endocrine Flashcards
adrenal insufficiency is aka…
what is AI
inadequate production of adrenal hormones including glucocorticoids, and mineralocorticoids.
addisons disease. Primary AI is
autoimmune adrenal cortical destruction leading to deficiency in mineralcorticoids and glucocorticoids
Secondary/Tertiary AI is caused by?
decreased ACTH production by the pituitary. most often due to cessation of long term glucocorticoid treatment.
labs of adrenal insufficiency show
hyponatremia, EOSINOPHILIA, hyperkalemia, possibly hypercalcemia,
8am plasma cortisol level for AI
At 8am, cortisol level is less than 3 if there is no exogenous glucocorticoid administration. Failure of cortisol to rise above 18 following ACTH administration confirms the diagnosis
genetic causes of pheochromocytom
MEN 2A/2B, von Hippel-Lindau, neurofibromatosis
MEN2A/2B components
MEN2a -pheochromocytoma, medullary carcinoma, parathyroidma
MEN 2b
pheochromocytoma, medullary carcinoma, marfanoid habitus/ mucosal neuromas.
blood test for pheochromocytoma?
elevated plasma free metanephrines or 24 hour urine metanephrine
conns syndrome. how does it present?
hyperaldosteronism from a unilateral adrenal adenoma.
really high blood pressure, high BP, urine chloride low, renin low, alkalosis, hypokalemia, hypomagnesium
labs in hyperaldosteronism
hypokalemia, alkalosis, HTN, hypomagnesium, increased aldosterone/renin ratio
treatment for bilateral adrenal hyperplasia causing hyperaldosteronism
spironalactione is aldosterone receptor blocker
MEN type 1
3 p’s: pancreas, pituitary, parathyroid
MEN 2A
medullary thyroid ca, pheochromocytoma or adrenal hyperplasia, parathyroid hyperplasia
MEN 2B
medullary thyroid ca, pheochromocytoma, oral and intestinal neuromas, marfanoid habitus
what is the mechanism behind a person with primary hypothyroidism developing hyperprolactinemia?
chronically increased TRH overpowers dopamines inhibitory effect on prolactin release and causes secondary hyperprolactinemia. An increase in prolactin causes suppression of GnRH –> secondary amenorrhea
potential complications of hypothyroidism
~hypercholesterolemia due to decreased renal excretion of LDLs
~HTN due to increased TPR
~hyperprolactinemia which suppresses GnRH –>secondary amenorrhea
~
Hormone features of turners
high fsh
high LH
low estrogen
buccal smear w/normal epithelial cells with no barr bodyies
Metabolic syndrome symptoms
Insulin resistance, obesity, atherogenic dyslipidemia, HTN
What does gonadotrophins (fsh/lh) look like in pcos?
Increased fsh
Increased LH
another name for PCOS
Stein-Leventhal syndrome
low sex hormone binding globulin is PCOS is cause by
high levels of androgens
