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4th Yr - CMS 1 > Endocrine > Flashcards

Endocrine Flashcards

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Introductory Sommelier Exam (CMS) flashcards
1
Q

what is the endocrine system ?

A

The endocrine system is a complex network of glands and organs that produce and release hormones to regulate various physiological functions in the body

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2
Q

what are some of the key components of the endocrine system?

A

pituitary, thyroid, adrenal, pancreas, and reproductive glands (ovaries and testes), as well as organs like the hypothalamus

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3
Q
  • What is the arrangement of the endocrine system?
A
  1. Hypothalamus
  2. Pituitary Gland
    - divided into anterior and posterior
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4
Q

what is the role of the hypothalamus ?

A
  • hypothalamus receive signals from brain from other parts of your body and the hypothalamus communicates by secreting its own hormones or by specialised nerves
  • it can also communicate with the pitutary gland
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5
Q

what is the role of the pituatry gland?

A
  • produce loads of hormones which circulate around body
  • some have affects on end organs or it stimulates another gland
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6
Q

why does the endocrine system tend to go wrong ?

A

due to the feedback loop

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7
Q

where is the thyroid situated?

A

sits in lower part of anterior of the neck

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8
Q

why are the thyroid hormones important?

A

regulate metabolic activity
- increases metabolic rate
- increases basal metabolic rate
- ie . burn energy quixker, higher bp, mind works faster, heart beats faster
- can’t survive without these

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9
Q

what are the thyroid hormones?

A

thyroxine T4 > tri-idothyronine T3

They exert their effects on peripheral tissues, to increase metabolic activity

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10
Q

where are the thyroid hormones produced?

A

produced by thyroid in response to secretion of thyroid stimulating hormone TSH by the pituatry

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11
Q

what is the hormone that tells the pituatry to TSH?

A

TRH comes from hypothalamus

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12
Q

what conditions affect the thyroid?

A

Goitre - thyroid swelling = one sided or both - moves when swallow
derbyshire neck - iodine deficiency

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13
Q

where can we get iodine from?

A

cerebros - iodine salt
fish
wheat
green veg
eggs

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14
Q

what is hypothyroidism?

A

low T3/T4

failure to form T3 T4 - from drugs or iodine deficiency or autoimmune destruction of thyroid, thyroidectomy

treatment- thyroid supplements or radio iodine treatment

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15
Q

what are the signs and symptoms of hypothyroidism ?

A
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16
Q

why do we need t4 t3 ?

A

for growth and development

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17
Q

what is congenital hypothyroidism?

A

occurs at birth or shortly after - short stature, developmental delays

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18
Q

what are the signs and symptoms of hyperthyroidism ?

A
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19
Q

what are the causes of hyperthyroidism ?

A

autoimmune stimulation
graves disease
thyroid tumour

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20
Q

how do we diagnose thyroid disease ?

A

clinical examination - herat rate, bp, tremor, weight loss, neck exams, imagine of neck ultrasound, CT MRI, T3 T4 TSH blood tests

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21
Q

how do we manage hypothyroidism ?

A

thyroxine tablets
thyroid replacement therapy

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22
Q

how do we manage hyperthyroidism ?

A

Surgery to remove - but need to give THRT
radio iodine

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23
Q

where are adrenal glands situated?

A

above kidneys

24
Q

what do the adrenal glands produce ?

A

steroid hormones

25
Q

how is cortisol secreted ?

A
  • hypothalamus releases CRH
  • which triggers pituartry to release ACTH
  • ACTH triggers adrenal gland to produce cortisol
26
Q

what is hydrocortisone and what does it do?

A
  • act in feedback loop same way as cortisol does
  • so it will stop hypothalpis from producing CRH and in turn stop pituarty from producing ACTH an din turn stop adrenal cortex from producing cortisol
27
Q

what is Cushing syndrome? signs and symptoms?

A
  1. Cushing’s Syndrome refers to a condition characterised by the overproduction of cortisol, often caused by various factors, including medications or tumors.
28
Q

what is Cushingtons disease?

A

Cushing’s Disease specifically refers to a form of Cushing’s Syndrome where the overproduction of cortisol is triggered by a pituitary adenoma (tumor) secreting excessive adrenocorticotrophic hormone (ACTH).

29
Q

What distinguishes Cushing’s Disease from other causes of Cushing’s Syndrome?

A

In Cushing’s Disease, the primary cause is the pituitary adenoma leading to elevated levels of ACTH, which, in turn, stimulates the adrenal glands to produce more cortisol.

30
Q

what are the causes of cushings syndrome?

A
  1. Iatrogenic-steriod prescription - the prolonged use of exogenous steroids, such as corticosteroid medications, can lead to iatrogenic Cushing’s Syndrome.
  2. Cushing’s disease - Cushing’s Disease specifically refers to Cushing’s Syndrome caused by a pituitary adenoma secreting excessive adrenocorticotrophic hormone (ACTH).
  3. Other tumours secreting ACTH - Tumors outside the pituitary gland, known as ectopic ACTH-producing tumors, can stimulate the adrenal glands to produce excess cortisol, leading to Cushing’s Syndrome.
31
Q

what is adrenal insufficiency?

A

insufficient production of hormones by the adrenal glands

32
Q

what are the non specific symptoms of adrenal insufficiency ?

A
  • Malaise
  • Weight loss
  • Nausea, vomiting, abdominal pain
  • Fatique, depression
  • Muscle pain
  • Joint pain
33
Q

what is Addisons disease ?

