Endocrine Flashcards
Acromegaly treatment
Somatostatin analog (octreotide) Surgery radiation GH receptor antagonist (pegvisomant)
If think someone has excess GH what test do you order?
Oral glucose tolerance test (when increase sugar levels, GH should decrease if stay high then abnormal high GH) Confirm with Measure IGF-1
Which hormones does the anterior pituitary release?
•FSH •LH •ACTH •TSH •Prolactin •(I) •Growth Hormone
GH function
Stimulates linear growth and muscle mass through IGF-1 (liver) Increases glucose
What stimulates and what inhibits GH?
stimulate: GHRH and hypoglycemia Inhibit: somatostatin, IGF-1, hyperglycemia
Prolactin does what?
Stimulates milk production Tonically inhibited by dopamine
Prolactinoma clinical symptoms?
Galactorrhea Amenorrhea Hypogonadism Mass effect
Treatment prolactinoma
Dopamine agonist (cabergoline, bromocriptine)
17 alpha hydoxylase deficiency
High aldosterone levels and XY ambiguous genitalia , hypokalemia, low cortisol
21 hydroxylase deficiency
Low aldosterone, hypotension, low cortisol, XX ambiguous, hyperkalemia
11 beta hydroxylase deficiency
Low aldosterone, HTN (high 11 deoxycortisol) , XX ambiguous genitalia
fatigue, difficulty sleeping, weight loss and increased anxiety. Large goiter. Diagnosis and etiology?
Graves’ disease (high T3 and T4, low TSH) Autoantibodies to thyroid stimulating hormone receptors, bulging eyes (exophthalamos) *(Thyroiditis could also cause hyperthyroid, it is self limited)
Treatment hyperthyroidism
Beta blocker protect heart Thioamides Radioiodine ablation Surgery
Hypothyroid vs hyperthyroid
Hypothyroid: decrease heat production, weight gain, constipation, dry cool skin Hyperthyroid: increase heat production, weight loss, diarrhea, warm moist skin, palpitations
What is Wolff chaikoff effect?
Temporary increase iodine (contrast or exposure), which temporarily inhibits thyroid peroxidase => decrease iodine organification=> hypothyroid symptoms