality hyponatraemia
Pseudohyponatraemia
- hyperlipidaemia
- hyperproteinaemia
Causes of hypo osmolar (<285)
Hyponatraemia with hypovolaemia
and low urinary sodium
Vomiting Diarrhoea Sweating Burns Pancreatitis
Causes of hypo osmolar (<285)
Hyponatraemia with hypovolaemia
and high urinary sodium
Diuretics
Causes of hypo osmolar (<285)
Hyponatraemia with normovolaemia
and high urinary sodium
Hypothyroidism
Adrenal insufficiency
Siadh
Causes of hypo osmolar (<285)
Hyponatraemia with normal volume
and low urinary sodium
Low solute intake
Polydipsia
Causes of hypo osmolar (<285)
Hyponatraemia with hypervolaemia
and low urinary sodium
CCF
Nephrotic syndrome
Cirrhosis
Causes of hypo osmolar (<285)
Hyponatraemia with hypervolaemia
and high urinary sodium
Renal failure
What is a high and low urinary sodium
Low < 20
High > 20
What is a normal osmolality
285-295
What is central pontine myelinosis
symmetrical midline demyelination of the central pons
Motor dysfunction, respiratory paralysis and change in mental state
Causes of siadh
Drugs - antidepressants, antipsychotics, vincristine
Malignancy- sclc, brain, pancreas
Cns infection, trauma, ischaemia
Pulmonary- pneumonia, ards
Define gpa
Small and medium vessel vascitilits involving the formation of granuloma
Commonly affect the lungs, upper respiratory tract and kidneys
Diagnosis of GPA
Anna
Pr3
Less commonly mpo
Diagnosis goodpastures
Anti gbm
Anca