A

primary adrenal insufficiency caused by autoimmune destruction of adrenal gland
rare

34
Q

what are the signs and symptoms of Addisons disease?

A

no that common

35
Q

what is secondary adrenal atrophy ?

A

where the adrenal glands experience a decrease in size and function due to factors external to the adrenal glands themselves. This atrophy is often a consequence of prolonged exposure to exogenous steroids, such as hydrocortisone and prednisolone.

  • the way adrenals respond to stress, illness, surgery = needs more cortisol = leads to adrenal crisis

adrenals unable to respond

36
Q

what is adrenal crisis?

A

when cortisol levels fall significantly

37
Q

what are the non specific symptoms of an adrenal crisis ?

A
38
Q

what is acute adrenal insufficiency?

A

addisonian crisis caused by being unwell or not taking steroid u need to take

39
Q

who has a steroid emergency card?

A

ppl with Addisons, or have taken steroid above a certain amount

  • tells pt what do if they feel unwell
  • help pt manage their sick days
  • helps us know what to do and see what type of adrenal disease they have
40
Q

who has primary adrenal failure ?

A

pts with Addisons disease - have to take steroids DAILY as they cannot make them themselves - some ppl need them after surgery, stress or unwell if not can lead to addisonian crisis

41
Q

why do we treat pts with Addisons disease much more carefully then secondary adrenal insufficiency ?

A

if they have adrenal crisis it will affect all the targets of the different hormones eg. response to stress, glucocorticoids, salt water balance, affect their ability too produce their own catacamines, and maintain BP

42
Q

who is at risk of adrenal crisis?

A
43
Q

who are at risks of getting secondary adrenal insufficiency?

A
  1. Patients with Secondary Adrenal Suppression/Atrophy
  2. Long term oral steroids (≥5mg prednisolone/day for 4 weeks)
  3. High dose short courses (≥40mg prednisolone for 7 days, repeated or also taking long term lower doses
  4. Inhaled steroids (≥1000mcg/day) Usual dose is 800mcg/day
  5. Combinations!
  6. Inhaled, oral, cream, injections, nasaL
44
Q

how do we manage addisonian crisis?

A
  1. Prevention
  2. Don’t stop the steroids!
    - Assess the risk:
    + Addisons disease: higher risk
    + have they got secondary adrenal insuffucney and have Steroid treatment: lower risk
  3. Do they need steroid cover?
45
Q

Do they need steroid cover ?

A
46
Q

what are our post op instructions for ppl who are at risk of adrenal crisis?

A
47
Q

what is the role of bone ?

A

regulating ca level

48
Q

which hormones has a major influence on bone ?

A

parathyroid hormone
- produced by parathyroid gland

49
Q

what happens when there is low Ca?

A
  • drop in ca is detected by parathyroid glands
  • PTH produced which has 2 effects ;
    1. bone - stimulates osteoclasts to to resorb bone which relates ca into blood
    2. kidneys (longer term effect) - stimulates metabolism of vit d3 which releases calitriol which stimulate absorption of ca from gut
50
Q

what is hypothyroidism?

A

characterised by a deficiency or absence of parathyroid hormone (PTH), which is usually secreted by the parathyroid glands.

51
Q

what are the 3 causes of hypothyroidism?

A

autoimmune - autoimmune destruction of the parathyroid glands.
thyroidectomy - damage or removal
hypocalcemia - reduced PTH secretion, resulting in decreased calcium levels in the blood (hypocalcemia). PTH plays a key role in calcium homeostasis, and its deficiency can lead to impaired calcium absorption from the intestines and increased calcium loss from bones and kidneys.

52
Q

what is hyperparathyroidism?

A

Parathyroid working over time to produce PTH which increase blood Ca levels

53
Q

what is hyperparathyroidism divided into?

A

secondary
primary
hypercalceima

54
Q

what are the secondary hyperparathyroidism causes ?

A
  1. Hypocalcemia: Secondary hyperparathyroidism can occur as a compensatory response to hypocalcemia, often associated with conditions such as vitamin D deficiency or chronic renal failure.
  2. Vitamin D Deficiency: Inadequate levels of vitamin D can lead to reduced calcium absorption and stimulate the parathyroid glands to increase PTH secretion.
  3. Renal Failure: Chronic kidney disease can result in impaired calcium and phosphorus regulation, leading to elevated PTH levels.
55
Q

what are the primary hyperparathyroidism causes?

A
  1. PTH-Secreting Tumor: The most common cause of primary hyperparathyroidism is the presence of a benign tumor (adenoma) in one or more of the parathyroid glands, leading to excessive PTH secretion.
  2. Parathyroid Gland Abnormalities: Hyperplasia or, rarely, carcinoma of the parathyroid glands can also cause primary hyperparathyroidism.
  3. Other Cancers: Certain cancers can produce a PTH-like substance, leading to hypercalcemia.
56
Q

list some manifestations of hypercalceima ?

A
  1. Stones: Kidney stones (nephrolithiasis) due to increased calcium in the urine.
  2. Bones: Bone pain, fractures, and osteoporosis.
  3. Abdominal Groans: Gastrointestinal symptoms, including constipation, nausea, and abdominal pain.
  4. Psychic Moans: Fatigue, weakness, and possible mood disturbances.

4th Yr - CMS 1 (27 decks)

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