Endocrine

Question 1

How is the endocrine system arranged

Answer 1

Starts in Hypothalamus (part of the brain), interacts with pituitary gland, which sends a signal to bind to a gland, negative feedback loop

Question 2

Name the hormones the thyroid prodcues to regulate metabolic activity

Answer 2

T3 and T4

Question 3

Name the hormones the thyroid produces to regulate metabolic activity

Answer 3

T3 and T4

Question 4

How does the pituitary act on the thyroid from the hypothalamus

Answer 4

Hypothalamus produces Thyrotropin-releasing hormone (TRH), to act on pituitary
Pituitary produces Thyroid-stimulating hormone (TSH)

Question 5

what is Thyrotropin-Releasing Hormone

Answer 5

Hormone secreted from the hypothalamus to act on the pituitary to stimulate it to act on the thyroid

Question 6

How can you identify a Goiter? (swollen thyroid)

Answer 6

The swelling will move when pt swallows

Question 7

What causes ‘Derbyshire neck’/ Goiter?

Answer 7

Iodine deficiency
Iodine needed for thyroid hormones, thyroid grows in size to try and compensate for lack of

Question 8

What causes Hypothyroidism

Answer 8

Low T3/T4 hormone levels
Iodine deficiency, drugs, autoimmune thyroid damage, radio-iodine therapy

Question 9

Signs and symptoms of Hypothyroidism

Answer 9

Gain weight, loss of appetite, loss of energy, low BP/HR, intolerance to cold, depression

Question 10

Signs and symptoms of Hyperthyroidism

Answer 10

Tachycardia, AF, palpitations, weight loss, tremor, anxiety

Question 11

What do T3/T4 do?

Answer 11

Increase metabolic rate

Question 12

Management of Hypothyroidism

Answer 12

thyroxine tablets, thyroid hormone replacement therapy

Question 13

Management of Hyperthyroidism

Answer 13

Surgical removal of gland, radio-iodone to damage the gland a little bit

Question 14

Name 4 hormones the adrenal glands produce

Answer 14

• glucocorticoids (cortisol)
• mineralocorticoids (aldosterone)
• adrenaline/noradrenaline
• Androgens (develop sexual characteristics)

Question 15

What is the function of glucocorticoids?

Answer 15

Glucose metabolism, sugar and energy balance

Question 16

Describe the pathway from hypothalamus to adrenal gland

Answer 16

Hypothalamus produces Corticotrophin-Releasing hormone (CRH) for pituitary
Pituitary produces Adrenocorticotrophic hormone (ACTH) for adrenal gland

Question 17

How does the negative feedback loop work for the adrenal gland

Answer 17

Hypothalamus produces CRH for pituitary to stimulate it to produce ACTH to act on adrenal gland, produces cortisol which is detected by hypothalamus to reduce production of CRH

Question 18

how is the adrenal -ve feedback loop important in prescribing?

Answer 18

Prescribing corticosteroids for inflammation, works as a imitator or cortisol so will be detected and reduce levels of CRH and reduce adrenal gland action

Question 19

What is the cause of Cushing’s syndrome

Answer 19

Excess cortisol (too much cortisol)

Question 20

What are the signs and symptoms of Cushing’s Syndrome

Answer 20

(cortisol controls metabolism)
-Diabetes
-Central Obesity
-Acne
-Peripheral wasting
- thin hair, facial hair, thin skin

Question 21

Causes for Cushing’s Syndrome

Answer 21

[Cushing’s syndrome is just the name for having the characteristics from too much cortisol]
- Cushing’s disease = pituitary adenoma secreting too much ACTH
- too many steroids prescribed
- another tumour producing ACTH

Question 22

What is another name for Addison’s disease?

Answer 22

Primary Adrenal Insufficiency

Question 23

What are the symptoms of adrenal insufficiency?

Answer 23

Very non-specific:
malaise
weight loss
nausea, vomiting, abdominal pain
fatigue, depression
muscle and joint pain

Question 24

Cause of Addison’s Disease

Answer 24

Autoimmune destruction of the adrenal gland

Question 25

Cause of secondary adrenal insufficiency

Answer 25

Exogenous steroid medication, will act on hypothalamus like cortisol to initiate -ve feedback loop

Question 26

What is an Addisonian crisis

Answer 26

When the body experiences a stress event, it cannot produce extra cortisol like it would normally because it is being suppressed through secondary adrenal insufficiency

Question 27

How can you prevent Addisonian Crisis, and how does it present?

Answer 27

Take extra steroids on the day of surgery/extractions
Presents the same as addison’s

Question 28

What are the post-op instruction after surgery with addisonian cover

Answer 28

need to make sure pt understands that:
- they must keep taking steroids
- if the get dry socket, infection, pain, must keep up and maintain fluids
- have a steroid rescue pack

Question 29

What controls the body’s calcium levels

Answer 29

Parathyroid gland and the parathyroid hormone

Question 30

how does parathyroid hormone (PTH) work?

Answer 30

• PTH causes bone resorption, osteoclasts to break down bone to increase calcium levels
• PTH causes kidneys to stimulate Vit D3 conversion to calcitrol (stimulates gut Ca absorption)

Question 31

What stimulates parathyroid hormone release?

Answer 31

Low blood calcium levels

Question 32

What does Calcitriol Do?

Answer 32

Converted from Vit D3, stimulates Ca absorption in the gut

Question 33

What will be the result of hypoparathyroidism?

Answer 33

Hypocalcaemia as PTH isn’t being released to increase serum Ca levels

Question 34

Causes of hyperparathyroidism

Answer 34

• PTH secreting tumour
• Parathyroid tumour
• Renal failure (/Vit D deficiency)

Question 35

Signs and symptoms of hyperparathyroidism

Answer 35

• Stones (more calcium to create duct stones)
• Bones (osteoporosis, bone weakening)
• Abdominal groans (constipation)
• Psychic moans (important in CNS functioning)